WASTE INCINERATION & PUBLIC HEALTH

Committee on Health Effects of Waste Incineration

Board on Environmental Studies and Toxicology

Commission on Life Sciences

National Research Council

NATIONAL ACADEMY PRESS
Washington, D.C.



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WASTE INCINERATION & PUBLIC HEALTH WASTE INCINERATION & PUBLIC HEALTH Committee on Health Effects of Waste Incineration Board on Environmental Studies and Toxicology Commission on Life Sciences National Research Council NATIONAL ACADEMY PRESS Washington, D.C.

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WASTE INCINERATION & PUBLIC HEALTH NATIONAL ACADEMY PRESS 2101 Constitution Avenue, NW Washington, DC 20418 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This project was supported by Grant No. EPA-R-822039 between the National Academy of Sciences and the U.S Environmental Protection Agency (EPA), and Grant No. DHHS-U5O/ATU39903 from the Agency for Toxic Substances and Disease Registry, U.S. Department of Health and Human Services, and U.S. Department of Energy. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project. Library of Congress Cataloging-in-Publication Data Waste incineration and public health / Committee on Health Effects of Waste Incineration, Board on Environmental Studies and Toxicology, Commission on Life Sciences, National Research Council. p. cm. Includes bibliographical references and index. ISBN 0-309-06371-X (casebound) 1. Hazardous wastes—Incineration—Health aspects. 2. Health risk assessment. 3. Incineration—Health aspects. 4. Medical wastes—Incineration. 5. Pollution prevention. I. National Research Council (U.S.). Committee on Health Effects of Waste Incineration. RA578.H38 W37 2000 363.72'87—dc21 00-009914 Waste Incineration and Public Health is available from the National Academy Press , 2101 Constitution Ave., NW, Box 285, Washington, DC 20055 (1-800-624-6242 or 202-334-3313 in the Washington metropolitan area; Internet: http://www.nap.edu). Copyright 2000 by the National Academy of Sciences. All rights reserved. Printed in the United States of America

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WASTE INCINERATION & PUBLIC HEALTH THE NATIONAL ACADEMIES National Academy of Sciences National Academy of Engineering Institute of Medicine National Research Council The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. William A. Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. William A. Wulf are chairman and vice chairman, respectively, of the National Research Council.

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WASTE INCINERATION & PUBLIC HEALTH COMMITTEE ON HEALTH EFFECTS OF WASTE INCINERATION DONALD R. MATTISON (Chair), March of Dimes, White Plains, New York REGINA AUSTIN, University of Pennsylvania Law School, Philadelphia, Pennsylvania PAUL C. CHROSTOWSKI, CPF Associates, Inc., Takoma Park, Maryland MARJORIE J. CLARKE, Rutgers University, Piscataway, New Jersey EDMUND A. CROUCH, Cambridge Environmental, Inc., Cambridge, Massachusetts MARY R. ENGLISH, University of Tennessee, Knoxville, Tennessee DOMINIC GOLDING, Clark University, Worcester, Massachusetts IAN A. GREAVES, University of Minnesota, Minneapolis, Minnesota S. KATHARINE HAMMOND, University of California, Berkeley, California ALLEN HERSHKOWITZ, Natural Resources Defense Council, New York, New York ROBERT J. MCCORMICK, Franklin Engineering Group, Inc., Franklin, Tennessee THOMAS E. MCKONE, University of California, Berkeley, California ADEL F. SAROFIM, University of Utah, Salt Lake City, Utah CARL M. SHY, University of North Carolina, Chapel Hill, North Carolina GEORGE D. THURSTON, New York University School of Medicine, Tuxedo, New York Staff RAYMOND A. WASSEL, Project Director CAROL A. MACZKA, Senior Staff Officer BONNIE SCARBOROUGH, Research Assistant ERIC B. KUCHNER, Intern KATHRINE IVERSON, Information Specialist MIRSADA KARALIC-LONCAREVIC, Information Specialist TRACIE HOLBY, Senior Project Assistant RUTH DANOFF, Senior Project Assistant CATHERINE KUBIK, Senior Project Assistant Sponsors Agency for Toxic Substances and Disease Registry, U.S. Department of Health and Human Services U.S. Environmental Protection Agency U.S. Department of Energy

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WASTE INCINERATION & PUBLIC HEALTH z BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY GORDON ORIANS (Chair), University of Washington, Seattle, Washington DONALD R. MATTISON (Vice Chair), March of Dimes, White Plains, New York DAVID ALLEN, University of Texas, Austin, Texas INGRID C. BURKE, Colorado State University, Fort Collins, Colorado WILLIAM L. CHAMEIDES, Georgia Institute of Technology, Atlanta, Georgia JOHN DOULL, University of Kansas Medical Center, Kansas City, Kansas CHRISTOPHER B. FIELD, Carnegie Institute of Washington, Stanford, California JOHN GERHART, University of California, Berkeley, California J. PAUL GILMAN, Celera Genomics, Rockville, Maryland BRUCE D. HAMMOCK, University of California, Davis, California MARK HARWELL, University of Miami, Miami, Florida ROGENE HENDERSON, Lovelace Respiratory Research Institute, Albuquerque, New Mexico CAROL HENRY, Chemical Manufacturers Association, Arlington, Virginia BARBARA S. HULKA, University of North Carolina, Chapel Hill, North Carolina JAMES F. KITCHELL, University of Wisconsin, Madison, Wisconsin DANIEL KREWSKI, University of Ottawa, Ottawa, Ontario JAMES A. MAC MAHON, Utah State University, Logan, Utah MARIO J. MOLINA, Massachusetts Institute of Technology, Cambridge, Massachusetts CHARLES O'MELIA, Johns Hopkins University, Baltimore, Maryland WILLEM F. PASSCHIER, Health Council of the Netherlands KIRK SMITH, University of California, Berkeley, California MARGARET STRAND, Oppenheimer Wolff Donnelly & Bayh, LLP, Washington, D.C. TERRY F. YOSIE, Chemical Manufacturers Association, Arlington, Virginia Senior Staff JAMES J. REISA, Director DAVID J. POLICANSKY, Associate Director and Senior Program Director for Applied Ecology CAROL A. MACZKA, Senior Program Director for Toxicology and Risk Assessment RAYMOND A. WASSEL, Senior Program Director for Environmental Sciences and Engineering KULBIR BAKSHI, Program Director for the Committee on Toxicology LEE R. PAULSON, Program Director for Resource Management ROBERTA M. WEDGE, Program Director for Risk Analysis

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WASTE INCINERATION & PUBLIC HEALTH COMMISSION ON LIFE SCIENCES MICHAEL T. CLEGG (Chair), University of California, Riverside, California PAUL BERG (Vice Chair), Stanford University, Stanford, California FREDERICK R. ANDERSON, Cadwalader, Wickersham & Taft, Washington, D.C. JOANNA BURGER, Rutgers University, Piscataway, New Jersey JAMES E. CLEAVER, University of California, San Francisco, California DAVID S. EISENBERG, University of California, Los Angeles, California JOHN L. EMMERSON, Fishers, Indiana NEAL L. FIRST, University of Wisconsin, Madison, Wisconsin DAVID J. GALAS, Keck Graduate Institute of Applied Life Science, Claremont, California DAVID V. GOEDDEL, Tularik, Inc., South San Francisco, California ARTURO GOMEZ-POMPA, University of California, Riverside, California COREY S. GOODMAN, University of California, Berkeley, California JON W. GORDON, Mount Sinai School of Medicine, New York, New York DAVID G. HOEL, Medical University of South Carolina, Charleston, South Carolina BARBARA S. HULKA, University of North Carolina, Chapel Hill, North Carolina CYNTHIA J. KENYON, University of California, San Francisco, California BRUCE R. LEVIN, Emory University, Atlanta, Georgia DAVID M. LIVINGSTON, Dana-Farber Cancer Institute, Boston, Massachusetts DONALD R. MATTISON, March of Dimes, White Plains, New York ELLIOT M. MEYEROWITZ, California Institute of Technology, Pasadena, California ROBERT T. PAINE, University of Washington, Seattle, Washington RONALD R. SEDEROFF, North Carolina State University, Raleigh, North Carolina ROBERT R. SOKAL, State University of New York, Stony Brook, New York CHARLES F. STEVENS, The Salk Institute for Biological Studies, La Jolla, California SHIRLEY M. TILGHMAN, Princeton University, Princeton, New Jersey RAYMOND L. WHITE, University of Utah, Salt Lake City, Utah Staff WARREN R. MUIR, Executive Director JACQUELINE K. PRINCE, Financial Officer BARBARA B. SMITH, Administrative Associate LAURA T. HOLLIDAY, Senior Program Assistant

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WASTE INCINERATION & PUBLIC HEALTH OTHER REPORTS OF THE BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY Scientific Frontiers in Developmental Toxicology and Risk Assessment (2000) Modeling Mobile-Source Emissions (2000) Copper in Drinking Water (2000) Ecological Indicators for the Nation (2000) Hormonally Active Agents in the Environment (1999) Research Priorities for Airborne Particulate Matter: I. Immediate Priorities and a Long-Range Research Portfolio (1998); II. Evaluating Research Progress and Updating the Portfolio (1999) Ozone-Forming Potential of Reformulated Gasoline (1999) Risk-Based Waste Classification in California (1999) Arsenic in Drinking Water (1999) Brucellosis in the Greater Yellowstone Area (1998) The National Research Council's Committee on Toxicology: The First 50 Years (1997) Toxicologic Assessment of the Army's Zinc Cadmium Sulfide Dispersion Tests (1997) Carcinogens and Anticarcinogens in the Human Diet (1996) Upstream: Salmon and Society in the Pacific Northwest (1996) Science and the Endangered Species Act (1995) Wetlands: Characteristics and Boundaries (1995) Biologic Markers (5 reports, 1989-1995) Review of EPA's Environmental Monitoring and Assessment Program (3 reports, 1994-1995) Science and Judgment in Risk Assessment (1994) Ranking Hazardous Waste Sites for Remedial Action (1994) Pesticides in the Diets of Infants and Children (1993) Issues in Risk Assessment (1993) Setting Priorities for Land Conservation (1993) Protecting Visibility in National Parks and Wilderness Areas (1993) Dolphins and the Tuna Industry (1992) Hazardous Materials on the Public Lands (1992) Science and the National Parks (1992) Animals as Sentinels of Environmental Health Hazards (1991) Assessment of the U.S. Outer Continental Shelf Environmental Studies Program, Volumes I-IV (1991-1993) Human Exposure Assessment for Airborne Pollutants (1991)

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WASTE INCINERATION & PUBLIC HEALTH Monitoring Human Tissues for Toxic Substances (1991) Rethinking the Ozone Problem in Urban and Regional Air Pollution (1991) Decline of the Sea Turtles (1990) Copies of these reports may be ordered from the National Academy Press (800) 624-6242 (202) 334-3313 www.nap.edu

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WASTE INCINERATION & PUBLIC HEALTH Preface The National Research Council (NRC) established the Committee on Health Effects of Waste Incineration to assess relationships between human health and incineration of hazardous waste, municipal solid waste, and medical waste. In this report, the committee explains its findings and recommendations about waste incineration and public health. Despite differences in waste composition and incineration processes, the same types of pollutants of concern can be emitted by each kind of incinerator. Therefore, the committee took a generic approach in addressing the dispersion of pollutants from incineration facilities into the environment, pathways of human exposure, possible health effects, social issues, and community interactions. The committee did not compare risks posed by the different types of waste incineration, nor did it assess risks posed by any particular waste-incineration facility. As discussed in this report, even within the same type of waste incineration, there is broad variability in the emission patterns of pollutants, facility-specific emission characteristics (e.g., stack height and local weather conditions that can affect dispersion of released pollutants), the number of people potentially exposed to incineration emissions, and the total contaminant burden of those people resulting from all pollutant sources. It is also important to keep in mind that the committee was not asked to compare the health risks attributable to waste incineration with those attributable to other waste-management alternatives, such as land disposal. Therefore, the committee took no position on the merits of incineration compared with other waste-management alternatives. During the course of its deliberations, the committee reviewed scientific

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WASTE INCINERATION & PUBLIC HEALTH literature, government-agency reports, and unpublished data. The committee solicited information from persons representing federal, state, and local governments; academe; technical consulting firms; environmental-advocacy organizations; public-interest groups; and communities with waste incinerators in their environs. Several members toured a facility in Lorton, Virginia that incinerates municipal solid waste. The committee received useful information and perspectives from the following persons, who made presentations to the committee: Germaine Buck, State University of New York at Buffalo; Dorothy Canter, U.S. Environmental Protection Agency; Frank Caponi, County Sanitation Districts of Los Angeles County; Daniel Carey, American Ref-Fuel Company; Fred Chanania, U.S. Environmental Protection Agency; David Doniger, U.S. Environmental Protection Agency; Lawrence Doucet, Doucet & Mainka, Inc.; Heidi Fiedler, University of Bayreuth, Germany; Simon Friedrich, U.S. Department of Energy; Jeffrey Hahn, Ogden Projects, Inc.; Rick Hind, Greenpeace; Wally Jordan, Waste Energy Technologies, Inc.; Steven Kroll-Smith, University of New Orleans; Stephen Mandel, Rosemount Analytical, Inc.; Melanie Marty, California Environmental Protection Agency; Peter Park, Center for Community Education and Action; Mark Pollins, U.S. Environmental Protection Agency; Jerome Nriagu, University of Michigan; Juan Reyes, Agency for Toxic Substance and Disease Registry, U.S. Public Health Service; Philip C. Sears, Allee, King, Rosen & Fleming; Terri Swearingen, Tri-State Environmental Council; and Stormy Williams, Desert Citizens Against Pollution. This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC's Report Review Committee. The purpose of this independent review is to provide candid and critical comments that assist the NRC in making the published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. The committee wishes to thank the following individuals for their participation in the review of this report: John C. Bailar III, University of Chicago; A. John Bailer, Miami University; Gaylon Campbell, Washington State University; A.J. Chandler, A.J. Chandler & Associates, Ltd.; Caron Chess, Rutgers University Center for Environmental Communication; Walter Dabberdt, National Center for Atmospheric Research; Donald Hornig, Harvard University; Kathryn Kelly, Delta Toxicology Inc.; Richard Magee, New Jersey Institute of Technology; Jonathan Samet, Johns Hopkins University; and Kenneth Sexton, University of Minnesota. The individuals listed above have provided many constructive comments and suggestions. It must be emphasized, however, that responsibility for the final content of this report rests entirely with the authoring committee and the NRC. The committee is thankful for the useful input of Kun-Chieh Lee and Sanford S. Penner into its deliberations early in the study. We also wish to express our

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WASTE INCINERATION & PUBLIC HEALTH appreciation to the following National Research Council staff members for their effective support of our work: Raymond Wassel, Carol Maczka, James Reisa, Bonnie Scarborough, Ruth Crossgrove, Ruth Danoff, Tracie Holby, Katherine Iverson, Catherine Kubik, Eric Kuchner, and others. Donald R. Mattison, Chair Committee on Health Effects of Waste Incineration

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WASTE INCINERATION & PUBLIC HEALTH Contents     EXECUTIVE SUMMARY   1  1   SCOPE OF THE COMMITTEE'S EFFORT   12      Charge to the Committee,   13      Committee's Approach to Its Charge,   13      Organization of the Report,   15  2   WASTE INCINERATION OVERVIEW   17      Types of Waste Incinerated,   17      Waste Management,   26      The Development of Pollution Prevention, Combustion Controls, and Emission Controls,   30      Conclusions,   32  3   INCINERATION PROCESSES AND ENVIRONMENTAL RELEASES   34      Waste Storage, Feed Preparation, and Feeding,   35      Combustion Processes,   37      Gas-Temperature Reduction Techniques,   41      Air-Pollution Control Techniques,   42      System Operation,   48      Process Emissions,   50      Stack Emission Rate Information,   56      Fugitive Emissions,   63

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WASTE INCINERATION & PUBLIC HEALTH      Ash and Other Residues,   63      Summary,   65      Conclusions,   68      Recommendations,   69  4   ENVIRONMENTAL TRANSPORT AND EXPOSURE PATHWAYS OF SUBSTANCES EMITTED FROM INCINERATION FACILITIES   71      Transport Pathways in the Environment,   73      Assessing Human Exposure to Environmental Contaminants,   80      Environmental Dynamics of and Possible Exposures to Various Substances,   82      Environmental Pollution Concentrations Associated with Waste Incineration,   97      Conclusions,   110      Recommendations,   111  5   UNDERSTANDING HEALTH EFFECTS OF INCINERATION   112      Tools for Evaluating Health Effects,   114      Results of Epidemiologic Studies of Incinerator-Exposed Populations,   120      Results from Risk Assessment Studies,   129      Populations at Risk,   161      The Committee's Consensus Judgments about Waste Incineration and Public Health,   165      Conclusions and Research Needs,   179  6   REGULATION RELATED TO WASTE INCINERATION   182      Overview of Incineration Regulations Relevant to Public Health and the Environment,   183      Regulations Applicable to Municipal Solid-Waste Incinerators,   186      Regulations Applicable to Hazardous-Waste Incinerators,   193      Incineration in Connection with Superfund Cleanups,   199      Regulations Applicable to Medical-Waste Incinerators,   200      Critical Comparison of MACT-Based Regulations,   202      Summary of Regulations Relevant to the Occupational Health and Safety of Incineration Employees,   203      Regulatory Compliance and Enforcement,   209      Conclusions and Recommendations,   214  7   SOCIAL ISSUES AND COMMUNITY INTERACTIONS   217      Identifying the Affected Area,   219      Socioeconomic Impacts of Incineration Facilities,   223

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WASTE INCINERATION & PUBLIC HEALTH      Perceptions and Values,   228      Risk Communication,   233      Conclusions,   242      Recommendations,   244  8   UNCERTAINTY AND VARIABILITY   246      Confronting Variability and Uncertainty,   249      Uncertainty and Sensitivity Analyses,   257      Uncertainties in the Communication of Risk Information,   259      Conclusions,   259      Recommendations,   260     REFERENCES   261     APPENDIX A:  BIOGRAPHICAL INFORMATION ON THE COMMITTEE ON HEALTH EFFECTS OF WASTE INCINERATION   295     APPENDIX B:  OFF-NORMAL OPERATIONS OF SIX FACILITIES   301     LIST OF ABBREVIATIONS   311     INDEX   315

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