PRELIMINARY, DATA SUMMARY
                    FOR THE
                   HOSPITALS
             POINT SOURCE CATEGORY
  Office of Water Regulations and Standards
               Office of Water
United States Environmental Protection Agency
              Washington,  B.C.

                 August 1989

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                              PREFACE
     This  is  one  of  a  series  of Preliminary Data Summaries
preparedly the Office of Water Regulations and Standards of the
U.S. Environmental Protection Agency.  The Summaries contain
engineering,  economic  and environmental data that pertain to
whether the industrial facilities in various industries discharge
pollutants in their  wastewaters and whether the EPA should pursue
regulations to control such discharges.  The summaries were
prepared in order to allow EPA to respond to the mandate of
section 304(m) of the  Clean Water Act, which requires the Agency
to develop plans  to  regulate  industrial categories that
contribute to pollution of the Nation's surface waters.

     The Summaries vary in terms of the amount and nature of the
data presented.   This  variation reflects several factors
including  the overall  size of the category (number of
dischargers), the amount of sampling and analytical work
performed  by  EPA  in  developing the Summary, the amount of
relevant secondary data that exists for the various categories
whether the industry had been the subject of previous studies (by
EPA or other  parties),  and whether or not the Agency was already
committed  to  a regulation for the industry,  with respect to the
last factor,   the pattern is for categories that are already the
?o iHS     ire?ulftor£  activity (e.g.,  Pesticides,  Pulp and Paper)
to have relatively short Summaries.   This is because the
Summaries  are intended primarily to assist EPA management in
designating industry categories for rulemaking.  Summaries for
categories already subject to rulemaking were developed for
comparison purposes and contain only the minimal amount of data
needed to provide some perspective on the relative magnitude of
the pollution problems created across the categories

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                         ACKNOWLE DGEMENTS
Preparation of this Preliminary Data Summary was directed by Dr
Frank H  Hund of the Industrial Technology Division, with support
provided under EPA Contract No. 68-03-6302.               support
          Industrial Technology Division (WH-552)
          U.S.  Environmental Protection Agencv
          401 M Street, S.W.
          Washington,  D.C.  20460

          Telephone (202)  382-7131

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 1.0
 2.0
 3.0
                          TABLE OF CONTENTS

                                TITLE
 EXECUTIVE SUMMARY

 INTRODUCTION
           1.1
           1.2
           1.3
           1.4
      SUMMARY
      PURPOSE AND AUTHORITY
      REGULATORY STATUS
      SUMMARY OF METHODOLOGY
                1.4.1
                1.4.2
                1.4.3
                1.4.4
                1.4.5

                1.4.6

                1.4.7
                1.4.8
                Review and Assessment
                Supplemental Data Gathering
                Supplemental Questionnaire
                Sampling and Analytical Program
                Industrial Profile and
                Subcategoriz at ion
                Water Use, Solids Generation, and
                Waste Characterization
                Pollutant Parameters
                Assessment of Control and
                Treatment Technologies
 INDUSTRY PROFILE

 2.1   SUMMARY
 2.2   STANDARD PROCESSES AND PRACTICES

 WASTE CHARACTERIZATION
 1
 1
 3
 3

 4
 •4
 4
 5

 5
 7
 11

  12
4.0
3.1  CHEMICAL WASTE
3.2  RADIOACTIVE WASTE
3.3  INFECTIOUS WASTE
3.4  PHYSICALLY HAZARDOUS  MATERIALS
3.5  WASTEWATER
     3.5.1     Hospital A
     3.5.2     Hospital B
     3.5.3     Hospital C
     3.5.4     Hospital D
3.6 POLLUTANTS
     3.6.1 INTRODUCTION
     3.6.2 TRADITIONAL POLLUTANTS
     3.6.3 PRIORITY POLLUTANTS
     3.6.4 HAZARDOUS NON-PRIORITY POLLUTANTS
     3.6.5 INDUSTRY MASS LOADINGS
     3.6.6 DISCUSSION

TREATMENT AND DISPOSAL METHODOLOGIES
 12
 12
 14
  17
 17
 20
 23
 23
 29
 35
 35
 35
 35
 35
 35
40

 45

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                       TABLE OF CONTENTS  (continued)

                            TITLE
PAGE
         4.1  CHEMICAL WASTE
         4.2  RADIOACTIVE WASTE
              4.2.1     Separation and Confinement
              4'.2.2     Dilution  and  Dispersion
         4.3  INFECTIOUS WASTE
              4.3.1     Steam Sterilization
              4.3.2     Incineration
              4.3.3     Liquid Disposal  in Sewer
         4.4  PHYSICALLY HAZARDOUS WASTE
         4.5  WASTEWATER
              4.5.1     Pretreatment  Technologies
                        4.5.1.1   Silver Recovery
                        4.5.1.2   Solvent Recycling and
                                  Reclamation
               4.5.2     Biological  Treatment
                         4.5.2.1   Trickling Filters
                         4.5.2.2   Activated Sludge
                         4.5.2.3   Aerated Lagoons
 45
 45
 45
 48
 49
 50
 51
 51
 52
 52
 52
 52

 54
 54
 56
 56
 58
GLOSSARY OF ACRONYMS

REFERENCES

APPENDIX A - ITD LIST OF ANALYTES

APPENDIX B - MAXIMUM PERMISSIBLE CONCENTRATIONS OF
             POLLUTANTS IN AIR AND WATER
  61

  62

  64


  69

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 TABLE NO.
        LIST  OF  TABLES

         TITLE	
 2-1
 2-2
 2-3
 3-1
 3-2
 3-3
 3-4
3-5
 ESTIMATED AMOUNTS OF  POLLUTANTS
 DISCHARGED TO WATER,  AIR, AND
 CAPTURED IN SLUDGE

 DISTRIBUTION OF REGISTERED
 HOSPITALS BY BED SIZE (1985)

 DISTRIBUTION OF COMMUNITY
 HOSPITALS, 1975 TO 1985

 DISTRIBUTION OF REGISTERED
 COMMUNITY HOSPITALS AFFILIATED
 WITH MEDICAL SCHOOLS  BY BED
 SIZE (1985)

 CHEMICAL HAZARDOUS WASTE GENERATED
 BY THE HOSPITAL INDUSTRY

 USE OF RADIOISOTOPES IN PATIENT
 CARE,  1983 AND 1984

 DESIGNATION OF INFECTIOUS WASTE
 TYPES

 HOSPITAL EFFLUENTS COMPARED
 WITH NONINDUSTRIAL POTW
 INFLUENTS

 INFECTIOUS WASTE  DISPOSAL
 METHOD  RECOMMENDATIONS
                                                          ii
                                                          10
                                                          13
                                                         15
                                                         16
                                                         18
                                                         21
3-6


3-7


3-8


3-9


3-10

3-11
SUMMARY  OF  REPORTED ANALYTICAL       24
RESULTS  - HOSPITAL A

SUMMARY  OF  REPORTED ANALYTICAL       26
RESULTS  - HOSPITAL B

SUMMARY  OF  REPORTED ANALYTICAL       30
RESULTS  - HOSPITAL C

SUMMARY  OF  REPORTED ANALYTICAL       33
RESULTS  - HOSPITAL D

PRIORITY POLLUTANTS  DETECTED          36

HAZARDOUS NONPRIORITY POLLUTANTS      36
DETECTED

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   LIST OF TABLES (continued)
TABLE NO.
3-12

3-13

4-1
4-2
A-l
B-l
TITLE
DATA SUMMARY FOR THE
INDIRECT DISCHARGING HOSPITALS
HOSPITAL INDIRECT DISCHARGE
LOADING SUMMARY
RADIOISOTOPIC HALF-LIVES
STEAM STERILIZATION
ITD LIST OF ANALYTES
MAXIMUM PERMISSABLE CONCENTRATIONS
PAGE
37

41

46
50
63
70
OF POLLUTANTS IN AIR AND WATER

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                          LIST OF  FIGURES

                           TITLE
4-1
HOSPITAL SAMPLING POINT
SCHEMATIC

TYPICAL HAZARDOUS WASTE
TREATMENT AND DISPOSAL
ROUTES
                                                        46

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                   EXECUTIVE SUMMARY
                  Writers and P»blicly owned treatmen works




e- The sampling program, conducted at four hospitals
              ^



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    ESTIMATED AMOUNTS OF POLLUTANTS DISCHARGED TO WATER,
               AIR AND CAPTURED IN SLUDGE
          Estimated Waste Discharges (Units are Ibs/yr)
               To POTWs and        To Recieving
               EOP Treatment
BODS
TSS
COD
259,000,000
135,000,000
567,000,000
Priority Pollutants
Volatiles          37,960
Metals            255,135
Semivolatiles      56,210

Nonpriority Pollutants
Volatiles          545,675
Metals             314,995
Waters
a
a
a
Air
NA
NA
NA
Sludge
NA
a
NA
                     3,037
                      a
                      a


                     43,654
                     a
33,405
480,194
 NA - Not applicable
 a - Insufficient data are available for a reliable estimate
 b - A significant amount of metals will apportion to sludge
                                 ii

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 1.1  SUMMARY
                           SECTION 1.0


                           INTRODUCTION
                           the ffi°St current  information available
                         °f wa?tewater and solid wastes containing
                K       non-Priority pollutants by hospitals.   ThI
            of this document are to  (1)  provide a technical basis
 for determining whether additional national regulations' Snould bl
      °     ""™     to the Clean  Water Act  (CWA) ,  anl  (2)  makl
                         information  regarding  the  discharge  of
 indstry.               non-priority pollutants  by the  hofpital
              i.ndustrv Profile is presented in Section 2.0.  Section
     ri??  and1ZhS h°2Pltal wast*w*ter in terms  of the  presence  of

               cS^t

 tmen'teohrirS-WaSte mana^^t  practices  and  contlt? ^
 treatment technologies are described in Section 4.0. Environmental
     *C?n^1C .impaCt analvses *ave  not been performed as Trt  of
      docuLn?d'  C°nse^entlv  «» such analyseSP are discussed in
                                              is  required by
 1-2  PURPOSE AND AUTHORITY


 The  U.S.  Environmental  Prbtection
        of
                                        of promulgation  of these
                                    this  review Program  and  as  a
                           .   with  several  environmental groups,

                                            of  toxic  ^-tA;

To achieve these goals, the  Industrial Technology Division riTD)
                     ™ .*?****»*.  Proposing, ^nd  promSgatiSg
                     guide^lneas>  new source performance standardl
                      Stand.ards'  and b^st  management  practices
                      point  source discharges; (2\  assurin
                      of scientific,  economic  'an^^echSca
                « ^H t0-  SUPP°rt  the Affluent limitations   and
                gathering,  developing,   and  analvzina  data   anri
                              t0 the ^nnual  revieYw and  periodic
          .  ^                  and standards; and  (4)  developing
          ^formation required for the judicial  review of
            guidelines and standards.
       f or
       for
  and rs
standards,

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In addition  to its responsibilities under  the CWA, EPA  is  also
charged by  the Resource  Conservation  and  Recovery Act  of  1976
(RCRA) with oversight of "cradle-to-grave" management of hazardous
solid wastes.   Section 3018(a) of  RCRA,  as amended by  the  1984
Hazardous and Solid Waste Amendments (HSWA) ,  directed EPA to submit
a report  to  Congress concerning wastes discharged  through sewer
systems to publicly owned treatment works (POTWs) that are exempt
from RCRA regulation as a result of the Domestic Sewage Exclusion
(DSE)  of  RCRA.    The DSE,  established by  Congress  in  Section
1004(27)  of  RCRA,  provides that  solid or  dissolved  material in
domestic sewage is not solid waste as defined in RCRA; therefore,
it cannot be considered hazardous waste for RCRA purposes.  The DSE
applies to domestic sewage and industrial wastes discharged to POTW
sewers containing  domestic  sewage,  even if the industrial wastes
would otherwise be considered hazardous.

The report (the Domestic Sewage Study,  or DSS)  was prepared by the
EPA Office of Water and submitted to Congress on February  7, 1986.
The  DSS  examined  the  nature  and  sources  of  hazardous wastes
discharged to  POTWs, measured the effectiveness of  EPA's  programs
in   dealing  with  such  discharges,   and  recommended  program
improvements to achieve better control of hazardous wastes  entering
POTWs.

Implicit  in the DSE is the assumption that the pretreatment program
mandated  by the  CWA can  ensure adequate  control  of industrial
discharges to  sewers.  This  program, detailed  under Section 307(b)
of  the CWA  and implemented in 40 CFR  Part 403,  requires EPA to
establish pretreatment standards for pollutants discharged to POTWs
by  industrial  facilities for those pollutants that interfere with,
pass through,  or are otherwise  incompatible with the  operation of
POTWs.

As  follow-up  to  the  DSS,  Section  3018(b)  of  RCRA  directs the
Administrator to revise  existing  regulations  and  promulgate any
pretreatment  standards  controlling the discharge  of  individual
hazardous constituents  to  POTWs  that  are necessary to ensure
adequate  protection of human  health and the environment.  These
regulations are to be promulgated pursuant to RCRA,  Section 307 of
the CWA,  or  any  appropriate  authority possessed by  EPA.   The
regulations must  be  promulgated within 18  months after submission
of  the DSS to Congress (i.e.,  by August 1987).

The DSS concluded that the DSE should  be retained  at the present
time, and recommended  improvements to  various EPA  programs  under
the CWA for better control  of hazardous wastes entering POTWs.  In
 addition, the DSS recommended study efforts  to  fill  information
 gaps, and indicated that.other statutes (e.g., RCRA and the  Clean
Air Act)  should be considered along with the CWA to control either
hazardous waste dischargers or receiving POTWs, or both (if the
 recommended  research  indicates the   presence of problems  not
 adequately addressed by the CWA).

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 One  recommendation of  the  DSS  was  that EPA  review  and amend
 categorical pretreatment  standards to achieve  better control of
 the hazardous  waste  constituents.   The DSS  recommended that EPA
 modify existing standards  to improve  control of organic priority
 and  non-priority  pollutants,  and also  promulgate  categorical
 standards for  industrial  categories not  included  in  the Natural

 ERC°2120? D?C?£?S      11  ^^  C°nSent DSCree (NRDC V« Train' 8
 Because the  DSS  identified hospitals  as a  possible  source  of
 hazardous  pollutants,  and  hospital  discharges  to  POTWs  are
 unregulated for these pollutants, EPA decided to review and update
 existing  data  related  to  the  discharge  of  both priority  and
 hazardous non-priority pollutants from hospitals.

 1lJ   REGULATORY STATUS   Previous  hospital industry  regulatory
 efforts resulted in the following measures:               guiatory

           development of an industry profile
           sampling and analytical program to characterize water
           use and wastes
           assessment of control  and  treatment technologies
           development of final  Best  Practicable Technology fBPT)
           regulations.                                    **  v    '
     o
     o

     o
     o
 The  1976 Development Document provided the technical basis for the
 interim final BPT limitations for biochemical oxygen demand (BODS)
 total  suspended  solids  (TSS),  and  PH,  and proposed Best Availabl4

 SS^S°SpiB5T) SS NSPS f°r B°D5 and TSS-  Tn 1981'  the Proposed
 BAT  and NSPS  for BODS and TSS  were withdrawn.
     SUMMARY OF METHODOLOGY
1.4


a?!thi^Ud^' EPVire<*ed its  efforts primarily toward obtaining
all  available  information  on   the  discharge  of  priority  and
hazardous  non-priority  pollutants  from  hospitals.   The  data-
gathering  efforts  and  the subsequent  information  assessments
conducted for this study were divided into eight tasks  which are
discussed in the following sections.             ^asjcs, wnicn are
1.4.1
       REVIEW AND ASSESSMENT
A review  of the existing wastewater data,  compiled for the 1976
Development Document, was performed.   This review indicated that
     ^i    S!fl2«nt  data were available on indirect discharging
              f • dx*ect  discharger data included conventional and
          IiVe4-  1°nam1 P°llutant data, but no priority or hazardous
           data.    To  comply  with Section  3018(b)  of  RCRA,  EPA
initiated  a  sampling  program designed to  characterize hazardous
TSIT;  discharge  by the  industry.  This  study concentrated  on
indirect dischargers because more than  97 percent of the hospitals
are indirect dischargers and little or no  information was available
concerning them.

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1.4.2  SUPPIJ3MENTAL DATA GATHERING

Following  review of  the  existing data  base,  state  regulatory
agencies  were  contacted  to  obtain  more  effluent  data  from
hospitals.   The  American  Hospital  Association  (AHA)  was  then
contacted,  and they  recommended that  the American Society for
Hospital  Engineering  (ASHE),  an  association within the  AHA,  be
contacted.  A meeting with ASHE  was  held in July 1986  to discuss
the  approach  to  information-gathering  and hospital  wastewater
sampling.  The  recommendations received from ASHE were incorporated
into the study.  ASHE recommended other organizations and experts
in  the hospital  engineering  field,  including  the Centers for
Disease Control (CDC)  and the National Institutes for Health (NIH).

A  literature  search  was  performed  to obtain  current  data  on
hospital waste generation and disposal practices.  The generation,
treatment,  and  disposal   of  hazardous  waste  was  emphasized;
specifically,  the characterization of wastewater sources and the
origin of wastewater  contaminants.   The literature used for this
document was obtained from governmental and private  sources.  Data
from the AHA Annual Survey of Hospitals were obtained to describe
the  industry  population, services provided, and  bed size (i.e.,
number of  beds per hospital).

1.4.3   SUPPiLEMENTAL  QUESTIONNAIRE

Due  to the lack of current data describing the hospital  industry
and  in the event  that  further  study of the  hospitals might be
desirable,  a  survey questionnaire was drafted in order to obtain
pertinent information  about the  industry, such  as  the wastes
produced  and how hazardous wastes are handled and disposed of.  An
initial  draft questionnaire  was  submitted to ASHE  for review;
comments were received and incorporated before completing the  final
draft.  However, after review of the information and data presented
in this document and  in consideration of the fact that  additional
study  efforts  will  not  be  required,  the Agency  has  decided not to
send a survey  questionnaire to the hospital industry.

1.4.4   SAMPLING AND  ANALYTICAL  PROGRAM

A sampling program was conducted at  four hospitals to  screen for
toxic  and hazardous  pollutants  in hospital  wastewater.   The
following criteria were developed  to  select  the  hospitals for
sampling:  (1) because  of  the  lack  of  data concerning  indirect
discharges and EPA's  need to comply  with Section 3018(b)  of  RCRA,
the hospitals  should  be indirect dischargers;  and (2)  because the
average  size  of a  U.S. hospital  is  approximately 200 beds, the
sampled  hospitals should be close to this size.    As a result  of
input  from ASHE,  it  was  also decided that at  least  two of the
sampled  hospitals be research and teaching hospitals  since  these
hospitals should represent a  "worst case" situation in  terms  of
both  the  variety  and concentrations  of  toxic  and  hazardous
pollutants.

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 Before  sampling  the hospitals,  site visits  were  performed to
 confirm whether  the criteria established for candidate hospitals
 were met.   Since both hospitals satisfied the criteria, sampling
 episodes  were  conducted  soon  after  the  site visits.    Each
 hospital's  effluent was sampled  for two consecutive  days   The
 parameters analyzed  included all compounds on the EPA  ITD  List of
 Analytes (see Appendix A) .   This list includes organic, inorganic
 and conventional  analytes.   In addition,  pH and temperature were
 recorded every four hours  and settleable solids were  analyzed once
 per day during the sampling episodes.

 The preliminary   data  from  these hospitals  indicated that  the
 worst-case scenario  still  needed to  be represented.  Therefore
 with input from ASHE, two  larger research and teaching hospital^
 were  chosen  for sampling,  because  the   pollutant  variety  and
 hospitals      WSre 6Xpected  to be greater  than   at community


 The effluent samples from the research hospitals were analyzed for
 the same parameters  as the  samples  from the community hospitals.
 However  preliminary results indicated that the research 'hospital
 SnS?S? ??? "?  S19nificantly  different  from  the  community
 hospital effluent.  Results  of the sampling episodes are discussed
 in section  3.5.
1'4-5
        INDUSTRIAL PRQFTLE AND SUBCATEGORIZATION
 The  detailed  information collected  in previous  data  .
 efforts  by EPA and  AHA was the  basis  for the industry MiWJ.Ax«
 Jo ™?*  °n .c°llecjed during the present study has  been compared
 to earlier information to update and revise the industry profile
 and  subcategorization scheme,  as  necessary.

 -1'4*6   WATER USE. SOLIDS  GENERATION. AND WASTE CHARACTERIZATION

 Both the  data base established previously by EPA and the new data
 were reviewed to  update water use and waste characterization  for
 the  industry.     Literature  was  reviewed  (see References)   and
 information  obtained  during  the  data collection  efforts   was
 evaluated (including  the  sampling program and  analytical data
 obtained  from state  and municipal authorities).

 1.4.7   POLLUTANT PARAMETERS


S^*"*1?10*1  data  base Was  uPdated to include information
obtained  from previous industry studies  in addition to the current
data.  To identify  the pollutants of concern, the data base was
5^1™L!:i^Je^CJit°011^lsf^d  freguency of occurrence in the
1.4.8
       ASSESSMENT OF CONTROL AND TREATMENT TECHNOLOGIES

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Both previous and new  waste treatment information on full-scale,
pilot-scale, and laboratory-scale in-plant controls and treatment
systems  was  evaluated.    Literature  on  in-plant controls  and
treatment systems was also collected and reviewed.

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 2.1  SUMMARY
                            SECTION 2.0

                         INDUSTRY PROFILE
 To be  registered as  a hospital,  an institution  must meet  AHA
 requirements.  However, membership  in AHA is not  a prerequisite
 for registration.   According to  the  1986  edition  of the  AHA
 Hospital Statistics, 6,872 hospitals were registered  in the u.s
 i"19f5' Wlth a total of 1,317,630 beds and  staffed by 3,625,000
 full-time personnel.  These statistics compare to the 1975 totals
 of 7,156 hospitals,  1,466,000  beds,  and  3,023,000  full-time
 employees.    Currently,  152 hospitals with  13,639  beds are non-
 registered.   Table 2-1 lists the 1985 distribution of registered
 hospitals by bed size.
     u    the hosPitals  can  be classified as community  hospitals,
 which  are defined as nonfederal, short-term, general and special
 hospitals, excluding hospital units  of institutions with facilities
 and services available  to  the  public.   Non-community  hospitals
 include  federal  hospitals,  long-term hospitals,  hospital units of
 institutions, psychiatric hospitals, hospitals for tuberculosis and
 other respiratory diseases,  chronic disease hospitals, institutions
 for the mentally  retarded, and  alcohol and chemical -dependency
 r33?1^3*  T-here are 5'732  roistered community hospitals compared
 to  1,140 registered non-community hospitals  in the U.S.

 The average  size of community hospitals  increased from  16O to  175
 ?ndSL bftween *975 and 1985.  Community  hospitals with  less than
 100 beds comprise 38 percent of the registered industry population.
 Moderately sized (i.e.,  100 to 399 beds) community hospitals make
 up  another 38 percent,  and  those with  more than 400 beds make  up
 approximately eight percent of the registered industry population!
 Table  2-2  compares the  1975 and 1985  distributions of  community
 hospitals.   There  are  895 community  hospitals  affiliated with
 medical  schools.  Table 2-3  presents  the distribution of these
 hospitals by bed size.  The average size of registered noncommunitv
 hospitals decreased from 441 beds in 1975 to  289  beds in  1985  due
 to  the fact that there are 89  fewer  noncommunity  hospitals in 1985
 than 1975,  as  well  as  the -decreased number  of  long-term care
              diJ»°J and indirect dischargers also changed between
 ™™         n. n 1975f there Were over 7'000 hospitals, of which
approximately 92 percent sent their waste to POTWs.  The remaining
hospitals treated their own waste.  By 1985, the number of indirect
dischargers had  increased to include  approximately  97  percent of
the hospital industry.
                          TABLE 2-1
    DISTRIBUTION OF REGISTERED HOSPITALS BY BED SIZE (1985)

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                          TABUB 2-1




    DISTRIBUTION OF REGISTERED HOSPITAL BY BED SIZE (1985)
Claggj f* f?a tif on f Beds),
6-24
25-49
50-99
100-199
200-299
300-399
400-499
500 or more
No. of Hospitals
267
1,134
1,666
1,618
848
507
301
531
Beds
5,066
42,310
120,854
228,844
206,261
175,773
134,387
404.135
Source:  AHA Hospital Statistics; 1986 Edition; Table  8
                                 8

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                            TABLE 2-2

          DISTRIBUTION OF COMMUNITY HOSPITALS,  1975 TO 1985
  Bed  Size  Category
  ~1d_Census  Div
                       Number of
 Total Community Hospitals

 Bed Size Category

     6-24
    25-49
    50-99
   100-199
   200-299
   300-399
   400-499
 500 or more

 Census Division

 New England
 Middle Atlantic
 South  Atlantic
 North  Central
 South  Central
 Mountain
 Pacific
                        299
                      1,155
                      1,481
                      1,363
                        678
                        378
                        230
                        291
                        265
                        663
                        791
                      1,727
                      1,319
                        356
                        754
                                      5,732
  248
  596
  826
1,669
1,325
  375
  693
                                                  Percent
                                                  hanc
             - 2.4
208
982
1,399
1,407
739
439
239
319
-30.4
-15.0
- 5.5
3.2
9.0
16.1
3.9
9.6
- 6.4
-10.1
  4.4
- 3.4
  0.5
  5.3
- 8.1
Source:
AHA Hospital Statistics; 1986 Edition; Table

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                        TABLE 2-3
                                                          WITH
                                                    itals
Source:  AHA Hospital Statistics: 1986 Edition; Table 8
                                  10

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2.2  STANDARD PROCESSES AND PRACTICES

The main  function  of  a hospital is to provide health care to the
people of a community; its size will depend on the population that
it plans  to serve.   Some hospitals provide  services other than
health care, including research, teaching,  long-term health care,
and nursing home facilities.  In addition,  specialty hospitals deal
with specific types of illnesses,  such as psychiatric disorders,
tuberculosis  and  respiratory  diseases,   alcohol   or  chemical
dependency, and obstetrics.

Regardless of the type of facility, activities are similar in all
hospitals.   Most hospitals are  open  24  hours a day,  365  days a
year, with most  activities continuing around the clock.  A hospital
must be able to  provide  the  necessary support facilities for the
staff, as well as patients and their visitors, including surgical
suites,  patient   rooms,   laboratories,   cafeterias,   laundries,
restrooms, heating and air conditioning  units,  and  other support
systems.  These services all require a reliable water supply.

According to the 1976  Development Document,  hospitals use water at
a rate  of 242  gallons per bed  per day.   (Based on  the  latest
information,  this  figure has  not changed.)    This  water  is
discharged  to  either  the  municipal  sanitary  system  or  the
hospital's  own   treatment system.    Solid waste  generated  in
hospitals can either  be treated on-site  or transported  off-site
for disposal in  a  secured landfill.  The  main  method of on-site
treatment is incineration; the  resulting  ash  is transported to a
secured landfill for final disposal.
                               11

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                           SECTION 3.0
3.0
WASTE CHARACTERIZATION
Wastes generated in hospitals can be classified as either general
(i.e., nonhazardous) or hazardous waste.  Approximately 85 percent
of the  total  hospital wastestream can be  classified as general,
with the remainder classified as hazardous waste (ASHE, 1985).  The
types of hazardous waste generated include chemical, radioactive,
infectious, and physically  hazardous,  or a combination of these.
The primary  sources of wastewater in  hospitals include sanitary
wastewater  and  discharges  from  surgical  rooms,  laboratories,
laundries, X-ray departments, cafeterias, and glassware washing.

In 1976, EPA investigated the need for establishing subcategories
to determine if segments of the hospital  industry existed in which
separate  effluent limitations  and standards  might apply.   EPA
considered  and assessed  the following  factors:  the  size,  age,
location,  and  type of hospital;  the nature  of wastes generated;
and the treatability of wastewater.  EPA  found  that the wastewater
characteristics  of the hospitals studied were very similar and
independent  of  these  factors.    EPA  concluded   in  the  1976
Development  Document  that further  subcategorization  was  not
required to establish effluent limitations guidelines and NSPS for
the hospital industry.  Based on industry sampling,  review of the
1976 document, and literature searches,  no fundamental changes  in
the industry have  occurred  since the 1976 document indicating the
need for  further subcategorization.

3.1  CHEMICAL  WASTE

Chemical wastes generated in hospitals consists of spent solvents,
acidic  and  caustic  solutions,   and  solutions  containing heavy
metals.    Solid chemical  wastes  include organic  and inorganic
compounds and heavy metals.   The amount of chemical hazardous waste
generated by  the  hospital  industry  is  summarized  in  Table 3-1
 (ASHE,  1985).

Most  of the solvents used  by  the hospitals  category are used  at
research and teaching hospitals.  The solvents used most frequently
include alcohols,  xylenes,  formalin (i.e., formaldehyde in ethyl
alcohol),  and toluene.   Alcohols and  xylenes are  used  in the
histology processing  operations  in  both clinical  and research
laboratories.   Formalin  is used  as a preservative in pathology
departments.   Toluene is used in  liquid scintillation and  can  be
radioactive when  used for this  purpose.   Other  solvents that
contribute to the waste load  include  halogenated   solvents used
primarily for degreasing or cleaning equipment, and acetone used
for cleaning glassware.
                                12

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Solutions  containing  heavy  metals  are used  and  produced  in
hospitals.  Spent solution produced in the X-ray developing process
contains  silver.     Certain  medicines,  disinfectants,  mildew
inhibitors, and thermometers contain mercury.  Arsenic is used in
laboratories in chemical reactions and can be used to kill cells.

Solid chemical wastes include both organic and inorganic compounds,
most  of which  are generated  in  laboratories.    These  compounds
include  salts,  precipitates  from  various  chemical  reactions,
metals, and solid chemicals  with expired shelf-lives.

3.2  RADIOACTIVE  WASTE

Nuclear   medicine   is   practiced  in   nearly   every   hospital;
approximately  25  percent of  the total low level radioactive  waste
generated  in  the  U.S.  originates  from clinical  practice  and
biomedical research (Olsen,  1985).   Medical uses  of  radioisotopes
are common and varied (Table 3-2)  (Brill, 1985).

The types  of radioisotopes used will vary  depending on  whether  a
hospital  is affiliated  with research  or specialized in  certain
treatments,  or  is relatively  small and concerned  with  general
health care.   The following radioisotopes  used in hospitals have
low radioactive levels and most have short  half-lives:
      H3
             ,35
      r131
           Co1
             63
       Ga'
      P33
                    87
 Yb
                          169
Cr!
                         .51
 Co0
Xe1
Ca*
                                    Tl
                                                 201
    Mo"
      In
        111
Tc!
             .99
 Low-level wastes  can be  solid,  liquid,  or gaseous  radioactive
 products from a variety of medical processes.  These wastes include
 paper,   absorbed   liquids,   protective   clothing,   contaminated
 plastics, tools,  sealed  sources  (e.g., radium needles), biological
 wastes,  laboratory  animal   carcasses,  scintillation  vials  and
 liquids, needles  and syringes,  and other  contaminated handling
 materials.

 3.3  INFECTIOUS WASTE

 In most hospitals,  10 to  15  percent of  the total waste stream is
 generally classified as  infectious.   However,  depending  on the
 definition used by hospital management,  the contribution may be as
 high as 30 to  40 percent (ASHE,  1980).   Most  infectious waste
 consists of  contaminated  synthetic materials,  such as disposable
 plastic tubing and paper  products.  Opinion varies on what should
 be designated as infectious waste; Table 3-3  summarizes various
 waste types as designated by the EPA,  CDC, and  Joint Commission on
 Accreditation of  Hospitals (JCAH).  The "Other"  category includes
 linens, paper and plastic products, and items that may have been
 in contact with a patient  considered to have an  infectious disease.
                                 14

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                             TABLE 3-2

                USE OF RADIOISOTOPES IN PATIENT CARE
                            1983 AND 1984
Sources
Nuclear Medicine  Imaqina
(B)                     y
Radioinununoassay
(C)
Isotopic Radiation Therapy
      No.  of
_Annual_Procedures

  6,130,000  (A)

 54,800,000  (C)

     61,000  (S)
 No.  Percent
_of_Hospitals_

  3,830  (60.3)

  4,500  (70.9)

  1,390  (21.9)
Si
                                                          "
                              15

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                               TABLE 3-3

                 DESIGNATION OF INFECTIOUS WASTE TYPES
                                                           EPAf3)
Microbiological
Blood and Blood Products
Communicable Disease Isolation
Pathological (including Autopsy)
Items containing Secretions/Excretions
Contaminated Laboratory Wastes
Sharps
Surgical ("Dirty" Cases)
Dialysis Unit
Other
Yes
Yes
Yes
Yes
No
Yes
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
No*
No*
Yes
No*
No*
No*
* EPA regards these waste types as "optional " infectious wastes,
that is, the individual facility should decide whether the waste
in question is infectious.

  (1) Garner, J.S. and Favero,  M.S.  Guideline  for Handwashinq and
      Hospital Environmental Control; Centers  for Disease Control;
      November 1985.

  (2) Personal Communication, March  7, 1989, Nan Bangs (E.G. Jordan
      Co.) Ode Keil (Joint Communication On Accredation of
      Hospitals), referencing  Joint  Commission on Accredation of
      Hospitals, "Managing Hazardous Materials" ; Plant, Technology,
      and Safety Management  Series;  1986.

  (3) US  EPA EPA Guide for  infectious Waste Management; Office
      of Solid Waste and  Emergancy  Response; USEPA  530-SW-86-014;
      May 1986
                                 16

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3.4
PHYSICAT.LY HAZARDOUS MATKRTAT.g

3.5
WASTEWATER

     BOD5.
     COD
     TSS
     TOC
       50 to 400 mg/1
       150 to 800 mg/1
       60 to 200 mg/1
       50 to 300 mg/1

                              17

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                                  I ABLE 3-4

        Hospital  Effluents Compared With Nonindustrial  PUIW intluents
Pollutant

Volatile Organics
  Acetone
  Benzene
  Bromodichloromethane
  Chloroform
  Toluene
  1,1-Dichloroethane

Semi volatile Organics
  Benzoic Acid
  o-Cresol
  Phenol
  alpha-Terpineol
  4-Nitrophenol
 Priority Pollutant Metals
   Cadmium
   Chromium
   Copper
   Lead
   Mercury
   Nickel
   Silver
   Zinc

 Common Ions
   Calcium
   Iron
   Magnesium
   Sodium

 Elements
   Aluminum
   Barium
   Boron
   Manganese
   Molybdenum
   Titanium
                                    Range of
                                    Concentrations
                                    Found in 14
                                    Nonindustrial
                                    POTW Influents*
0-
<
1
5
   33 ppb
  - <5
   38
   283
   - 260 ppb
50
1 - 9 ppb
1 - 159
21 - 330
16 - 194
0.2 - 1.7
4-64
1-45
89 - 806
8-90 ppm
679  - 13,074
1-36
41 - 208
 537  -  6540  ppb
 53  - 395
 136  -  561
 28  - 301
 <35  -  140
 7 -  157
                          Range of
                          Concentrations
                          Found in 4
                          Sampled
                          Hospitals
<50 - L,721 ppb
<10 - 104
<10 - 30
<10 - 24
    - 23
    - 38
                           <10 - 789 ppb
                           <10 - 11
                           <110 - 405
                           <10 - 174
                           <50 - 83
                           <5  - <10  ppb
                           <3  - 140
                           <25 -  105
                           <50 -  <200
                           <0.2 - 4.5
                           <12 -  42
                            2.7 -  140
                            25  -  227
                            7.9 - 204.0 ppm
                            84 - 3,080
                            0.9 - 9.2
                            11 - 240
                            90 - 1670 ppb
                            26 - 1680
                            35 - 207
                            2 - 184
                            <10 - 140
                            10 - <50
                                           18

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                             TABLE 3-4 (Continued)

         Hospital  Effluents  Compared  With Nonindustrial  POTH Influent
Pollutant
Conventional
  BODS
  TSS
  O&G

Nonconventionals
  COD
  TOC
  NH3/N
 Range  of
 Concentrations
 Found  in 14
 Nonindustrial
 POTW Influents*
95 - 329 ppm
85 - 508
13 - 75
183 - 867 ppm
47 - 265
4-24
Range of
Concentrations
Found in 4
Sampled
Hospitals
23 - 340 ppm
170 - 3900
7.5 - 99.0
98 - 1000 ppm
24 - 190
2.2 - 8.1
   The  industrial  contributions  to the 14 POTWs ranged from one to ten percent
   The  median  industrial  contribution was six percent.                 percent,
                                    19

-------
Chemicals may enter the wastewater directly as a result of disposal
in laboratory sinks, as well as  a  result  of accidental spills in
laboratories or chemical storage  areas. The radioisotopes that may
enter wastewater directly as a result  of  patient excretion after
treatment  are not regulated.    Some  isotopes  are  sewered after
dilution  or after they  have decayed  to  a  specified,  allowable
level.  The concentrations of radioisotopes  from these sources are
very  low  and the radioisotopes  generally have  short half-lives.
Disposal  of  radioisotopes  in  this  manner  is  regulated  by  the
Nuclear Regulatory  Commission,  in addition  to  certain state and
local authorities.

Waste considered infectious may also appear in hospital wastewater.
Table 3-3 summarizes various designations of infectious  waste types
by the EPA,  CDC, and JCAH. Some  of the waste listed as infectious
will  be  disposed  of  in  the   hospital  wastewater  because  of
recommendations  by  CDC  or JCAH.    Table 3-5  summarizes  the
recommended disposal methods for  the various infectious  waste types
and sources.

Currently,  no federal regulations govern the disposal of infectious
waste; however, certain local or state regulations do  apply.  The
EPA,  CDC,  and JCAH have each developed guidelines, summarized in
Table 3-5.  Currently, hospital management decides which guidelines
or combination of guidelines to  follow, unless they are regulated
by a  local or state authority.

Specific pollutants may be present  in hospital wastewater in levels
greater  than  expected  from domestic wastewater  (i.e.,   silver,
barium,  sodium,  and acetone).    Figure  3-1  is  a schematic of the
sampling  point locations for all  sampling episodes.  Analytical
data  summaries for  each hospital  sampled are  presented in the
following sections, along with brief descriptions of the hospitals.
To maintain confidentiality, each facility is identified by a  code
letter.
 3.5.1
HOSPITAL A
 This facility,  located in  New England,  is a  325  bed  hospital
 serving the surrounding community.   Water is supplied by  an  on-
 site well  and  is softened  before  use.    The various sources  of
 wastewater at this hospital include  patient rooms,  laboratories,
 the X-ray department,  the cafeteria,  surgical suites,  the cooling
 water system,  and sanitary wastewater.   Laundry is processed off-
 site by  a private  contractor.  On-site waste  treatment at  this
 facility consists of  specific unit operations, depending  on  the
 objective.   These include  grease  traps  in the  cafeteria,  acid
 neutralization tanks in the laboratories,  a plaster  recovery tank
 in the room designated for fitting casts,  and  a  silver recovery
 system in the X-ray department. Sewered wastewater  is treated at
 a municipal treatment plant.  Three raw wastewater samples were
                                 20

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                             TABLE  3-5
             INFECTIOUS WASTE  DISPOSAL METHOD RECOMMENDATIONS
WASTE TYPE OR  SOURCE
                                        CDC
JCAHm
Microbiological                         1,8(1)   1,8
Blood and Blood Products                I,S,W(1) L,W
Communicable Disease Isolation          H(2)     L,W
Pathological (including Autopsy)        1(1)     c,I
Items containing Secretions/Excretions  N(l)     L,W
Contaminated Laboratory Wastes          I,S,G(1) I,S
Sharps                                  N(l)     I,S
Surgical ("Dirty" Cases)                N(l)     l,s
Dialysis Unit                           N(l)     I,S
Other                                   N(l)     N
                                                           D,I,S,T
                                                           D,I,M,S
                                                           I,S
                                                           A,C,I
                                                           IfS
                                                           A,I,S
                                                           I,S
                                                           I,S
                                                           I,S
                                                           A,I,S
Key: A
     c
     D
     G

     H
     I
     L
     M

     N
     S
     T
         steam sterilization with incineration of grinding
         cremation or burial by mortician
         chemical disinfection
         general  hospital  solid waste in puncture-resistant
         packaging
         according to hospital policy
         incineration
         sanitary landfill
         discharge to a sanitary sewer for treatment in municipal
         sewer systems (provided secondary treatment is available)
         not considered infectious waste
         steam sterilization
         thermal inactivation
  (1)  Garner, J.S. and Favero,  M.S.  Guideline  for Handwashina and
       Hospital Environmental Control; Centers for Disease Control;
       November 1985

  (2)  Garner J,S, and Simmons, B.P  "CDC Guidelines for  Isolation
       Precautions in Hospitals",  Infection  Control;  No. 5, pp.
       245-325.

  (3)  Personal Communication,  March 7,  1989,  Nan  Bangs (E.G.
       Jordan Co.) and Ode Keil  (Joint Commission on Accreditation
       of Hospitals),  referencing   Joint Commission  on
Accreditation of Hospitals,  "Managing Hazardous Materials";
 Plant. Technology, and Safety Management Series; 1986

  (4)  USEPA, EPA Guide For Infectious Waste Management;  Office of
       Solid Waste and Emergency Response; USEPA 530-SW-86-014;
       May 1986.
                                21

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           22

-------
 collected from a manhole in the sewer line located in a parking lot
 behind the  hospital.   Results of  sample  analysis for pollutants
 detected at least once are summarized in Table 3-6.  As indicated
 low concentrations of only a few organic pollutants were detected
 in  the raw  wastewater  samples.   Concentrations of metals  and
 conventional pollutants were in the range typical  of nonindustrial
 wastewater.    The hospital  engineer  indicated  that  the  water
 associated with this facility would  have  a  high level  of sodium
 which was evident in the results.                         *wuxum,

 3.5.2   HOSPITAL B

 This facility,  also located in  New England,  is a research  and
 teaching hospital with 232 beds.   Water is  supplied by  the local
 municipality.  Wastewater sources at this hospital include patient
 rooms,  laboratories, the cafeteria, the X-ray department, cooling
 water,  surgical  suites,  and the  sanitary  sewer.    Laundry  is
 processed  off-site  by  a  private  contractor.    The   hospital
 discharged approximately  300,000  gallons per  day  of wastewater
 during  each day of sampling.

 On-site wastewater treatment controls used at this hospital include
 grease  traps in the  kitchen,  limestone neutralization tanks  for
 laboratory wastewater,  and  silver recovery  for the large  X-ray
 facilities.  Sewered wastewater is  treated  off-site at a municipal
 treatment facility.  Two raw wastewater samples were collected from
 a manhole  in the sewer line located in a grassy area along the main
 ?™™anC?  ^ -t0 the hosP±tal-   Tap water samples  were9 SfteiSS
 from a  faucet in  a storage building located  near the manhole used
 for  sampling.
      - 3~J summarizes the results of analysis for samples collected
at this facility.  The only organic compounds detected were acetone
and  chloroform,  in detectable concentrations.  Concentrations of
conventional  pollutants and  metals  (except silver)  were in the
range typical of nonindustrial wastewater.  Silver was detected at
approximately twice the  level  expected in nonindustrial wastewater;
this is probably due to  silver originating in the X-ray department.

3.5.3  HOSPITAL C

This hospital, located in the southeastern U.S.,  is a  research and
™SStS i ?aClll«Y -W±th  456.beds-   Water ^  supplied by the local
municipality.  Ma] or contributors  to the wastestream include the
i™ ratories' cafeteria, X-ray and photography departments, patient
rooms, laundry, surgical suites,  and  sanitary waste.  Average flow
from the hospital  and the research areas is unknown; however,  it
is estimated  that 80 percent originates in the  hospital  and  20
percent in the research buildings.  In-house wastewater treatment
techniques used  at this hospital include  dilution or decay  of
liquid  low-level   radioactive  compounds   (holding)  prior  to
discharge,  in accordance with state and  federal  guidelines.   No
other types of treatment are used prior to discharge to the
                               23

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 municipal sewer  system.  Two  raw samples were  collected from  a
 manhole in the sewer line into which wastewater from the hospital
 and research  areas  flows  before discharge  to  the city  sewer.
 Results of analysis  for samples collected at this  facility  are
 presented in  Table 3-8.   Review of the data shows that  relatively
 low concentrations of eight organic compounds were detected in the
 raw wastewater.   Silver and barium were detected at levels greater
 than typical  nonindustrial wastewater.   This is probably due to
 discharge  from    the   X-ray   and   photography   laboratories.
 Conventional  pollutants  were  detected  in  the  range typical of
 nonindustrial  wastewater.
 3.5.4
HOSPITAL D
This  eastern U.S.  research  and teaching hospital  has 452 beds.
Water  is  supplied  by the  local municipality.   sources  of the
wastewater stream include the  laboratories,  laundry, cafeteria
X-ray and photography departments, patient rooms,  surgical suites'
and  sanitary sewer.   The  average flow  of wastewater- from the
research and hospital areas  is unknown.

In-house  waste treatment  techniques  employed  at  this  hospital
include solvent recovery of  xylene and ethanol, as well as grease
traps located in the cafeteria.   With  solvent recovery, xylene and
ethanol are distilled; the pure product is reused,  while the impure
product is sent to  the  hospital's hazardous waste department for
appropriate disposal.

Raw wastewater samples were  collected from a manhole located next
•  m 5,hosPltal main entrance; the analysis results are summarized
in Table 3-9.  Review of the data show concentrations of only three
organic compounds.   Metals detected were  in the range typical of
nonindustrial wastewater  except for  silver,  which was  found at
greater  levels,  probably  due  to  discharge from the X-ray  and
photography departments.
                               29

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 3.6 POLLUTANTS
 3.6.1  INTRODUCTTON


 The traditional,  priority,  and hazardous non-priority  pollutants
 characterized in Section 3.0 are discussed in this section relativl
 to their occurrence in the  hospital  industry's wastewater.

 3-6.2  TRADITIONAL POLLUTANTS
            requires  the  Administrator   to  establish   effluent
     »   H  ' 9uldelin?s' and standards for traditional pollutants.
 Among  these  conventional  parameters  (i.e.,   BODS,  TSS   fecal

                                                    -'
                                 -                               es
 «h«*«         '  col?r'  ammonia,  radioactivity,  nitrogen,   and
 phosphorus)  were  considered.    BOD5  and TSS  were the parameters

   "tS ** representative of specTXf S3
                               across the industry; data collected
                Campling  program do  not change  this conclusion
 These pollutant parameters were identified in 100 percent of  the

                                                                -I
 3-6.3   PRIORITY POLLUTANTS


 The priority pollutants detected in hospital wastewater as a result
 of the  ITD/RCRA SMBHnr, and Analysis Program are listed 1
3.6.4  HAZARDOUS  NONPRIORITY POLLUTANTS


The   hazardous  nonpriority   pollutants  detected   in   hospital

Pro^rf^ af,-=t.Jef^  °f  the  ITD/RCRA  Sampling and  *OSpltal
•Hio  TTTI  T •! *.+•  -.«   •»   10-           	*"" — — —«.*»»»*.!=. ta.i.t=  J.J.OUGU Oil
tne  ITD  List  of   Analytes;   however,   they   are  not  crioritv

pollutants.    Analytical   results   for   the  detected  hazardous
nonpriority pollutants  are  discussed in  Section 3*6.1.   hazardous


3.6.5  INDUSTRY MASS
ni-3"*-12  presents  raw data  from the  indirect dischargers  by
pollutant group as identified in tables 3-10 and  3-n. "argers  Dy
                W6re  calculated for each  pollutant.   The  first
                                35

-------
                       Table 3-10

               PRIORITY POLLUTANTS DETECTED
Volatile Oraanics

Benzene
Bromodichloromethane
Chloroform
Toluene
1 , i-Dichloromethane

Metals

Chromium
Copper
Lead
Mercury
Nickel
Silver
Zinc
                                         Semivolatile Oraanics

                                         Phenol
                                         4-Nitrophenol
                                         Miscellaneous

                                         Cyanide
Acetone
Pesticides and Herbicides

Dichloran
Etridazone
                         Table 3-11

         HAZARDOUS NONPRIORITY POLLUTANTS DETECTED

     Hie Oraanics                         Semivolatile Orqanics

                                           Alpha-Terpineol
                                           Benzoic acid
                                           o-Cresol
                                           Elements

                                           Aluminum
                                           Barium
                                           Boron
                                           Manganese
                                           Molybdenum
                                           Titanium
                                36

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C) was an average of the detected pollutant concentration excluding
the ND values (or the detection limit).

Three estimated mass loading values were also calculated for each
pollutant  group.    In  each method,  the pollutant  concentration
averages   were   summed  by   compound  group.     The   pollutant
concentration sums were multiplied by the number of operating days
per year (365),  the gallons of wastewater generated per bed (242),
and the total number of beds in the indirect discharging hospital
industry  (1,290,521),  as well  as  a conversion factor  to pounds
discharged per year. The second and third values for mass loading
were calculated in the same manner, except for using Method B and
Method C averages, respectively.

For each pollutant, the percent detected above detection limit is
presented  instead  of  a  percent  occurrence.    This  approach
eliminated counting an ND value as an occurrence.

Table  3-13  summarizes  the hospital industry  mass loadings  by
compound group, based  on data from the four indirect discharging
hospitals  sampled during this study.

3.6.6  DISCUSSION

EPA's hospitals sampling effort included  one community and three
research and teaching hospitals having an  average of 330 beds.  As
discussed  in Section  2,  there  215 direct  and  6,662  indirect
discharging hospitals  in the  United States.   The  Agency sampling
effort  was not  an attempt to characterize  hospital  wastewater
discharges in the  United  States.    Such an  effort would have
required that the Agency sample a much larger number of hospitals
of varying types an sizes.  The purposes of EPA's efforts were to
confirm  what  is  known   about  hospital  operations  and  their
propensity for  generating toxic and  hazardous  pollutants and to
determine  if additional  study is  warranted.   EPA's rationale was
essentially that if either expected pollutants were found at higher
than  expected  levels or  at treatable levels  or  that unexpected
pollutants were  found at  a detectable levels, the  Agency would
conduct additional sampling and study efforts which might include
sending a  survey questionnaire to a  sampling of U.S. hospitals.

In  summary, the  sampling  results confirm  what  is  known about
wastewater generating operations within hospitals.  Essentially no
unexpected pollutants were found despite the fact that the Agency
analyzed  samples  for over 400 toxic and  hazardous  (ITD listed)
pollutants.  The pollutants detected were  found at low levels well
below the wastewater  treatability levels established  for these
pollutants.  Consequently, the Agency does not believe that further
study of  the  hospitals  category  is warranted.    A   complete
discussion of all  of  the  pollutant observations from  the four
hospital study is presented below.
                                40

-------
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The pollutants and associated levels detected in the wastewater of
the  four indirect discharging  hospitals are  for the most  part
typical of nonindustrial wastewater.  However, some pollutants were
detected  at   levels   above  those  expected   for  nonindustrxal
wastewater.    These  pollutants were  silver,  barium,  mercury,
phenols, and acetone.  In addition,  some toxic volatile organics
(solvents)   were  detected  in   a   few   samples.      Finally,
alpha-terpineol and benzoic acid were  detected in a few samples.
The  sources  of silver and barium  in hospital  wastewater are the
x-ray and  other  diagnostic operations  conducted at all hospitals
while the detectable concentrations of mercury probably result from
the  disposing  of  chemical solutions  containing mercury.   Phenols
are  used as  disinfecting  agents in operating  room and other area
cleanup  operations.    Acetone  is  commonly  used   in  hospital
laboratories  to  clean  glassware.    Various   solvents  such  as
chloroform,  benzene or 1,2-dichloroethane may  be used in various
research and other laboratories  in  the course  of routine bench
level analytical procedures.  Alpha-terpineol has been detected in
the  wastewater  of  other  categories  but the  source  of  this
pollutants  has not yet been established.  The sampling results
for  each of  above  pollutants or groups of pollutants  is  discussed
in following paragraphs.

Silver

The  average  concentration  of silver discharged  from  the one
hospital which had an  in-house silver recovery system was 7.8 ug/1
 (three  data points)  while  the average  concentration of silver
discharged from the three hospitals which did not have  in- house
silver  recovery systems  was 69.4 ug/1  (five  data points).   The
former  concentration  is  below the  average silver  concentration
found in the influents of POTWs receiving a less than ten percent
contribution  of  industrial  wastewater   (10 ug/1).    The latter
effluent    concentration    is   well    below    the
precipitation/clarification treatability level  (about 1000  ug/1)
 for silver.   An average  indirect  hospital with  192 beds would be
expected to  discharge 0.01  Ibs  per  day of  silver  to its  POTW
assuming it did not  have a silver recovery system  in-place,  and
 0.09 Ibs  per  day of  silver if it did.   The  total  discharge of
 silver from all indirect  hospitals is estimated to be 600  Ibs per
 day assuming no silver recovery systems are in-place and  67 Ibs per
 day assuming all  indirect  hospitals have silver recovery systems
 in-place.

 EPA projects  that the  average direct  discharger hospital  with
 activated sludge  or  aerated lagoon type of biological  treatment
 in-place would remove up to 96 percent of the silver generated by
 its x-ray  and photographic  development  operations  (see the  EPA
 treatability  manual.  Vol.Ill  section  3.2.1)    Although  many
 hospitals have trickling filters  rather  than  activated sludge or
 aerated lagoon  systems,  and data on  silver removal  by trickling
 filters  is  not  available,  EPA  expects that  silver removal  by
 trickling filters would be similar to that exhibited by activated

                                 42

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and  aerated lagoon systems since  the  primary removal mechanism,
adsorption  onto biomass,  should also  be  operative for trickling
filters as  well.

In summary/ neither the amount of  silver discharged by individual
hospitals (direct or indirect) with or  without silver  recovery nor
the total amount of silver expected to  be discharged by direct and
indirect hospitals is  significant.  Therefore, the Agency is not
considering technology based  national  regulations  for silver.

Phenols  Phenol was detected twice  in the raw waste of  one hospital
at   an   average  concentration  of  216   ug/1.     In  addition,
4-nitrophenol was found once  in the raw waste  of another hospital
at a concentration of  83  ug/1,  and o-cresol was detected once in
the raw waste of one hospital at a concentration of 11 ug/1.  All
three  pollutants  appear  to  be readily  biodegradable  (see EPA
Treatability Manual, Vol.  Ill sections 3.2.1 and 3.2.2 )  and, as
a result, similar concentrations in the influent  of hospitals with
biological  treatment  should  be  reduced to  nondetect levels and
would result in de minimus discharges  of  these pollutants to the
nation's surface waters from direct discharging hospitals.  Neither
the concentration levels nor the frequency  of occurrence of phenol
and  4-nitrophenol  suggest that their  discharge  by the hospitals
category would  cause pass-through  or interference problems at the
nation's POTWs.   Consequently,  the Agency  does  not  believe that
controls on the discharge of these pollutants  are warranted.

Barium

Barium was  detected  in all eight  raw  waste samples  taken at all
four sampled hospitals at an average  concentration  of 321 ug/1.
The average concentration  of  barium detected in the  influents of
nonindustrial POTWs (see Table 3-13) was 138 ug/1. While the Agency
expects barium to be found in the wastewater of the vast majority
of hospital dischargers,  direct and indirect, the concentration
levels are not expected to be  significant.   Only one sample showed
barium  at  a  concentration  higher than   1  ppm  (1620  ug/1)).
Generally,  barium  concentrations  in the  wastewater  of  a  given
hospital will vary depending on the number of diagnostic procedures
being conducted.

The  Agency  expects  that  the barium  concentration  in  the  raw
wastewater of direct discharger hospitals will be reduced greatly
as the  result  of adsorption  onto  the  biomass in  the biological
systems in-place.  Similarly,  the barium that hospitals discharge
to POTWs will  accumulate in  POTW  sludges.   Assuming all  of the
barium discharged  by  the average  direct hospital  accumulates in
the average  POTWs sludge, then the average hospital will contribute
0.12 Ib/day  of barium to its POTW's sludge.   This amount should not
cause sludge disposal problems.
                               43

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Acetone

Acetone, a hazardous nonpriority pollutant was detected in the raw
waste of  three hospitals  in  five o*.  six  samples at  an average
concentration of 1,001 ug/1.  Acetone is a water soluble, extremely
volatile, but biodegradable pollutant and,  as a result, should be
both volatilized and  biodegraded to  a considerable extent in the
biological systems  of direct  dischargers such  that discharges of
acetone to the nation's surface waters from hospital should be de
minimus and not of  concern.   While the projected daily discharge
of acetone from  the nation's 6,667 hospitals  is  projected to be
about 2573 Ibs/day based on an average discharge concentration of
1 ppm, this acetone loading  is  not significant because the total
discharge would be spread out evenly  among the nation's POTWs such
that the  average daily loading  of acetone  is about  0.5 Ibs per
POTW.  The Agency does expect small  amounts of  air emissions of
acetone at POTWs without secondary treatment which  receive hospital
wastes, however.   Nonetheless, the Agency does not  believe that the
projected loadings of acetone  from hospitals will cause either pass
through or interference problems at the nations' POTWs.

Mercury    was detected  in  four  of eight  samples  in  the  raw
wastewater of  three hospitals at an average concentration of 1.5
ug/1 or only  slightly above  influent.  The average concentration
of mercury observed at nonindustrial POTWs which is 0.6 ug/1.  This
average level  is  significantly  below any categorical average and
well below any reasonable wastewater treatability level (See EPA
Treatability Manual,  Vol.Ill  sections 3.1.1 through 3.1.5 ).  As
a result, mercury discharges  from hospitals are not of concern.

Other Pollutants Detected

In  addition  to  the  above   pollutants,  various other organic
pollutants were detected at least once albeit at low concentrations
in the  raw wastewater of hospitals. Chloroform  was  detected in
three samples  at  two hospitals  at an average concentration of 18
ug/1.  Benzene was  found  in two  samples collected  at one hospital
at   an  average   concentration  of   98   ug/1.      Toluene  and
bromodichloromethane  were found in one sample  at one hospital at
concentrations of 23 and 38  ug/1, respectively.   In addition to
these  observations,  certain  other  low level  concentrations of
alpha-terpineol and benzoic acid were found  in  samples of hospital
wastewater.  However, the analytical veracity of these observations
is suspect.
                                44

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                            SECTION 4.0



                TREATMENT AMQ DISPQSAT.
 4.1  CHEMICAT.

                                      route  for
4-2  RADIOACTIVE
4'2'1
        SEPARATTQN AND

                                45

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                  I HAZARDOUS WASTES GENERATED
                  	—
                      i
INVENTORY
DISPOSAL
                UNCLAIMED
                               EXCHANGE
                                               USABLE
                                RESIDUE
                     NON-HAZARDOUS WASTE
  HAZARDOUS WASTE
                i
                               TREATMENT:
                                NEUTRALIZATION
                                PRECIPITATION
                                EVAPORATION
                                DISTILLATION
         DISPOSAL OFF-SITE
                 BY
        LICENSED CONTRACTOR
        • ERA-APPROVED LANDFILL
        • EPA-APPROVEO
           INCINERATOR
               DISPOSAL ON-SITE
               SANITARY SEWER
               FUEL SUPPLEMENT
               SOLID WASTE LANDFILL
               INCINERATOR
                                     46

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                            TABLE 4-1




                     RADIOISOTOPIC HALF-LIVES
RADIOISOTOPE
H3
C14
P32
S35
Ca45
Cr51
Co57
Co60
Ga67
Mo"
Tc"m
In111
•j-123
I125
•j-131
Xe133
Yb188
Tl201
* Source: Robert C. Weast, Editor.
and Phvsics; 6 3RD Edition; CRC Press,
HALF-LIFE fDAYS)*
4.5 X 103
2 X 106
1.43 X 101
8.71 x 101
1.65 X 102
2.78 X 101
2.7 X 102
1.9 X 103
3.25 X 10°
2.78 X 10°
2.5 X 10°
2.81 x 10°
5.54 X 10'1
6 X 101
8 X 10°
5.27 X 10°
3.2 X 101
3.04 X 10°
CRC Handbook of Chemistry
Inc.; Boca Raton. Florida:
pp. B-256-339; 1982.Table 4-1
                                47

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Restricting the quantity of radioactive materials and handling of
these fluids  are important standard operating  procedures (ASHE,
1985).  The most widely practiced waste management technique for
radioactive solids  is storing  for decay and then  packaging for
disposal for disposal at a designated land-burial site in a remote
location with controlled access (Hendee, 1986).

To ensure the safety and integrity of  the on-site decay area and
storage process,  it is essential  that  radioactive substances be
monitored and controlled at all times.   These monitoring procedures
should  be recorded  and should reflect the  results  of periodic
surveys of the hospital storage area.

4.2.2  DILUTION AND  DISPERSION

Dilution and dispersion techniques are appropriate for most liquids
and  gaseous  radioactive  hospital  wastes.    Allowable  discharge
concentrations  to the  sanitary sewer  and  air are  given in the
maximum permissible concentration (MFC)  tables of Chapter 10 of the
Code of Federal  Regulations  (CFR) Part 20  (see Appendix B).  The
regulations allow for an average of the discharge  concentrations
over  a specific  time period;  many institutions  have  chosen to
discharge at the MPC to avoid any questions about the concentration
at any point beyond the institution's  control.  In essentially all
regions, measurements must be taken at exit points to verify  these
calculations  (St. Germain, 1986).

Some  institutions choose  not  to  discharge radioactive materials
into  the sanitary  sewer, except for  patient  excreta,  which is
currently exempt from regulation as radioactive waste.   However,
some institutions store the urine from patients who had  been  given
large amounts of Iodine-131 before discharging  it  to the  sanitary
sewer  (St.  Germain,  1986).

The  objective  of these  waste  disposal techniques  is  to reduce
concentrations of radioactive materials to background levels before
they enter  the sanitary  sewer  system  or are discharged  into the
atmosphere  (ASHE, 1985).

4.3   INFECTIOUS WASTE

The  disposal  of  infectious  waste currently  is  not  federally
regulated.   Recommended  disposal methods have been developed by
the  EPA,  CDC,  and  JCAH  (see Table 3-5)  (ASHE, 1985) .    The most
common method of treatment  and disposal is  steam sterilization,
followed  by incineration and  landfill disposal and sewering for
certain liquids.

4.3.1  STEAM STERILIZATION

Steam sterilization is used to treat  infectious  waste  and  render
 it noninfectious by killing any pathogens present in the  waste
material.   Before being  placed in the  steam sterilizer,  waste  is

                                48

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 Trill -»--iY««fr  4.      w«t neaa  (e.g., 15  minutes at  121 C r25O°Fi^
procedure,  the waste is sent to a saniJarTlfndmi rordlsposal?
                                 49

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                         TABLE 4-2

                   STEAM STERILIZATION
Tempe
 48
 245
 250
 257
 270
 280
                  116
                  118
                  121
                  125
                  132
                  138
Minutes

    30
    18
    12
     8
     2
     0.8
John  Hopkins  university,
Baltimore, Maryland; 1981
                                   .
                                  Hygiene  and Publxc  Health,
                              50

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 4•3•2   Incineration
 With  incineration,  the waste  is combusted, producing  oases and
 tKouSh 5T aSh'.   T^ Pr°duct gases are  vented to t^e3 atmosphere
 through the incinerator stack,  while the  residue from incineration
 aLant™ 10?S- **?**  I* di^osed of ^ a sanitary landfill   Th2
 advantage of incineration is that it greatly reduces the mass and
 volume of the waste  (often by more than 95 percent) thich  in tu?n
 substantially reduces transport and disposal costs              '
       F'       f ither be  located on-site at the hospital where
 the infectious waste  is  generated or at some  off-sitf location
 Any incinerator can be used  to treat  infectious  waste if

                                  pathogens  and
 Traditionally,   pathological  incinerators  have  been   used  to

 wastr^ML?^09^"-1 Wa£*e'.as wel1 - other types of" infectious
 rela?iv.!v  «=™ athological incinerators are multi- chambered with
 relatively  small  capacities;   they  provide  high   c
 temperatures and  can be operated intermittently.  Because
 design and operating characteristics, pathological

         ate                                   "
                                *
                .i          mode  of operation  is suitable  for
             ^   °ther tyF6S  °f infectious waste  because  a  single
           seldom  generates   quantities  large   enouah   for-   »
continuous-feed  incinerator.   \ost large hosp ita^^ an d medica?
centers have  pathological  incinerators on the premises ;  tKycai
?fc?litfes  Und ^  Small6r ^^^als, as well Pas large  reseat


A rotary kiln is much larger than a pathological  incinerator  and
is therefore usually found  in an industrial setting   A rotarv'kiJn
provides a controlled environment which, coupled with ^rot^tio^
SS1^^" comPlete combustion of the 'waste.  The T rotar? k?ln Is
the traditional type of incinerator used to treat many Smes of
hazardous waste.  Rotary kilns are  also being used in
                        .           problems may be assoiae
                    °f  nteCti°US Waste'  ^r example, infectious

                                                  Because a large
                               51

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amount  of  infectious
                        waste  consists  of  plastics  and  mo 1st


 ends    decrease.   If this occurs, the inf ectious ^erxal  wxll

SS                 SrSe                    JK.1 &SS  to
esla^isS standard operating procedures and monitor performance  on
a regular basis to ensure proper  incineration.

4.3.3  Liquid Disposal  in Sewer
a^well  as excretion from infected patients or animals.

4.4   PHVSICALLV HAZARDOUS WASTE
 ail needles  and syringes  SIKJUJ.U *^«= j. «-*««..•.•>-»-  	  	
 disposal by incineration or in a landfill; this can be achieved by
 grinding or compacting after treatment.









 damage to  incinerators  and personnel.

 4.5 WASTEWATER

 4  5.1  Pretreatment Technologies






 disposal of hazardous substances according to RCRA.

 4.5.1.1   silver Recovery

                                  52

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Silver recovery is used by x-ray departments to recover silver from
the spent fixer solution produced when developing x-ray film.  Only
about one-third of the silver remains on the film to form an image;
the  balance  is washed  into the  fixer  solution  (ASHE,  1980).
Although the primary reason for silver recovery is an economic one,
local water  quality regulations may require  hospitals  to reduce
concentrations of silver in their wastewater.  Metallic replacement
and  electrolytic plating  are the  most  common methods  used  to
recover silver.

Silver recovery by metallic replacement involves a chemical process
to obtain silver  from the spent  fixer  solution.  The spent fixer
solution  is  brought  into contact  with a more chemically active
metal, such as iron.   The reaction results in the more active metal
going into solution and the silver precipitating out for recovery
(ASHE, 1980).   Cartridges containing  the more  active  metal are
installed  in or  near the  x-ray  department.   The spent  fixer
solution  flows  through the  inlet of the  cartridge,  and comes  in
contact with the metal.   The fixer solution then flows'out of the
cartridge to  a drain.  The  silver precipitate  is collected and
sold.  This method can recover 95 percent  or more of the available
silver.  Efficiency decreases significantly when the cartridge is
near exhaustion or used infrequently.   A summary of the advantages
and  disadvantages of this methodology compared  to  other silver
recovery systems follows (ASHE,  1980).

Advantages

o    Low initial cost
o    Ease of installation and disconnection
o    No energy requirement
o    Low maintenance
o    High theoretical recovery efficiency
o    Usable with wash water

Disadvantages
o

o

o
o
     Units must be  replaced every 90 days;  therefore,  lifetime
     costs are high.
     Careful  monitoring is  required to avoid exhaustion, plugging,
     or channeling.
     Shipping and refining costs are high.
     The possible dollar return  may  be  low  because of  the high
     costs.
o    Spent fixer solution cannot be reused.

Silver recovery by electrolytic plating uses an electrical charge
to obtain the silver.   A controlled  direct  electrical  current is
passed between two electrodes,  charging one positively  (anode) and
one negatively  (cathode).   Because the silver ions  in the spent
fixer solution carry a positive charge,  they are attracted to the
stainless steel  cathode and build up into a  layer.   Silver is
plated on the cathode at a  rate determined by the recovery current
                               53

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(8 amps = 1 troy ounce in 1 hour) (ASHE, 1980).

A summary of the advantages and disadvantages of this methodology
compared to other silver recovery systems follows (ASHE, 1980).

Advantages

o    High purity of silver
o    Low shipping and refining costs
o    Extended life of equipment
o    Reusable fixer solution in recirculating systems
o    Constant efficiency of operating properly

Disadvantages

o    Higher capital expenditure*
o    Increased maintenance and downtime because of complexity*
o    Lower theoretical efficiency*
o    More complex installation*
o    Electrical energy required

*    As compared to metallic replacement only

4.5.1.2   Solvent Recycling and Reclamation

Hospitals  use many  different  types  of solvents throughout  the
facility.  Any  solvent  remaining after use (i.e.,  spent solvent)
is considered a hazardous waste.  Because of federal regulations,
these solvents  must  be tracked from  "cradle  to grave" to ensure
proper disposal of hazardous waste materials.  To accomplish this,
many hospitals  have  established collection programs  to contain
these hazardous wastes for documentation and disposal.

Some hospitals  use large quantities  of specific solvents (e.g.,
alcohols, xylenes) that  can be reclaimed after  use.  Reclamation
or recycling  of spent solvents,  often  by  an outside contractor,
reduces the amount of hazardous waste produced and the solvent to
be purchased.

Reclamation.can also be performed "in-house" if enough solvent is
recycled to render the purchase of equipment economically feasible.
In-house reclamation 'is accomplished by distillation of the spent
solvent.  Most hospitals use this technology to  reclaim xylene and
ethanol.

Xylene and ethanol are used primarily in the histology laboratories
to  prepare tissues  and slides.    During  this  preparation,  the
solvent becomes contaminated with various dyes.   The spent xylene
or  ethanol can be distilled,  which  provides  a  relatively  pure
(i.e., 90 to 95  percent)  solvent that can be reused.  The remaining
amount  of  contaminated  solvent must be contained and disposed of
as a hazardous waste.
                                54

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Most  hospitals have a plan  designed  to meet RCRA regulations to
collect and package hazardous wastes before transport to a disposal
site.  These plans require documentation of the type  and amount of
hazardous waste produced and a system for tracking these wastes to
the  final  disposal site.  The  hospitals are responsible for the
proper packaging,  transporting,  and disposing of their  hazardous
waste.  Most hospitals hire  a contractor to  transport  and dispose
of  the  waste,  who  documents  the  disposal  locations  for the
hospital's records.

4.5.2   Biological Treatment

Most hospitals are located in areas of high population  density and
97  percent discharge to  municipal treatment  systems.   However,
approximately  215 hospitals  treat their own  wastewater and are
direct  dischargers.    The   most   common biological  wastewater
treatment system for these hospitals is the trickling  filter;  other
systems include activated sludge and aerated lagoons.

4.5.2.1   Trickling Filters

A trickling filter is a biological waste treatment process in  which
a  fixed  microbial population is  used to biodegrade the organic
components of wastewater.  The physical unit consists  of a suitable
structure  packed with an inert medium  (usually rock,  wood,  or
plastic) on which  a  biological  mass is grown.   The wastewater is
distributed over the upper  surface of  the  medium;  as  it  flows
through the medium covered with biological slime, both  dissolved
and  suspended organic  matter are removed  by adsorption.   The
adsorbed matter  is oxidized  by  the organisms in the slime during
their  metabolic  processes.   Air  flows through  the  filter  by
convection, thereby providing the oxygen needed to maintain aerobic
conditions.

As  the microorganisms  grow, the  thickness of  the slime   layer
increases.  Periodically, the slime breaks off the medium and is
replaced with  new growth.   This  phenomenon of  losing the  slime
layer, called  sloughing,  is  primarily a  function  of the organic
and hydraulic loadings on the filter.  The effluent from the filter
is  usually passed  to  a  clarifier  to  settle  and remove the
agglomerated solids.

Wastewater is applied to  the  filter by either a fixed-spray nozzle
system or a rotating distribution system.  Fixed-spray nozzles are
used less frequently  than rotary distributors  because  the latter
have greater reliability and  ease of maintenance.  The rotary units
consist of two or more distributor arms mounted on a pivot in the
center of the  filter.  As a  result of the dynamic action of the
incoming wastestream, the arms rotate  and the  nozzles  distribute
the wastewater.  Most filter processes incorporate recirculation
of the treated effluent to provide uniform hydraulic loading and
dilute high-strength wastewater.
                               55

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The main advantages of trickling  filters are simplicity, low power
and operating  costs,  and ease of operation and maintenance.   In
addition, because of its inherent stability, a trickling filter is
not easily upset by  shock loads  or  sudden variations in influent
volume.

Limitations  include vulnerability  to climatic  changes and  low
temperatures.  Recirculation may  be  restricted during cold weather
as  a result  of  cooling  effects;  flies  and  odors  are  common
problems; and wastewater containing  high concentrations of soluble
organics is less effectively treated.  Also, trickling filters have
limited flexibility and control compared to other processes.
4.5.2.2
Activated Sludge
The  activated  sludge process  is  a  biological treatment  used
primarily to remove organic material from wastewater.  This process
is   characterized by the  suspension  of aerobic and facilitative
microorganisms,  maintained in a relatively  homogeneous state by
either mixing or the turbulence induced by aeration.  These
microorganisms oxidize soluble organics and agglomerate colloidal
and  particulate solids  in the  presence of  dissolved molecular
oxygen.  If needed, the process can be preceded by sedimentation
to  remove  larger  and heavier solid  particles.  The  mixture of
microorganisms,  agglomerated  particles, and wastewater  (referred
to as mixed liquor) is aerated in an aeration basin.  The aeration
step  is  followed by  sedimentation  to separate biological sludge
from treated wastewater.   The major portion of  the microorganisms
and  solids removed by sedimentation  is recycled to the aeration
basin to be recombined with incoming wastewater.  The excess, which
constitutes the  waste  sludge,   is  sent  to  sludge  disposal
facilities.

The activated sludge biomass consists  of bacteria, fungi, protozoa,
rotifers,  and  other higher forms of  life.  The  bacteria comprise
the  most  important  group of  microorganisms  because  they  are
responsible for  stabilization of the  organic  matter and formation
of the biological  floe.  The function of the biomass is to convert
soluble  organic compounds to cellular material.  This  conversion
consists   of  transfer  of organic  matter  (also referred  to as
substrate  or  food) through  the cell  wall  into  the  cytoplasm,
oxidation  of substrate to produce energy, and synthesis of protein
and  other cellular components  form  the  substrate.   Some of  the
cellular material undergoes auto-oxidation  (i.e.,  self-oxidation
or  endogenous respiration) in  the  aeration basin; the  remainder
forms new  growth  or excess sludge.    In addition  to the  direct
removal  of dissolved organics by biosorption, the biomass can also
remove  suspended and colloidal matter.   The suspended matter is
removed  by  enmeshment  in the biological  floe.   The  colloidal
material is removed by physiochemical adsorption on the biological
floe.  Volatile compounds may be driven off,  to a certain extent,
in  the aeration process.  Metals are also partially  removed,  and
accumulate in the sludge.

                                56

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  food-to-microorganism (F/M)  ratio-  that is 9 1-t  ^fcribed  as the
                              sohe



























4-5'2.3  Aerated Lagoons
                               57

-------
sufficient land is available at reasonable cost.


	    	 ^-^j:	«+. 4-ir^oc of laaoons can be group*
The many different types of
classes, based on the nature of

Aerobic Alaae Laaoons




algal  photosynthesis  are the  J^f^^^^eatinl soluble





Anaerobic I^aaoons



                                                    IPI
  vanultative !Laaoons



           of soluble organic by-
                                          the


                                        proaucing carbon dioxide
  and methane.
                                58

-------
Aerated  Lagoons

Aerated  lagoons  are medium depth basins  (i.e.,  8 to 15 feet)  in
which  oxygenation  is  accomplished  by  mechanical  or diffused
aeration units and from induces surface aeration.  Surface aerators
may   be   either  high-speed,   small -diameter,   or   low-speed
large-diameter impeller devices, either fixed-mounted on piers  or
float-mounted on pontoons.  Diffused aerators may be  plastic pipe
with regularly spaced holes, static mixers, helical diff users   or
other types. Aerated lagoons can be either aerobic or  facultative
Aerobic ponds are designed to maintain complete  mixing.   Thus, all
solids are in suspension; separate sludge settling and  disposal
facilities are required to separate the solids from the treated
The major  advantages  of treatment lagoons are  that they (1) can
w??£ x? ~Mlderable variations in organic and  hydraulic loading
with little adverse effect on effluent quality;  (2) require minimum

control and thus can be operated by relatively unskilled operators;
J7' .  *?Ye  low  operation  and  maintenance  costs.     The  major
limitations are  (1) the large land area  required;  (2)  localized
              that "?y. °C?Ur When Conditions become anaerobic  (more
                        iGing occurs>'- (3) excessive accumulation
                         Cells in  the  effluent, which  creates  a
                    suspended solids load in the receiving water;
                                                              and
                               59

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AHA
ASHE
BAT
BOD
BPT
CDC
CFR
COD
CWA
DO
DSE
DSS
EPA
HSWA
ITD
JCAH
MLSS
MFC
ND
NIH
NRDC
NSPS
POTW
psig
RCRA
 SRT
 TOC
 TSS
            GLOSSARY OF ACRONYMS

American Hospital Association
American Society for Hospital Engineering
Best Available Technology
Biochemical Oxygen Demand
Best Practicable Technology
Centers for Disease Control
Code of Federal Regulations
Chemical Oxygen Demand
Clean Water Act
Dissolved Oxygen
Domestic Sewage Exclusion
Domestic Sewage Study
U.S. Environmental Protection Agency
Hazardous and Solid Waste Amendments
Industrial Technology Division
Joint Commission  on Accreditation  of Hospitals
Mixed Liquor Suspended  Solids
Maximum Permissible Concentration
Not Detected
National  Institutes for Health
Natural Resources Defense  Council
New Source  Performance  Standards
Publicly  Owned Treatment Works
pounds  per  square inch  gauge
Resource  Conservation and  Recovery Act
 Sludge  Retention Time
 Total Organic Carbon
 Total Suspended Solids
                                 60

-------
                            REFERENCES

 American Society for Hospital Engineering.  "Revised Hospital Waste
 Management",  Technical   Document  Series  Number  055864;  John
           May'     ^ Management Consultant;  ABAX,  Inc.; Bayside,
                   f°r  HosPital  Engineering.   "Silver Recovery for
              study conducted by  Michael O.  Brinkman,  President;
 Hospital Maintenance Consultants; Catalog No. 1300; 1980.

 Barbeito,  M.S.   and  G.G.  Gremillion.   "Microbiological  Safety
 Evaluation   of   an   Industrial   Refuse   Incinerator";   Applied
 Microbiology; 16(2) :291-295; February 1968.               Applied


              R" M>D*  e^' a1''  "DisP°sal of Low-level Radioactive
 Nvembr l0  AmeriCan Medical Association; 254(17) ;2449-51;
      K-i       o      °n Autoclave  Bags";  American Society  for
 Microbiology (ASM)  News; 44(6);283; June 1978.

 Everall  P.H. and C.A. Morris.   "Failure  to Sterilize  in Plastic
 Bags";  Journal of Clinical Pathology; 29 (12) ;1132; December 1976.


 Hendee,  William R.   "Disposal of Low-level  Radioactive  Wastes";
 igse113" ^  NU°lear Medicine' Volume XVI, No. 3; pp. 184-186; July


 Karle,  D.A.    "Sterilization  of  Laboratory Biological  Wastes" •
Litsley,  B.Y.   "Microbiology of Sterilization"; Official  Journal
Olsen, John, M.D.  "Nuclear Medicine: How Medicine is Handling its
Own Hazardous Wastes"; Ohio State Medical Journal;  81(3) : 175-  182;
March 1985.

Perkins, J.J.  Principles and Methods  of sterilization in Health
                    ion,.  Chanes  c.  Ihonas,   Inc.;   Springfield,
Rubbo,  S.D.  and  J.F.  Gardner.   A  Review of  Sterilization and
Disinfection; Lloyd-Luke Ltd.  (medical books); London; 1965. -
«                        .' and F'A- Sarubbi*  ^.  "Decontamination
of Laboratory Microbiological Wastes by Sterilization" /Applied and

Environmental Microbiology; 43 (6) :1311-1316; June 1982.

                                61

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St.  Germain,  Jean.     "Institutional  Storage  and  Disposal  of
Radioactive Materials"; Seminars in Nuclear Medicine; Volume XVI,
No   3-  PP.  187-190; July  1986.   United  States  Pharmaceutical
Convention, Inc. "Sterilization"  in the United States Pharmacopeia;
19th Revision; Rockville, Maryland; pp. 709-714; 1975.
                                 62

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     APPENDIX A




ITD LIST OF ANALYTES
         63

-------
                            TABLE A-l
                   LIST OF ANALYTES MONITORED
Volatile Organic Compounds

1,1,1,2-Tetrachloroethane
1,1,1-Trichloroethane
1,1,2,2-Tetrachloroethane
1,1,2-Trichloroethane
1,1-Dichloroethane
1,l-Dichloroethene
1,2,3-Trichloropropane
1,2-Dibromoethane
1,2-Dichloroethane
1,2-Dichloropropane
1,3-Dichloropropane
1,3-Dichloropropylene
1,3-Dichloro-2-propanol
1,4-Dioxane
l-Bromo-2-chlorobenzene
l-Bromo-3-chlorobenzene
2-Butenal
2-Chloroethyl vinyl ether
2-Hexanone
2-Picoline
3-Chloropropene
4-Methyl-2-pentanone
Acetone
Acrolein
Acrylonitrile
Allyl alcohol
Benzene
Br onto form
Bromodichloromethane
Bromomethane
Carbon disulfide
Carbon tetrachloride
Chioroben z ene
Chloroethane
Chloroform
Chloromethane
Chloroprene
Cis-1,3-dichloropropene
Dibromochloromethane
Dibromo chloropropane
Dibromomethane
Dichlorofluoromethane
Diethyl  ether
Dimethyl sulfone
Ethyl benzene
Ethyl cyanide
Volatile Organic Compounds

Methyl ethyl ketone
Methyl iodide
Methyl methacrylate
Methylene chloride
N,N-dimethy1formamide
Tetrachloroethene
Toluene
Trans-1,2-dichloroethene
Trans-1,3-dichloropropene
Trans-1,4-dichloro-2-butene
Trichloroethene
Trichlorofluoromethane
Vinyl acetate
Vinyl chloride

Semivolatile Organic Compounds

1,2,3-Trichlorobenz ene
1,2,3-Trimethoxybenzene
1,2,4,5-Tetrachlorobenzene
1,2,4-Trichlorobenzene
1,2-Dichlorobenzene
1,2-Diphenylhydrazine
1,3,5-Trithiane
1,3-Dichlorobenzene
1,3-Dichloro-2-propanol
1,4-Dichlorobenzene
1,4-Dinitrobenzene
1,4-Naphthoquinone
1-5-Naphthalenediamine
l-Chloro-3-nitrobenzene
1-Methylfluorene
1-Methylphenanthrene
1-Methylphenanthrene
1-Naphthylamine
1-Phenylnaphthalene
2,3,4,6-Tetrachlorophenol
2,3,6-Trichlorophenol
2,3-Benzofluorene
2,3-Dichloroaniline
2,3-Dichloronitrobenzene
2,4,5-Trichlorophenol
2,4,5-Trimethylaniline
2,4,6-Trichlorophenol
2,4-Diaminotoluene
2,4-Dichlorophenol
                                64

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                   Table A-l (continued
 Ethyl methacrylate
 Isobutyl alcohol
 Methacrylonitrile
  2,4-Dinitrophenol
  2,4-Dinitrotoluene
2,6-Di-tert-butyl-p-benzoquinone
 Semivolatile Organic Compounds
 2-Chloronaphthalene
 2-Chlorophenol
 2-Isopropylnaphthalene
 2-Methylbenzothioazole
 2-Methylnaphthalene
 2-Naphthylamine
 2-Nitroaniline
 2-Nitrophenol
 2-Phenylnaphthalene
 2-(Methylthio)benzothiazole
 3,3-Dichlorobenzidine
 3,3-Dimethoxybenzidine
 3,6-Dimethylphenanthrene
 3-Methylcholanthrene
 3-Nitroaniline
 4,4-Methylene bis(2-chloroaniline)
 4,5-Methylene phenanthrene
 4-Aminobiphenyl
 4-Bromophenyl phenyl ether
 4-Chlorophenyl phenyl  ether
 4-Chloro-2-nitroaniline
 4-Chloro-3-methylphenol
 4-Nitrobiphenyl
 4-Nitrophenol
 5-Chloro-o-toluidine
 5-Nitro-o-toluidine
 7,12-Dimehtylbenz(a)anthracene
Acenaphthene
Acenaphthylene
Acetophenone
Alpha-terpineol
Aniline
Anthracene
Aramite
Benzanthrone
Benzidine
Benzoic acid
Benzo(a)anthracene
Benzo(a)pyrene
Benzo(b)fluoranthene
Benzo(ghi)perylene
Benzo(k)fluoranthene
Benzyl alcohol
       Semivolatile Organic
       Compounds

       Carbazole
       Chloroacetonitrile
       Chyrsene
       Dibenzothiophene
       Dibenzo(a,h)anthracene
       Dichloran
       Diethyl phthalate
       Dimethyl phthalate
       Dinitrocresol
       Diphenyl ether
       Diphenyl sulfide
       Diphenylamine
       Di-n-butyl  phthalate
       Di-n-octyl  phthalate
       Di-n-propylnitrosamine
       Erythritol  anhydride
       Ethylenethiourea
       Ethylmethane  sulfonate
       Fluoranthene
       Fluorene
       Hexachlorobenzene
       Hexachlorobutadiene
       Hexachlorocyclopentadiene
       Hexachloroethane
       Hexachloropropene
       Hexanoic acid
       Indeno(1,2,3-CD)pyrene
       Isophorone
       Isosafrole
       Longifolene
       Malachite green
       Mestranol
       Methapyri1ene
       Methyl  methanesulfonate
       Naphthalene
       Nitrobenzene
       N,n-dimethylformamide
       N-decane
       N-docosane
       N-dodecane
       N-eicosane
       N-hexacosane
       N-hexadecane
                               65

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                          Table A-l (continued)
Biphenyl
bis(2-chloroethoxy)methane
bis(2-chloroethyl)ether
bis(2-chloroisopropyl)ether
bis(2-ethylhexyl)phthalate
bis(chloromethyl)ether
Bromoxynil
Butyl benzyl phthalate
                     Compounds
 N-nitrosodiethylamine
 N-nitrosodimethylamine
 N-nitrosodiphenylamine
 N-nitrosodi-n-butylamine
 N-nitrosomethylethylamine
N-nitrosomethylphenylamine
 N-nitrosomorpholine
 N-nitrosopiperidine
                                        Pesticides and Herbicides
N-octacosane
N-octadecane
N-tetracosane
N-tetradecane
N-triacontane
O-anisidine
O-cresol
O-toluidine
Pentachlorobenzene
Phenacetin
Phenanthrene
Phenol
Phenothiaz ine
Pronamide
Pyrene
Pyridine
P-chloroaniline
P-cresol
 p-cymene
 P-dimethylaminoazobenzene
 P-nitroaniline
 Resorcinol
 Safrole
 Sgualene
 Styrene
 Thianaphthene
 Thioacetamide
 Thiophenol
 Thioxanthone
 Triphenylene
 Tripropyleneglycol methyl ether
 Pentachloroethane
 Pentachlorophenol
 Pentamethylbenzene
 Perylene
 Carbophenothion
 Chlordane
 Chlorfenvinphos
 Chlorobenz ilate
 Chlorpyrifos
 Coumaphos
 Crotoxyphos
 Cygon
 Delta-BHC
 Demeton
 Diallate
 Diazinon
 Dichlone
 Dichlorvos
 Dicrotophos
 Dieldrin
 Dinoseb
 Dioxathion
 Disulfoton
 Endosulfan  I
 Endosulfan  II
 Endosulfan  Sulfate
 Endrin
 Endrin aldehyde
 Endrin ketone
  EPN
  Ethion
  Ethylenebisdithiocarbamic
    acid,  salts, and esters
  Famphur
  Fensulfothion
  Fenthion
  Gamma-BHC
  Heptachlor
  Heptachlor epoxide
  Hexamethylphosphoramide
                                 66

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                        TABLE A-l  (continued)
                    Pesticides and Herbicides
 Isodrin
 2,4,5-T
 2,4,5-TP
 2,4-D
 4,4'-DDD
 4,4'-DDE
 4,4'-DDT
 Aldrin
 Alpha-BHC
 Az inphos-ethyl
 Az inphos-methyl
 Beta-BHC
 Captafol
 Captan

 Pesticides and Herbicides
 PCB-1221
 PCB-1232
 PCB-1242
 PCB-1248
 PCB-1254
 PCB-1260
 PCNB
 Phorate
 Phosmet
 Phosphamidon
 Sulfotepp
 Tepp
 Terbufos
 Tetrachlorvinphos
 Thiram
 Toxaphene
 Trichlorofon
 Tricresylphosphate
 Trifluralin
 Trimethylphosphate
 Zineb
 Ziram

 Dibenzo-p-dioxins
 and  Dibenzofm-ans

 2,3,7,8-TCDD
 Dibenzofuran
Heptachlorodibenzofurans
Heptachlorodibenzo-P-dioxins
Hexachlorodibenz ofurans
Hexachlorodibenzo-p-dioxins
 Kepone
 Leptophos
 Malathion
 Maneb
 Methoxychlor
 Methyl parathion
 Mevinphos
 Mirex
 Monocrotophos
 Nabam
 Naled
 Nitrofen
 Parathion ethyl
 PCB-1016

 Elements
 Chromium
 Cobalt
 Copper
 Dysprosium
 Erbium
 Europium
 Gadolinium
 Gallium
 Germanium
 Gold
 Hafnium
 Holnium
 Indium
 Iodine
 Iridium
 Iron
 Lanthanum
 Lead
 Lithium
 Lutetium
 Magnesium
 Manganese
 Mercury
 Molybdenum
 Neodymium
 Niobium
 Osmium
 Palladium
 Phosphorus
Platinum
Potassium
Praseodymium
                                67

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                     TABLE A-l (continued)
Octachlorodibenzofurans
Octachlorodibenzo-p-dioxins
Pentachlorodibenzofurans
Pentachlorodibenzo-p-dioxins
Tetrachlorodibenzofurans
Tetrachlorodibenzo-p-dioxins

Elements

Aluminum
Antimony
Arsenic
Barium
Beryllium
Bismuth
Boron
Cadmium
Calcium
Cerium
 Conventional Pollutants

 BOD5
 Oil and Grease, Total Recoverable
 PH
 TSS
Rhenium
Rhodium
Ruthenium
Samarium
Scandium
Selenium
Silicon
Silver
Sodium
Strontium
Sulfur
Tantalum
Tellurium
Terbium
Thallium
Thorium
Thulium
Tin
Titanium
Tungsten
Uranium
Vanadium
Ytterbium
yttrium
Zinc
Zirconium

Miscellaneous
Pollutants

Ammonia,  as N
 COD
 Conductivity*
 Corrosivity
 Cyanides
 Flash Point
 Fluoride
 Nitrate/Nitrite
 Nitrogen,  Kjeldahl, Total
 Reactivity*
 Residue,  Filterable
 Salinity  (with calcium)*
 Salinity  (with sodium)*
 Sulfide
 Total Organic Carbon
 Total Phosphorus
 *    Analytes not monitored during 1986-87 sampling
                                 68

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            APPENDIX B

MAXIMUM PERMISSIBLE CONCENTRATIONS
  OF POLLUTANTS IN AIR AND WATER
               69

-------
       RADIATION STANDARDS
                                               TABLE   B-l
     s-i
151:411:
                            APPENDIX B-CONCENTRAT.ONS IN Am AND WATER ABOVE NATURAL BACKGROUND

                                                 CSM not« •! *nO 0( »pp«ne>i»)

EMflwnl MUfne numb*')
Annum (89) 	

Am«rc**n (05) _„««....«-....«. — 	





Anwnony -^ «• 	 ••"•" 	 — 	 '


Arpon (1 8)..«-.«™».-.— .—«-—*— "«*™*""
Afsttvc (33) ..«.—..«.•—•••««•*«•• «.•.—••—• .—..«••



Attttmt (B5) 	 	
B*num(56) 	 	 	 - 	

BtOiclwn (87) 	 ~

B«fylkum (4) 	 	
Bamutn(B3) 	 	 - 	 - 	




Catimwm (4B) • ••••• 	 • 	




OHommm (98) 	 - 	 -


Ike 227 	 	
AC 22B 	
Am 24t 	
Am 242m 	
Am 242 —-..-. 	
Am 243 	
Am 244 	
Sb 122..— 	
SO 124 	 -. 	
St> 125 	
A 37 	 -....-.. 	
41 ..«—..—.•"•
At 73 	
At 74 	 _. 	
At 76.....—. 	
At 77.-.- 	
Al 21 1 	 	
Bt 131 	 	
Bl 140...._ 	
Bk 249 	 	
Bk 250 	 - 	
Be 7 	 	
B. 206.. 	 	
Q, 207 	 — 	 .......
Bi 210..... 	 	
B, 212 	
Br 82 	 —
CO 109 	 	
CO 115m 	
Cfl 1 15 	
Ci 45 	 „ 	
Ca 47
^^
CI24B 	 	
CI 250 	
CI 251 	
D 252 	
Cl 253 	
CI 254 	

>
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7x10"'
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2x10"
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6x10"
2x10"
2>10"
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4>10"
4x10"'
6 xlO"1
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» 1X10"
" 1X10"
Table B-1 Source: 10 CFR 20, Nuclear Regulatory Commission Standards for
                      Protection Against Radiation, pp. 151:4112.3-4117.
                                                                                          £App*ndix B]
                                                       70

-------
151:4112.4
 TABLE   B-l


 Arrcccix B—Continued
1KB WJTK JBOTB W4TCIU
|Fr« notf!<»t rnil ofcpprndltj
                                                                                     FEDERAL REGULATIONS
Eteimnt Uiornlc number)
Carbon (t) 	 . 	 	 	
C«rium <»>.. 	
Ojluro (45)........
Cblorioe 07) 	 . 	
Chromium f24).._...
Cobalt (27) 	
Copper {2»)........
Curium (W) ............
Djjprojium (68).. .........
EiulelnluiB (*»)..„
Erbium (C8).._.._
Europium {63)_....._.. j
]
I
I
Frrefuoi (100)........... j
I
r
t luorln* P)......^...^ t
OadoXniun (•!)_ ...... o
0
O*Uliim{*|). ...... o
OrreiaohuB p»). ....... c
Oold(:»; 	 A
A
J*l
l>oiop« i
... CM B
(CO,) Su
... Cc Ml 5
C* 143 8
Ct 144 5
Cl 134m 8
C354m B
EJ264 8
El 256 8
Er 169 8
Er 171 8
I
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                                                    71

-------
                                             TABLE   B-l
RADIATION STANDARDS
    S-386
151:4113
                                                     S—CoBtlrtDtd
                                            4*» 1T4TKK A»OVB HATDI.U. SaCXOftODIt
                                             t8*e »ot» »t end •! appendix)
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-------
                                         TABLE    B-l
                                                                                       FEDERAL REGULATIONS
                                     4rn:.xt>ix It—Coutluurd
                            » «M  4KB W4TC8 «»0r» **TO»AJ

                                     |8ee nota »t ted of •p|«nOu|
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                                       73
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                                               6X10-'
                                               *X10->
                                               6X10-"
                                               SXIO-"
7XJO-«
7X10-'
4XJO-*
7X10-'
4X10-'
1X10-'
6XIO-«
                                              3X10-'
                                              1X10-'
                                              «X10"
                                              3X10-'"
                                              4X10-"
                                              4X10-"
                                              2X10-'
                                              exio-'
SX10-"
JXIO-i
3X10-"
8X10-'
2X19-J
SXH-K
                                                                           3X10-«
                                                                           •X.10-'
                                                                           2X10-'
                                              3X>0->
                                              SXIO-'
                                                                           6X10-'
                                              SXIi>-«
                                              3X10-'
                                              SXIO-'
                                                                           3X10-'
                                                                           SXIO-*
                                                                           3XIO-*
                                                                           sxitr*
                                                                           SXIirl
                                                                           5XlC->-

                                                                           SXI«r»
                                                                           SXIO-»
                                                                           1X1O-'
                                                                          BXIO-t
                                                                          SXIO-«
                                                                          sxio-'
                                                                          •XIO-'
                                                            3X10-'
                                                                                         • XIO"
                                                                                         •XiCrl
              3X10-'
              • XI IT'
              7X10-'
              8XIO-'
              8X10-'
              1XIO-'
              lx»o-»
              ixio-'
                                                                                         !XI|r«

                                                                                         3X10-'
                                                                                         3X10-'
             3X10 •
             2X10-'
             !XIO->
             3X10-'
             3X10-'
             3X10"
 1X10-'
 7X10-'
 3X>0-»
 3XiO-'
 8X10-'
 3X10-.'
 3X10-'
 4X10-'
 4X10"
 SXIO-'
SX10-«
 4XJO-'
 4X10-1
                                                                                        axio"
                                                                                        9X10-'
                                                                                        axio-'
                                                                                         1X50-
                                                                                         
-------
                                           TABLE   B-l
RADIATION STANDARDS
                                                                                S-316
                                                                            151:1115
                    Arrr.xiux U— Continued
COXCCKTIUTIOX* IN *>" «KO
                    |£ee notes at end el appen Jn
                                                                »4«O«MtX».
                                                                             itlnued

Cterceet (alonilc number)


feint.**) 	
SU:eoD (14) 	 M..^_-~..
SilTcr (t*j i" iinii«"«r 	

ScUluai Ul)..— ~~- — — 	
Strontium CI)... 	 ..._~..


Sulfur (18) 	 „_..— 	 -~
Tantalum (73) 	 	 	
TecbBctlusi (IS) 	 — •' ••••




Terbium (to)..—.™— .—.-- —
Th>1HotP CTI ) i • • • « • r • ¥-









Tttfijsten fflT«lfnn) p4>.~— —








Isotope •


Sc7* £
H3> 8
At IB B
At Jlfcn 8
Aft 111 |5
s
NoW 6
crtiin R
B
SrM B
8r(0 ii
crta if
SrK If
834 j>
Taltt B
TetVm B
TCK f
Te l>7m «
TeS7 8
TeWiJ B
1
j
Te 124m B
I
Te >:;ro £
To J27 8
T« 129m S
Te 128 8
Te Jilm 8
Te IK 8
TblSO 8
T1MO B
TIM) B
*
rj2W2 •
T12W B
TJi 2JS 8
TbSM S
Tb23! S
1
Tli natural 8
Tb2J4 8
Tn 170 B
Tsn J71 8
1
£o IIS B
I
Sn I!S B
w m *
\V 1S4 f
»
win •
vaao B
vm B
va» B
U8J« S'
Table 1
Column 1
Air

1X10-"
1X1T!
j'xiv
rxio-'
JXI"-1
axiir"
2x!iri
Jx'lir'
JX10-«
IXlir'
4X1V
3X1O-'
SXIlr'
1X10-'
3X10-'
4XJO-J
*X10"
4X1 tr'
3X10-'
4XIO":
3X10-;
3XIO--
4XIO-'
2XIO-J
3X10-'
6X10-'
8X10-'
SXH"'
2X10-'
1X10-'
3X10-'
4XK'"
JXI"-*
8X10"
exio-'
4X10-'
1 V 1 (f 1
J*^*u^
JXK*-'
4Xl«-»
2XIO-J
•XIV
4X10-'
4XIT'
8X10-'
8X10-:
JXIO-'
IXIO-'
3XIO-*
3X1V
axiu-j
•XIO-'
8X10-'
*XIO-'
3XIV
•xio"'
6X10-1'
3XIO-"
IO-*1
3X10"'
SXIl^11
3X10-"
3X10-"
•XIO-'
3X10-'
4XIV
3XIV
JXIO-'
2X10-'
4XIO-J
JXlV
8XH<-;
!5 J^Zi
axto-;
ax iv
3X«'»"
•Xl'*"'
JXIO-'
•XIU'
Column S
Water
0,r/ml)
«Xl|r>
6X10-1
3X1V
9X10"
ixiv
CXIO-s
5X10-'
axio-'
axio-;
3X10-'
JXIV
IXIV
2X!0-»
JXIO->
2X10->
2X1V
ixiv
JXIV
JX10-"
4X10-'
3X10-1
1X1 V
1X10-'
4X1V
4X10-
2X1V
2X10-'
4X1V
4XIV
JXIO-'
8X5V
2XIO-J
4XIO-J
JXIV
SXIV
2X1V
2X1V
JXIV
•XIV
«X1V
JX10-1
7XIV
*X10->
4XIV
8X10-'
3XIV
2X10-'
2X1 V
4X10-'
8X10-'
SXIV
3X10-'
•XIO"
IXIV
JXIO-i
axtv
sxiv

IXIV
4XIV
axio-'

5xn>-'
JXIV
txiv
CXIir'

•xio-
•X to-
Table U
Coiunia 1
Air
fftia-n
4X1V
8X10-'
3XIV
2X1V
ax iv
7X10"
3X1V»
lX^r*
>^X5tr**
3X10-"
4X1V
txiv
•XIO"
4XJV
ix:v
ax iv
8X10-"
8X1V
•XJV
axiv
IXIV
*X1V
flXIV
IXIV
ax iv
1X10"
2X1V
4X10-'
JXIV
7X10-'
2XIV
JXIO-'
4X1U-*
JXlt)-'
tXlir1
3X1V
3X1V
»X1V
2x10-;
1X1U-J
7XIV
4XH»-'
3XIV
IXH'"
•XIV
4X10-'
7X)V
SXIO-'
3XIV
•8X10-'
3XIV
8X10-"
§X1V
3X10-U
JO- n
1O-I1
JO-W
axiv
IV
JXIO-'
JXIO-'
4XIV
IXIV
4XIV
ax iv
4X10-'
axiv
4XBV

JXtU-'
ixio->
4XIV
9X1V-'
SXIt^'
4Xlf«
7XIV-1
CaiuueS
Wav
«»*.««)
axiv
axiv
VX!V
SXIII-'
IXIO"
axiir'
axiv
4X11T'
4XIO-;
4X1V
3X50-'
2X1IT*
3X10-*
7XJO-*
7XIO-'
axio"
3X10"
3X10-'
*XIO-»
4X1V
7X1V
SXIO-*
CX1V
3X1V
4X10-'
4X1V
IXIV
1X10-'
ixio-'
4X10"
2X1V
*xio-<
ex;s-»
SXl1*-'
3X10"4
IX1U-'
4XIV
3XIV
3X10-'
2X1V
fXIO-J
4X1V
3X10"
2XIV
4XIV
4XIV
4X!0-<
3X1V
IXIV
JXltr'
7XIV
lir'
SXIV
3X1V
8XIO-*
10"
10"
SXIV
SXIV
4XIO-J
*XIO-J
•XIO"
*xiv
8Xlt>-'
axiv
1^10-'
TXIO"
•xiv
i »X1V
> »Xlw»
i axiv
»
-------
                                                            TABLE   B-l
                                                                                                          FEDERAL REGULATIONS
                       JJ—CoatlBurd

    IN  *» AMI*  V/ATCk A»orB K4Tt*i

             ISre BOIC* at end *f •npeadiij
                                                                                                   xtloued

ZUeaent (atomic number)





Vanadium f53^ TT1.......t

Xeooc (*O....M.._.^__^.
Vtterblnm (TO) 	 ,.,-.
Yttrium O9> 	 ........





Zinc (K) 	 — 	 „.„..-.. 	
Zirconium (40) 	 ........._^_.


Any sinrle radionuetlrie not
listed «bOfc with dc.-avrncde
oliier thMi alpha emission or
•pontaorous 1'is.tinn aud with
ra<1ioieiiTe halMif* leu than
3 hours.
As? siurle radinnucliclr not
lined above wiin deenv mode
etber than (tilth* rnu<«'"Ti or
MH>I"<»IIFOUI ns;ion and u'itb
radionctivc half-life greater
than 2 houn.
Any sin»Je radtonuelldc not
listed above, whlrli decay* by
alpii* emission or spomantous
fiision.

Isotope *

U33S i-
V2K 8
V 934 S*
VS40 8
U-natural S1
v« I
I
Xe 13lm 8ub
X*1U Sub
Xi I33m Sub
Xe 131 fiub
\ K 1?K •£
* D **« B
f
Y«m 8
vc, i
YK 8

YI3 8
ZoU E
Znttra 8
ZeU 8
ZrU S
ZrW 8
I
tr67 £
L










Tahiti
Columul
Air
t>c/ml)
IXIO-i'
•XIO->»
lX10-»
'XIO-*'
JXlO-w
8X10-'
SXIO-'
7XIC-"
8X10^"
6X10-'
JXJirl
JX10-*
JX10-'
4X)0-«
TX10-'
•X10-'
JX10-'
SXiO"'
4X10-<
"axfo1'"
4X10-'
axio-'
8X10-'
1X10-'
JX10-'
•X10-'
4X10-'
axio-'
7X1 0-«
txio-«
1XIU-'
axio-'
JX10-'
Cduaaa
Water
axio-"
1XIO-*
1X1U-*
ixio-'
ix to-;
1X10-'
*x:fr«
eXIO-"
•x;o->
::~:n::nr:
3X10-'
1X10-"
1X10-"
"axi'S"

CV}(^4
•X10-«
•XIO-i
2X10-'
2X10-'
2X10-'
axio-«
8X10-'
axir,-i sxio-»
JX10-' j »X10-«
lX10-«



axi(M



"""
•X10-<



•XlO-i



4X10-'
Table II
Column I
Air
(*t/mJ)
rxl?"
ixii*"
axio-i
3X10-'
*Xltr<
axio-»
fXIO-'
4X10-'
3X10-'
axio-'
2X10-1
3X10-*
4X10-"
axio-«
CX10-'
CX 10-'
ixitn
JXJO-'

*X10-«
4XIO-«
axso-«
1X10-'
1X10-'
8X10-'
3X10-'
4X10"
1X10-'
4XIO-*
1X10-*
4XIO-«
axio-<
axio-«



1X10-"



8X10-"
Coltt»al
Water.
SXIO-*
xio-<
axio-i
axiir*
3X10-'

4XIC-'
axio-'
3X10-'
8X10-'
2X10-'
3X10-'
3X10-'
^.......•.^.•*


1X10"
2X10-*
2X10-»
3X10-1
•|yjfW|
axio^T"
CX10-*

iVKVl
9^1\f •
3X10-'
1X10-"
2X10-*
7X10-'
8X10-*
2X1P"
*X10-<
AVld*f
7X1"-'
2X10-*




axio-«



axio-.
   uble (S): Insoluble (I).
|Sub" aeant that rallies et»en are far submenloe fa
b>!<;pl.iri6aJ Infinite cloud of airborne material.
 R>eoe ndoa ccncentraoon* are approprl-
I for prot«enon from  r»dOD-332 combined
fe  Its «hort-ll»»d daughtera. AJt«ra»tiv«).
I «»U>e la Table I may be replaced by cm*.
*"   tVS)  Tworklne le»el." (A  "wirtttof
   to defined M aay combination of abort-
 _  r»doB>93a  daughter*,  t>oJonluin-ai8,
 I-2T4.  biuouth-214 aad polonlum-914  in
   ter of «r; »itaou***gvti to the detrce
            . that will mult to  tb* ultl-
          a er  1^5 « 10-  u*v  «r alt>ba
 u n^on-322 oooc«Dtr>tloaa
  »tr>ci«d afeui  mt*« than one rftdlonuelide. the limiting valuei
 for  purpotei «t tab Appendix ehould b< dclermtoed at
 lively, then tht Cbneer.liatians (hall b* limited so that
 tbe tollowtog mUUoosbip csttts:
                    C»
                           Cc
            MFC.  MFC*
                               S>
  Per •oia^ia  aauturet  of tT-238. tr-23«
  3-236 to ate chemical tcxlclty may tee tbe
  lot factor. XX tbo percent by weight (en-
  nent) of tJ-23f> li leu  tban t. tlie con*
Iratloa  value  for a 40-bour workweek,
 p* X. l» OJ mllllframi uranium per cubic
 •r  of  air average. For  any enrichment.
 product of ibe averaee concentration and
 > of ••ixieurc during a 40-hour workweek
 ..*•• >' »•>• WwfKy •»< eonoMitratton •/ each radtonu-
S.(de,Jn^*b! «"*»tur* •*? *»own. the limiting value*
•hould b* derived ai tollews: Delernme. lor each r"
dlODUClId* In the miiture. th»r»lk> beiwwn tnr auatitlty
prewnt In  the mltture and the limit otherwbe esu£
Itohed to Append iz B tor the specific radionuellde when
not In a mltture. The sum of such ratta lor all the
f*dlonuet!d*i to tbs mttuut mmy MA esesed -1" «*,


          : ll radtonuelUei A. B. and C are
                                                                 7?
  8. If either the Mcnifly or tne eoneentration of any
 radionuelide jr. the miiture is not knnwn. the Itmitlnr
 values tor purposes of Appendix B ahalj be:

  a. For purpous of Table I, Col. 1-exiO-"
  b. For purposrs of Table I. Col. 2—1X10-'
  e. For purposn of Table II. Col. I—2X10-"
  d. For purposes of Table 11. Col. 2-4X10-'

  a. If any of the conditions specified betow are Bet, tbe
 corresponding  values specified below may b* used la
 tleu of those specified to paragraph 3 above.

  a. ir the Identity of each radionuelide to tbe miiture
 tt known but the eaneentration of one er more of the
 rad ionuclMea In tht mixture*) net known the concentra-
 tion limit lor tlie ntsurre * the limit specified In Ap-
    Kdn "B" tor [tbe ndtenuelide to she mislur* bavtog
    lowest eoneeatratton I bolt; or

  ». If tb* MentHy ofeadi ndtonuelMc In tb* miitur*
 to not known, but It to known th»; eeruln • -.- <—-iclldai
BpeeinedrnAppiFndis*>B"arenolpee*enit       •:•>,
 tb* aoneentration limit tor tht miiture u .i.c .»«e:'.
 eeoontralioo Iteiit apeclfted Ir Appendii ~B" tor any
tvdionueJlde which k not  knows to k* abmt tratu tb*
»lsturc;ar    :
                                                                          B)

-------
                                                        TABLE    B-l
RADIATION STANDARDS
                                                                                                                                   151:41
                           CONCENTRATION IN AIR AND ^TER ABOTENATTOAL BACKGROUND-continued
                                                        (See notes at end of appendix]
                                        S E»nv»« :§:
                                                            - •« -WIS
                                                                                        Co> i    Co 2
                                                                                                                 Co- 2
                        M « * «iw,n trut S; K : 125.1126.: 12? I -.31 P '33 UM « onj)  Pi 21C. fa
                           tie  A: 2V.  R» 223. R« 22« ** 22S A: 22? R« 228. Tn 23C.  ft 231. Tn
                           232  TiMiM.*Sm 2«B. C? 2W. ine PIT. IV, t't no: »i«»»ni.
                        Mm* .nc-r.mi: & K 1125.1126 I 12S |i 131.1 133 MW.II *"*). ft. t-0. Po
                           210. R* 223. R* 22S. R* 22». P» 231. Tn.n»l Cm 2U C! 2K. »"0 *"> 25«

                        M it « kno^MTs' »0.1 128 (I 125 I 126. I 131. UW. « 004,). ft> 210. R» 226.
                           A* 229. Cm 2*8. «no O 2S* •»• nw o-t««m
                        « «« .ns-r. mi «:s.-<»-«!nrti« »ne A: 22. •»• ne
                        re* ••aw m»l A: 227. Tn 230. »» 231. ft. 23t ^, 238
                            2u  Cn- ?a D 2'k «no D 2S«. vt na: e*H.nL
                                                                                        3 .10-
                                                                                                         1»10'"
                                                     eenMit of ur«n.um §*) rt« Mughnrt * «H» **i Bnor to ehwwe* »««'»'"0 * tlw
                                                                                   ^, ,a tfwsn,^ through ,«te,m.22«. ~...d

                                                                                                               : « 71 ««,».

                                                                                                               . o, 3 m,cro-

                         conudtrtd « not prtMni m tf» miituf* SO«t
 AM'nanr-12'
 A«Mx C

-------