CUTS IN MEDICAL PVC NOT REALISTIC OPTION

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The call by a coalition of environmental activists and health-care providers to tighten rules on dioxin emissions from hospital incinerators is not such a bad thing.

Many of the incinerators aren't state-of-the art, and they pollute. Technology exists to address that problem, and can be acquired for less than the cost of hospitals doing away with PVC products.

The latter is what Greenpeace and several other environmental groups hope to pressure hospitals to do. That isn't going to happen in the foreseeable future, for economic reasons. Not only is the health-care community under great pressure to lower costs, but industry has not embraced an adequate substitute material for many medical products. Bringing a replacement material to market can be expensive, requiring major research and development expenditures as well as lengthy testing and regulatory approval.

Processing firms that depend on PVC for their livelihood have been aware of the dioxin-related environmentalist rumblings for years. Most have toyed with using alternative materials, just in case, the most recent being metallocene polyethylenes. But they simply have not found a material that meets the same performance and cost criteria.

That said, no profession is more concerned about maintaining a safe environment than health-care providers, whose job often involves treating people whose exposure to environmental hazards has resulted in injury or disease.

The American Medical Association has yet to issue a recommendation on the PVC issue and will not until the Environmental Protection Agency completes a review of the health effects of dioxin.

The reality is that the dioxin emitted from hospitals incinerating PVC products is far less a public health threat than other forms of medical waste that must be destroyed to prevent the spread of disease and infections. On-site incineration is still the best method to accomplish that.

This is not to say that physicians and hospital administrators can or should dismiss outright the coalition's campaign to reduce dioxin emissions. Dioxins are toxic and the first rule of medicine continues to be ``do no harm.''