A publication of Work On Waste USA, Inc., 82 Judson, Canton, NY 13617 315-379-9200 November 15, 1990

“...The growing volume of garbage is becoming an increasingly serious ecological, economic and social problem of the population in many different ways. A solution must be found in the interest of preventive health care. According to the Hippocratic oath, medical doctors are not only responsible for the well-being of the individual but also for the society in its entirety. Consequently, they should not remain outside the debate on the garbage problem; rather they should become informed and participate in the process of finding solutions. In fulfillment of the code of professional ethics, the representatives of the Medical Association of Munich respond to the garbage problem as follows:

1. All methods to get rid of garbage are problematic. Landfilling and incineration of trash can threaten human health. Both management methods cause the generation of toxic compounds which cannot be controlled and are commonly of unknown composition, quantity and toxicity. Those compounds can never completely be eliminated; they inevitably end up in the groundwater and air and finally reach the human body through many different pathways (drinking water, air, food chains). A comprehensive toxicological evaluation of the potential emissions is not currently possible.

2. A solution to the garbage crisis can’t be found at the end of the waste generation-waste management sequence, rather it has to be found at the beginning of the process. Waste minimization should have priority in communes (municipalities), the private sector and the business sector. The legislature must develop rules and regulations which will enhance efforts to drastically reduce the level of waste generation (e.g. of the packaging industry).

3. Strategies have to be developed for recycling valuable materials in the waste stream (such as glass, metals, paper and plastics) and separating the compostable fraction of the trash. The use of ‘throw-away’ materials (e.g. in the beverage industry) should be reduced. The application of ‘throw-away’ products in the medical sector should be reduced as well, as long as the use of such materials is not required for reasons of hygiene. The reusability/recyclability of products should be an objective of the industries manufacturing those goods (e.g. all commodities used in the medical field should use, as much as possible, the same plastic resin).

4. After implementing plans for waste minimization and the reuse/recycling of materials, a certain amount of garbage will remain. There is no single solution for handling those residues. Specific management methods have to be applied depending upon local conditions and the waste stream composition. Emphasis should be put on management methods which minimize the health risk. Economic considerations should play a secondary role. The application of cost/benefit analysis from a purely economic standpoint is inadequate as a decision making tool.

5. We are concerned that the Federal and State (Laender) governments consider incineration the most favorable option for handling the waste problem. We are further troubled by the fact that they support the operation of existing facilities and the construction of additional garbage incinerators. We consider garbage incineration as troublesome waste management technique with regard to our objective of maintaining the health of the population. The following evidence supports this argument:

* The process of incineration generates a multitude of new compounds. Only a few of them are understood with regard to their composition and toxicological properties. The waste stream with its current composition generates during the incineration process the highly toxic dioxin and furan compounds, which cannot be prevented. A total containment of those toxins is impossible.

* Material remains after the incineration process. This includes fly and bottom ash which has to be landfilled. The final disposal of these substances requires one third of the landfill space that would have been needed for the disposal of the unburned garbage. In addition, incineration residues, in gaseous form and as fine dust, are distributed over long distances throughout the landscape. Instead of containing and monitoring hazardous compounds, garbage incineration uses the concept of infinite dilution to handle dangerous by-products. Our living space is not limitless. The use of the atmosphere as a dumping ground will eventually lead to an accumulation of contaminants in the soil, vegetation and animals. Human beings, at the top of the food chain, belong to the group of organisms which are most susceptible to contaminants.

* Our air is already heavily burdened by emissions from traffic, industry and residential burning of fossil fuels. Garbage incineration adds to the pattern of abuse of the atmosphere as a dumping ground for emissions.

* Air contaminants are suspected of causing respiratory diseases, allergies and depression of the human immune system. Increased exposure to air contaminants, such as the ubiquitous dioxin, might increase the likelihood of cancer for human beings. The long-term toxicity of many environmental toxins is based on the lipophilicity of those compounds, which explains their slow rate of decline. Toxic compounds remain in the environment for decades and accumulate in our bodies. Today we generate toxins which will affect our children and grandchildren. For example: According to the German Health Agency, milk from nursing women is twenty (20) times more contaminated with dioxin than cow’s milk. The multitude of contaminants a woman has accumulated in her body over a time span of two to three decades reappears during nursing and is transferred to the baby.

* Incineration converts more or less benign garbage into material with a high content of toxic compounds. Fly and bottom ash have the characteristics of hazardous waste and have to be handled with special precautions. The safeguards necessary to operate a hazardous waste landfill cancel out the questionable advantage of volume reduction achieved through incineration.

* Standards for pollution control (e.g. German Clean Air Act --TA Luft, Rules and Regulation for Radiation Protection --Strahlenschutzverordnung, etc.) are frequently based on the concept of ‘best available control technology.’ However, they are not based on clinical and toxicological evaluations, at least not with regard to long-term effects. Therefore, those standards applied during the process of permitting facilities do not guarantee the nonexistence of health risks. This applies for garbage incinerators as well.

* Current garbage incinerators are designed for the generation of thermal energy. They are frequently linked to industrial facilities. Their continuous demand for fuel stimulates waste generation. Therefore, each additional incinerator is counterproductive to the efforts of source reduction.

6. We welcome the resolution of the 1990 German Medical Congress in Wuerzburg, which demands the development of strategies for source reduction and waste minimization in hospitals and private practices. We recommend a similar resolution for the conference in Munich.

7. We demand a reversal of policies which favor garbage incineration. Incineration should only be the last option when other waste management techniques are inadequate for ecological and medical reasons. Instead we demand a policy which emphasizes source reduction--in the interest of the people we are supposed to take care of...”

Thanks to Holger Eisl of the Center for the Biology of Natural Systems for the translation.