Mercury Disposal at Coffin Butte in Corvallis, Oregon

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Northwest mercury Waste Going to Coffin Butte in Corvallis

Mercury Poisoning in Minamata (see below)


by JIM LYNCH 

the Oregonian

MORTON, Wash. -- Most of the Northwest's infectious medical waste gets trucked to an inconspicuous processing plant in this tiny logging town where it is shredded, zapped with radio waves, then dumped in an Oregon landfill. 

The barbwire-ringed plant is run by Illinois-based Stericycle Inc., one of the nation's fastest-growing companies. And although Stericycle's recession-proof stock continues to dazzle analysts, its Morton plant unnerves some health and environmental officials. 

Part of the unease is that the plant was the center of a tuberculosis scare during the late 1990s when three workers contracted the potentially deadly lung disease and tests showed another dozen had been exposed to it. A landmark medical investigation concluded at least one worker's TB came from waste sent from a Portland laboratory. 

Now, Washington state officials are investigating whether the Morton plant is violating its operating terms by processing mercury from dental offices. The poisonous substance is considered one of the region's worst health hazards because even a tiny amount can damage the brain, kidneys and lungs, and it is hard to get rid of once it enters the body. 

Both Washington and Oregon are launching statewide campaigns to wean the public off mercury-tainted fish, mercury thermometers and other mercury-laced products. There is also a push to recycle mercury whenever possible and to dispose of it in special hazardous waste pits rather than in general dumps such as the Coffin Butte landfill north of Corvallis where Stericycle discards its Morton waste. 

 



Oregon officials contacted by The Oregonian were surprised to hear their Washington counterparts were investigating potential mercury problems with the region's medical waste. Until now, Oregon had not regarded Stericycle's truckloads of trash as a possible mercury menace. 

"I don't doubt there is an awful lot of mercury going through that system and ending up in our landfill," said Rich Duval, a landfill inspector for the Oregon Department of Environmental Quality. 

Duval said periodic landfill water tests haven't shown alarming mercury spikes. "In our lifetime, yeah, nothing will probably happen. But two generations from now, what mess are we going to leave behind?" 

The Morton plant began as one of many small regional disposal options, but grew fivefold during the past decade as it took over most of the Northwest's medical waste transport and disposal business. It now receives as many as 20 tractor-trailers a day and nearly 10,000 tons of waste a year from hospitals, dental offices and laboratories in Oregon and Washington. 

The plant uses a microwavelike technology to heat and decontaminate body fluids and soiled needles, syringes, gowns, tubing and other medical refuse capable of transmitting disease. It also receives about 50 pounds of mercury a year from dental offices in the Seattle area alone, a King County study estimates. 

Mike Philpott, Stericycle's district manager, said the plant doesn't knowingly accept mercury or any hazardous wastes and called the recent mercury estimates at the Morton plant "speculative and inaccurate." However, Philpott said, the company relies on its customers to weed out mercury and has no detection equipment at the plant. 

The Morton plant receives relatively little regulatory oversight. Two similar Stericycle plants in Wisconsin and Rhode Island are inspected and regulated by state agencies. The Wisconsin plant receives monthly surprise inspections. By contrast, Washington state officials provide no direct oversight of the Morton plant. 

The plant is licensed by Lewis County. Its lone regulator is a county health specialist who visits the facility several times a year -- rarely unannounced. 

Lewis County's top health official, Diana Yu, said her worries about the plant go beyond worker safety and mercury issues to general public safety. "We need to discuss how are we going to be sure everyone is protected all the way around," she said. 

Yu said Lewis County lacks the money or expertise to oversee the plant and thinks the Washington State Department of Ecology should regulate it. 

Kimberly Field, manager of the tuberculosis program for the Washington state health department, says the plant's TB flare-up should have wrought tougher state regulations and better worker protections. "I am still adamant and passionate that something needs to be done," she said. 

Field says the Morton TB investigation is the only inquiry she's worked in which Wall Street analysts repeatedly called her -- as recently as 2001 -- to better assess the potential impact of her findings on the future value of a company's stock. Industry overhaul The medical waste disposal industry was overhauled in the late 1980s after dirty needles and other hospital trash washed up on New Jersey beaches. 

As federal regulators demanded tighter oversight, hospitals and laboratories -- accustomed to burning their own wastes -- started shopping for someone to take their infectious garbage and regulatory worries away. 

Stericycle emerged in 1989 as one of many competitors for the new market. As its name suggests, it pitched itself as a recycling-oriented company. The recycling end of Stericycle never really took off, but its finances did. 

Today, Stericycle is the largest medical waste handler in the country by far. With about $400 million in annual revenues and more than 30 regional, Morton-like processing centers, it is 15 times as big as its nearest U.S. competitor and growing overseas, too. 

Fortune Magazine listed Stericycle as one of the top 10 fastest growing companies in the United States in 2000. Forbes ranked it the 32nd "best small company" in the country this year. 

In 1991, the Morton plant began as a modest operation that Lewis County licensed as a "solid waste transfer station." The plant wasn't supposed to accept hazardous or radioactive wastes, and job-hungry Morton welcomed the business. 

With about 1,000 residents set in the hills north of Mount St. Helens, Morton is a place where one of every eight households is below the poverty line and storefronts boast they are "supported by timber dollars." 

Stericycle swiftly became one of Morton's biggest employers, using about a dozen workers a shift to operate a plant where waste arrives in sealed red bags packed inside large plastic containers. Workers dump the waste into a pit where it is shredded, then cooked with low-frequency radio waves in an oven the size of a Winnebago. The final shrunken product is treated like household garbage and packed into Oregon-bound trucks. Such a facility in Oregon would require approval from the state, which also would oversee plant operations. But in Washington, which has no broad state medical waste regulations, Lewis County had to create its own rules. 

The Morton plant received more attention in 1995 after Stericycle's Woonsocket, R.I., plant -- one of the company's two other U.S. plants using radio-wave technology -- was fined $3.3 million by the state for violations that included "knowingly" exposing its workers to hepatitis B. 

Rhode Island officials also accused the company of doctoring records by mishandling test strips designed to verify that waste was being heated to the required minimum temperature needed to kill bacteria. In some instances, the test strips were allegedly heated in a cafeteria microwave oven rather than run through the plant with the waste. 

Stericycle challenged the findings and the fine and later agreed to pay $400,000. 

Two years later, the Morton plant was in the spotlight after three of its workers were diagnosed with tuberculosis. Skin tests indicated 13 other workers also were exposed to TB, although none of them had the active disease. 

Company officials asserted -- and still maintain -- the plant was not the source of the TB. Medical history was on their side. There had never been a documented case of TB transmitted by medical waste. 

A subsequent worker-safety investigation by the National Institute for Occupational Safety and Health found sloppy plant safety practices -- including unreported incidents of workers being punctured by used needles -- and spotty maintenance. 

But the bigger news flash came when a state-federal medical investigation used DNA fingerprinting to match one of the workers' tuberculosis to a rare strain in a woman treated at a Portland laboratory, which had its infectious garbage trucked to Morton. 

An October 2000 article in the Journal of the American Medical Association called it the first proof that medical waste can transmit TB, challenging the long-held assumption that the only way to get it was from someone who was contagious. 

As information poured in, Washington state legislators scrambled for ways to make the plant safer. Recommended remedies included requiring Stericycle to heat waste before shredding it and demanding that hospitals and labs decontaminate potentially infectious waste before it is trucked to Morton. 

Despite repeated efforts between 1998 and 2001, nothing passed the Legislature. 

Stericyle's Philpott said the Morton plant has subsequently instituted more worker-safety precautions than any other company facility, including requiring workers to wear respirators at all times. 

However, state Sen. Karen Fraser, D-Olympia, says she may revisit plant safety issues if mercury is deemed a serious problem at the plant: "My concern for worker safety continues." Report outlines concerns Last year, the Washington Toxics Coalition, a nonprofit Seattle-based environmental group, teamed with health advocacy organizations across the country to examine Stericycle's industry takeover in a report titled: "Stericycle: Living up to its Mission?" 

Among the report's highlighted concerns was the lack of testing for "mercury and other toxic substances" processed in Stericycle's nonburn waste processors such as its Morton plant. 

Simultaneously, Oregon and Washington have been devising anti-mercury campaigns. Oregon's effort is behind Washington's -- including its campaign to educate dentists about preferred disposal practices. But similar goals are emerging to dramatically cut mercury releases to the environment this decade. 

Most mercury exposure comes from eating contaminated fish. The national Centers for Disease Control and Prevention determined in 1999 that as much as 10 percent of women carry too much mercury. Symptoms include, fatigue, depression and headaches. Coal plants and garbage incinerators are considered prime mercury sources, but there are myriad others, including fluorescent lights and some dental amalgams used to fill cavities. 

The King County Health Department surveyed mercury-disposal habits of 221 dentists in the Seattle area in 2000. It concluded about 20 percent of dental mercury waste was sealed in red bags and hauled to Morton. The little-known study estimated the Morton plant processes 53 pounds of mercury a year from King County dental offices. 

If the estimates held up throughout Stericycle's Northwest service area, the Morton plant would annually process hundreds of pounds of mercury from dental offices. 

"Everybody agrees Stericycle is not a facility that is set up to handle mercury," said Gail Savina, a King County health official involved in the study. "Nobody knows what happens to mercury once it gets there. You've got all these different agencies, and yet nobody is really exploring where it's going." 

Rick Volpel, medical hazardous waste specialist for the Oregon DEQ, said the waste from the Morton plant should be more carefully monitored to determine whether it belongs in hazardous waste dumps, which typically charge at least four times as much for disposal. 

Stericycle dumped Morton waste at Oregon's massive Arlington landfill complex in north-central Oregon until early last year when it began trucking it to Coffin Butte, where mercury is a greater threat because the site's increased rainfall could help mobilize it and increase its chance to seep into groundwater, said Duval, the Oregon landfill inspector. 

Washington's ecology department recently drafted a memorandum of understanding it hopes to reach with Washington dentists to try to get them to stop dumping mercury into the waste stream. 

"We're saying (mercury) from dentists cannot go to Stericycle," said Dennis Bowhay, a senior policy analyst for the agency's hazardous wastes program. "There's no reason it can't be recycled." 

A draft copy of an upcoming state report titled "Washington State's Mercury Chemical Action Plan" recommends that the air and water at the Morton plant should be routinely tested for mercury. 

Stericyle's Philpott said the company will monitor mercury at the plant -- if it is required -- but that the issue would be better managed by health officials policing dentists who skirt disposal rules. 

Dave Misko, a hazardous waste supervisor at Washington's ecology department, said the agency is examining Morton's mercury issue, but also determining whether other dangerous wastes pass through as well. 

"The gray area of medical waste regulation needs some clarification," said Misko.


MINAMATA, Japan -- When Kazumitsu Hannaga hears that the fish in Minamata Bay are now deemed safe to eat, he grunts and moans, and his gnarled fingers shoot out in all directions to express his disapproval. But it is impossible to know exactly what Hannaga is trying to say. He cannot speak.

Hannaga was born severely deformed, poisoned in the womb when his mother ate fish contaminated with mercury that had been dumped into the bay by the local chemical factory.

Abandoned by his mother when he was a young child, and with his father paralyzed from the waist down by mercury poisoning, Hannaga has spent most of his 42 years in a hospital, his head usually tilted awkwardly to one side and his twisted legs curled up under a wheelchair. His main passion is to take photographs with a camera he can barely hold steady in his shaky hands.

Four decades after mercury poisoning made Minamata synonymous with environmental disaster, the prefectural government has declared that mercury levels in the fish in Minamata Bay now meet standards for safety. A 1.3-mile-long net that has cordoned off the bay's fish from the surrounding sea since 1974 is being removed, and commercial fishing in the bay should commence in the fall.

To many people here, the announcement marks a symbolic end to a saga that helped awaken the world to the evils of pollution and led Japan to question its ethic of growth at any cost.

"With this, I think the existing impression of Minamata as a polluted town will be wiped out," Joji Fukushima, the governor of Kumamoto Prefecture, said in an interview.

But for Hannaga and thousands of the sufferers of what is called Minamata disease, the scars still linger. And some patients fear that society will now be only too quick to forget them.

"I think they are hoping to put a quick end to Minamata disease," said Yasuko Araki, 52, who was stricken as a little girl and whose speech is barely intelligible.

Shinobu Sakamoto, who was born with brain damage and whose older sister died from mercury poisoning at age 4, agreed. "As long as we are alive," she said, "Minamata disease will never end."

In some sense, this city on the southwestern island of Kyushu is still at war with itself, as it has been since the mid-1950s, when the outbreak of the mysterious disease turned victims against the company, townspeople against townspeople and even victims against other victims.

Today, many people here hope to put the ordeal behind them to revive the economy, which is 16 percent poorer than that of the prefecture as a whole. "We are hoping to look forward more," said Ritsuko Sakamoto, whose family runs a fruit store.

But others, including Mayor Mazumi Yoshii, maintain that Minamata should become a "sacred city," a monument to the horror of pollution as Hiroshima is to the atomic bomb.

To some extent Minamata cannot escape its past even if it wants to. Only recently, a local junior high school soccer team, playing in a tournament out of town, was taunted by jeers of "Minamata disease" from other students. Principals of those schools came to Minamata to apologize.

Older people still vividly recall the way the cats in town started dancing weirdly and hurling themselves into the sea to die. Then, in 1956, people started showing the symptoms of central nervous system damage -- numbness of the hands and feet, inability to walk, partial or complete loss of speech, hearing and vision, and tremors and convulsions. More than 1,000 sufferers of Minamata disease have died.

The culprit was the Chisso Corp. factory, the foundation of the town's economy, which used mercury in the manufacture of acetaldehyde, a substance used to make plastics.

Chisso denied and concealed its involvement. It changed the location of its dumping, which only spread the poison over a wider area.

Japan's government, worried more about economic development than the health of its citizens, did not officially recognize mercury pollution as the cause until 1968. When one study group came to that conclusion in 1959, the Government dissolved the group the next day.

Especially at first, when it was thought that the disease was contagious, healthy people here shunned the victims and their families. If they were let into shops at all, they sometimes had to leave their money on the floor to be picked up with chopsticks. The sufferers, who were mainly poor fishermen and their families, were also resented as a threat to Chisso and the city's economy.

It took until 1973 before a court ruled that Chisso was at fault and the company agreed to pay each victim a lump sum of $60,000 plus annual fees and medical expenses. There were 2,262 patients eventually officially recognized, of whom about 1,000 are still alive.

But more than 10,000 others have milder symptoms and were not officially recognized for compensation. Last year, most of these people, nearing the end of their lives, accepted $24,000 each in a settlement from the company, while dropping claims against the national government.

Still one group of 59 victims in Osaka refused to accept the settlement and is keeping up the fight. "They didn't admit the national government's responsibility," said Toshiyuki Kawakami, one of the plaintiffs. "Unless we have that, how can you say the Minamata case is settled?"

Some critics think Japan has not learned its lesson completely. Although Japan vastly strengthened its pollution laws, and the nation is now a leader in some effluent control technology, Japan has been slower than many countries to act on recent problems such as dioxin emissions and for years it resisted halting the sale of blood products that had infected hemophiliacs with AIDS.

As for Minamata, its population has shrunk from 50,000 at the time for the outbreak to less than 33,000. Chisso, which did not stop dumping until 1968, is still the underpinning of the economy, but employs only 650 people compared to about 4,000 who worked there 40 years ago.

The company is effectively bankrupt, kept alive by the government so it can continue to make payments to the victims. So far Chisso has paid 242 billion yen, or about $2 billion, in compensation and cleanup costs. It borrowed this money from the prefecture and cannot repay.

The compensation has made the victims dependent on the perpetrator, forcing an uneasy truce.

"As a very pragmatic and severe choice, I hope Chisso will continue to exist," said Teruo Kawamoto, whose father, stricken with Minamata Disease, began talking to wall calendars before dying in a mental hospital.

That is a painful concession from a man who was convicted of assault and battery on Chisso employees after leading an 18-month sit-in in front of the company's Tokyo headquarters, seeking compensation. The conviction was overturned on appeal and today Kawamoto, 66, a recognized patient, is a city assemblyman.

There is no effective cure for Minamata disease. The 47 surviving congenital patients like Hannaga and Miss Sakamoto will remain severely handicapped for life, said Dr. Masazumi Harada, a professor at Kumamoto University Medical School who has devoted his life to caring for the victims.

Some, like Miss Sakamoto, 41, who walks and speaks awkwardly, are being cared for by aging parents who themselves are ill with the disease. "I just worry who will take care of me" in the future, she said.

Miss Araki, whose parents both died of Minamata disease, lives alone in a third-floor walkup apartment. She cannot read a newspaper, cannot hold a job and was never able to marry. Volunteers take her to a center a few times a week where she puts milk containers into boxes for recycling. "I wonder why I was born," she said, breaking into sobs.

But for some other patients time has cleansed the mercury from their bodies and their symptoms have subsided.

Eiko Sugimoto, a robust 59-year-old fisherwoman, says she was once so ill "I forgot my children's names." Her weight dropped to 80 pounds. "I couldn't feel where my hands were and my head was aching."

Mrs. Sugimoto's cure was to return to the sea in 1990. "My husband had to carry me on his back onto the ship sometimes," she said. Though she still has occasional convulsions, her condition has improved and four years ago she became able to eat by herself.

The healing has been psychological as well as physical. "I can now say that I do not hate anybody," she said. "You have to appreciate how wonderful it is that you are still living. That's all you can do."

But the seemingly healthy patients like Mrs. Sugimoto have helped breed suspicion and resentment among many Minamata residents.

"Almost totally healthy people are receiving money," said one man, who declined to give his name but said he worked as a security guard at a hospital for Minamata disease patients. "It's only a small number of people who are making a fuss -- the people who want money," he said.

With the payments from Chisso, once destitute fishermen have replaced dilapidated huts with solid new homes, which some townsfolk call "Minamata patient mansions." The victims are also said to have started giving lavish presents at weddings and funerals, forcing others in the town to keep up.

Sunao Nakayama, a taxi driver, says he is one of only two people in his company who provides service to the victims.

"You have to help them get in and out," he said. "When you go to the hospital you have to put away the wheelchair. And you have to go up to their apartment and help them take off their shoes. Some drivers won't do that. They say, 'They have hands and feet, they can do it themselves."'

Fearful of resentment, some people with symptoms have never applied for compensation or hide the fact that they have. At the Minamata disease memorial that opened here last year, the names of the dead are engraved on plates -- but the plates are hidden from view inside a copper chest.

Some fear their relatives will face discrimination in jobs and marriage. Kawakami, the Osaka plaintiff, said his healthy daughter was rejected for marriage seven times before finally finding a husband.

But the silence of so many victims angers the ones who have come forward to fight. "It's not right that there are only three people who talk about Minamata disease," said Mrs. Sugimoto.

The city is only now trying to dissolve these emotional entanglements and come to grips with its past. It is building three social halls -- which it calls "centers to fix our moorings" -- to bring people together. In 1993, the Minamata Disease Municipal Museum opened with the mission of preserving the lessons of the tragedy.

But even in Minamata, memories are fading. Young children now blissfully swim in waters that killed their grandparents.

In other countries, too, the race for economic development means that mercury continues to be used in dangerous ways. In the Amazon basin and in Indonesia, mercury is used in small-scale gold mining and is polluting rivers, said Hirokatsu Akagi, an official at the National Institute for Minamata Disease, a research center established by the Japanese government here in 1978.

In Guizhou Province, China, one company is making acetaldehyde the same way Chisso did. A chance for a repeat of the Minamata tragedy? "Unfortunately or fortunately," Akagi said, "the fish are completely dead because of the waste. So there's no possibility of consuming the fish."

In Minamata Bay itself, however, there will now again be the possibility of consuming the fish. But of the 160 members of the local fishing cooperative, only about 50 to 60 are still in operation.

While fishermen and their families were the hardest hit by mercury poisoning, some never wanted to stop fishing in their beloved bay.

Too ill with Minamata disease to fish from 1956 until 1960, Masaru Ishida returned to the sea as soon as he could, tying himself to the boat so he would not fall overboard. He even fished in the bay from 1965 to 1974, since fishing was not officially banned then.

When the net was finally placed around the bay in 1974 -- an action taken to assuage public fears that fish outside Minamata Bay were dangerous -- Ishida objected.

Recently, Ishida has been catching fish from the bay to have them destroyed by Chisso as a way of cleaning up the pollution and compensating fishermen. "When we had to dump the fish, we cried because they would not be eaten," he said.

Now 70 and in good health, he is anxious to return to bay fishing for real. "I'm hoping that the net will be removed as soon as possible to show the locality and Japan and the entire world that there will be no more Minamata disease," he said. "Unless we do that we cannot start rebuilding the region. Unless we regain the clean sea in Minamata the dead people will not rest in peace."

By ANDREW POLLACK

of Brown University


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