03/10/2011 05:08

Israel’s development in this sector still in its infancy, environmental experts say.

One way the public appreciates the relevance of environmental issues is in relation to their health. While saving the planet might be a little abstract, cancer clusters and pharmaceuticals in the water supply are emphatically not.

The intersection of health and environment was the subject of a conference in Tel Aviv on Tuesday sponsored by Clalit Health Services and Netanya Academic College.

The conference for medical professionals, many from the 37,000-strong Clalit workforce, focused on treatment of medical waste and the connections between health and environment. Clalit is the largest health fund of the four.

Two of the major highlights of the conference were the issues of air pollution and the treatment of medical waste.

Israel’s Clean Air Act went into effect in January and the Environmental Protection Ministry has until the end of the year to craft a national plan to reduce pollution. Air pollution is a major cause of pollution and death, primarily in the congested Dan Region.

Regarding treatment of medical waste, Tzipi Iser-Itsiq, the director of the Center for Environmental Protection at Netanya Academic College’s School of Law, compared the regulations in Israel with that of the UK. While Israel has about three pages of regulations that say medical waste should be treated but doesn’t say how, the UK has extremely detailed guidelines.

Keynote speaker Dr. Malcolm Holliday made clear in his lecture just how detailed and comprehensive those guidelines were. “The public cares first and foremost about its health. Health is the best motivator for environmental action,” Environmental Protection Minister Gilad Erdan declared at the opening of the conference.

He added that a new US EPA study had determined that 230,000 deaths had been avoided and tens of billions of dollars had been saved by the US Clean Air Act, which was enacted in 1970.

Erdan also drew attention to OECD figures that showed that indoor air was 100 times worse than outside air. He said more attention must be paid to building codes to improve the areas where humans spend 90 percent of their time.

Erdan said the revised green building standard, which was just published for public comment, was designed to improve indoor air, among other things.

But one of the most important places to maintain such environmentally friendly standards is within the walls of the hospital, according to Erdan.

“There is nowhere where it’s more important to maintain air quality as the medical facilities that you manage and develop,” he said.

Clalit has four million clients and runs 14 hospitals, director Eli Defes told the audience. The health fund had calculated the carbon footprint of the conference – from the transportation, electricity, food and so on involved – at 30.3 tons of greenhouse gases, and would offset it by planting trees, he added.

Holliday, regional head of operations at Newcastle Upon Tyne Hospitals and a member of the Health Protection Agency in the UK surveyed the treatment methods for medical waste.

“All healthcare produces waste,” he said. “Most waste is not hazardous. Some waste is hazardous and must be disposed of safely. In the UK, we used to dump it or bury it.

“However, awhile back we began to treat it through incineration. But incineration is expensive, new legislation on emissions means most incinerators cannot meet new standards without massive investment and incineration is unpopular. All of which led to alternative technologies,” he said.

According to Holliday, body parts, radioactive material, cytotoxic drugs, and syringe needles were all still incinerated.

“The danger of infection is the largest potential hazard, anything contaminated with blood can carry infection, HIV, hepatitis or MRSA [a serious staph infection],” the medical waste treatment specialist said.

Similar to advanced understandings of waste treatment, separation is key. The waste must be separated first into hazardous and nonhazardous, he said. Hazardous material is then treated according to one of a variety of technologies: autoclaving, heat disinfection or chemical disinfection.

As opposed to incineration, alternative waste treatments do not completely destroy the waste. As such, the trend has become to recycle the waste that has been rendered nonhazardous.

The metal, plastic and glass can be recycled, and the waste itself turned into fuel pellets, he said.

There were strict guidelines for determining when waste was treated enough to no longer be considered hazardous, he added.

In Israel, at Clalit, chemical treatment is used to treat medical waste, a Clalit employee who deals with medical waste commented.

MK Dr. Rachel Adatto said the Knesset Health and Environment Committee had begun looking into the levels of medical waste in the wastewater, which is particularly important because the water is reused for agricultural purposes.

She said she had placed a bill before the Knesset this week to regulate the issue.

While the UK, US and many other countries have quite advanced environmental regulation systems, Israel’s development in this sector is still in its infancy, Iser-Itsiq told The Jerusalem Post after the conference.

However, Iser-Itsiq said she remained optimistic for the future.

As far as technologies go, when waste does remain in water, there are many ways of purifying it. But according to Joseph Delloiacovo, vice president of US treatment technology firm MedAssure, new testing methods have discovered that traditional treatment techniques such as autoclaving weren’t actually rendering the waste harmless. As a result of the testing, the way autoclaves were used had been overhauled.

In the Haifa Bay area, a region considered particularly polluted, scientists recently attempted to monitor whether there is a connection between long-term exposure to air pollution and certain types of cancer, particularly looking at concentrations of sulfur dioxide and particulate matter alongside cancer rates.

“It was only lung cancer in men that was found to be higher risk than the baseline,” said Prof. David Barudai, from the Technion-Israel Institute of Technology’s Faculty of Civil and Environment Engineering.

But because certain research tools were not available in Israel and because too many personal variables – like smoking, for instance – could affect the study’s results, they were unable to form any substantial conclusion at this point, Barudai explained.

While there are growing connections between the environment and the health, scientists’ questions currently outweigh the answers.