sites must comply with applicable federal regulations. Incineration of PCBs is governed by the Toxic Substances Control Act (TSCA), and incineration of dioxins falls within RCRA.

The Agency for Toxic Substances and Disease Registry (ATSDR) was created under CERCLA in 1980 to assess, among other things, the public-health effects of Superfund sites, including the impact of incineration in the remediation process. ATSDR has undertaken health assessments in communities near incinerators used to burn hazardous substances. (See Chapter 5.)

REGULATIONS APPLICABLE TO MEDICAL-WASTE INCINERATORS

Medical-waste incinerators (MWIs) are used primarily to destroy regulated medical waste that is potentially contaminated with pathogens (also referred to as “hospital/medical/infectious waste”). EPA does not regulate infectious medical waste as hazardous waste (Battle 1994).

EPA has produced final MACT regulations for MWIs under the mandate of the 1990 CAA amendments. On February 27, 1995, EPA proposed new sourceperformance standards for new MWIs and emission guidelines for existing MWIs to fulfill the requirements of section 129 of the CAA (EPA Proposed Rules of Medical Waste Incinerators, Fed. Regist. 60(38):10653-10691 (proposed Feb. 27, 1995). On June 20, 1996, EPA issued a notice of availability of supplemental information and reopening of public comment period (Fed. Regist. 61(Jun. 20):31736-31779). The notice presented an assessment of the supplemental information submitted following the proposed standards and it solicited public comment on that assessment. Virtually every aspect of the 1995 proposal was changed significantly by the 1996 notice. Final rule-making took place on September 15, 1997 (Fed. Regist. 62(178):48348- 48391).

Medical/infectious waste is defined as any waste generated in the diagnosis, treatment, or immunization of human beings or animals, in research pertaining thereto, or in production or testing of biologicals, including cultures and stocks of infectious agents, human pathological waste, and sharps that have been used in animal or human patient care or treatment. Hospital waste is defined as discards generated at a hospital, except unused items returned to the manufacture. The definition does not include human corpses, remains, and anatomical parts that are intended for internment or cremation. For the purpose of this discussion, all of the above types of waste are referred to as “medical waste.”

Incineration facilities that burn medical waste are divided into three source categories based on waste burning capacity: small (less than or equal to 200 lb/hr), medium (greater the 200 to 500 lb/hr), and large (greater than 500 lb/hr). Separate emission standards apply to each subcategory. A summary of the emission limits for new and existing facilities are shown in Table 6-4. Emission limitations have been set for particulate matter, carbon monoxide, dioxins and



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