Impact of repackaging hazardous (infectious) hospital waste on the indoor air quality of a hospital.

With landfill bans on the disposal of hazardous (infectious) hospital wastes, many hospitals in the United States are faced with selecting alternative means of disposal. One alternative method of disposal is to repackage the waste and ship it off site for incineration. This paper reports on a study in which airborne bacteria were sampled in an area where waste was repackaged. Results of the sampling showed bacteria concentrations ranging from not detectable (central supply room) to 105 colonies/m3 air (approximately 40 feet from the incinerator room door). This would seem to indicate that the source of the bacteria was at or near the incinerator room door where the repackaging operation took place. Although some human pathogens were identified, most of the bacteria identified do not represent a serious health threat. However, Staphylococcus aureus was found in air samples collected from locations in the hospital served by the same ventilation system in the area of the repackaging operation. The waste handling practices used in hospitals need to be reevaluated, and the definition of 'sick building syndrome' needs to be expanded beyond chemicals to include microorganisms. More research is needed to characterize bacteria in air and to determine the impact of airborne bacteria on human health.

Emission of airborne bacteria from a hospital incinerator.

Only five studies have been found in the literature which provide any indication of the effectiveness of incineration for rendering infectious hospital waste innocuous. Although there is an indication from these studies for release of bacteria in stack gas, none of the studies identified the bacteria or determined the source of bacteria. The purpose of the present study was to investigate the potential for a hospital incinerator to release human pathogenic bacteria into the ambient environment. In this study, waste spiked with Bacillus subtillis was burned in a hospital incinerator. Although bacteria were found in the incinerator stack gas, (concentrations ranged from not detectable to 1157 colonies/m3 of air) no Bacillus subtilis was recovered from the stack gas. The results suggest that the source of the stack gas bacteria was not from unburned waste or from outdoor air. Analysis of samples of air from the incinerator room (not simultaneous with the stack gas samples) indicates that the source of the stack gas bacteria was most likely the combustion air.

High sodium in drinking water and its effect on blood pressure.

A recent study of two communities in Massachusetts showed that a group of high school sophomores exposed to 107 mg/liter sodium in their municipal drinking water had significantly higher systolic and diastolic blood pressures than a control group exposed to 8 mg/liter. The present study was undertaken to determine if these results could be repeated in two communities, LaGrange and Westchester, located in the Chicago metropolitan area. These communities have similar demographic and socioeconomic characteristics. However, the concentration of sodium in the municipal drinking water of LaGrange is 405 mg/liter as compared to 4 mg/liter for Westchester. A comparison was made between the blood pressures of high school juniors and seniors from the two communities. Of the 386 eligible students in LaGrange, 84% volunteered to have their blood pressures taken. In Westchester, 78% of the 401 eligible students volunteered. Results of the survey indicated that male and female systolic blood pressures in the high sodium community were not significantly higher than those in the low sodium community. Surprisingly, the observed systolic blood pressures of males in the lower sodium community were higher than those in the high sodium community. These findings did not corroborate the results of the Massachusetts study. However, the male and female diastolic blood pressures were significantly higher (p = 0.040 for males and p = 0.016 for females) in the high sodium community. The increases in diastolic blood pressures (approximately 2 mmHg for males and females) were not as large as those observed in the Massachusetts study (2.7 and 5.1 mmHg for males and females, respectively).

Microbial sampling variables and recreational water quality standards.

A study was conducted at two beaches on Lake Erie to evaluate the water sampling design for the collection of several microbiological indicator organisms in relation to day, time, and location of collection. The concentrations of these organisms were generally found to vary significantly (P less than 0.05) by the specific time of day and day of weekend that collection took place. However, the concentrations of these organisms did not vary significantly (P greater than 0.05) at various locations in the bathing area. Future studies investigating the health effects of recreational water as related to microbiological variables should be designed to collect water samples at the specific time of day and day of weekend that an individual was exposed. In addition, sampling at various locations in the bathing area should probably be considered for those beaches having poor dispersion of fecal waste sources.

High barium levels in public drinking water and its association with elevated blood pressure.

A maximum contaminant level for barium in drinking water has been set at 1. mg/L. This study examines for the first time, whether there are significant differences in mean blood pressure levels between a high and a low barium community. A total of approximately 2,400 Illinois residents in West Dundee, with a mean barium drinking water level of 7.3 mmg/L, and in McHenry, with a mean barium level of 0.1 mg/L, were studied. All other drinking water constituents were nearly identical between the two communities, with the major difference being the level of barium ingested. No significant differences (P greater than .05) were found in blood pressures between the high and low barium communities. Adjustment for duration of exposure, home water softeners, and high blood pressure medication did not alter the findings. The data from this study suggest that elevated levels of barium in drinking water do not significantly elevate blood pressure levels in adult males or females. It is recommended that the drinking water standard of 1. mg/L be re-examined for other possible health effects.

Effects of outboard motor exhaust emissions on goldfish (Carassius auratus).

Goldfish (Carassius auratus) were exposed to outboard exhaust products in water or to toluene (a constituent of outboard motor exhaust water) via a continuous flow bioassay dosing apparatus. Various physiologic and pathologic changes were noted. In the blood a consistent decrease (p less than 0.05) in the partial pressure of oxygen, a significant increase (p less than 0.05) in the partial pressures of carbon dioxide, and significant decreases (p less than 0.05) in pH and oxygen saturation were found in many of the blood gas experiments. Laboratory experiments also indicated that these fish are capable of metabolizing toluene to hippuric acid (p less than 0.05). Exposure up to 30 days to these exhaust products produced gross and microscopic lesions in the high-, intermediate-, and low-dose fish. Grossly, livers were smaller and pale; intestines were empty of ingesta and feces; and gills were coated excessively with mucus. Microscopically, the livers of the exposed fish had a decreased cytoplasmic:nuclear ratio, gill filaments were fused, and some kidneys had tubular vacuolization.

A review of environmental characteristics and health effects of barium in public water supplies.

A comprehensive review is made of sources, occurrence, removal, health effects and water quality standard of barium in public drinking water supplies. The primary source of naturally occurring barium in drinking water results from the leaching and eroding of this metal from sedimentary rocks into the aquifers of ground water. It is a localized problem in several areas of the United States. The removal of barium from drinking water appears to be most efficiently accomplished utilizing ion exchange softening. Health effects studies are based primarily on animal experimentation. Such effects include stimulation of smooth, striated, and cardiac muscle, elevation of blood pressure, initiation of catecholamine release, rapid and preferential deposition in bone, and excretion principally in the feces. Humans over 60 years of age appear to be at high risk to developing cardiac arrhythmias following the barium enema. The current United States drinking water standard of 1.0 mg/l is based on several faulty assumptions and should be critically reevaluated.

Amebiasis in goldfish.

Five cases of amebiasis were diagnosed in goldfish (Carassius auratus) from home aquariums and from a laboratory aquarium. Granulomas containing amoebae were in many organs but were most numerous in kidneys. Because there were pseudopods, food vacuoles, vesicular nucleoli and other ultrastructural characteristics of the organisms, we identified the organisms as amoebae. On the basis of mitotic stages it is possible they belong in the family Hartmannellidae.