Untreated biomedical waste from Faith Hospital is being dumped at the Cayman Brac landfill, a manner of disposal that may violate public health regulations.
While visiting the Brac landfill last week, the Compass found dozens of red bags in an open pit emblazoned with the biohazard symbol, “DANGER,” and “CAYMAN ISLANDS HEALTH SERVICES AUTHORITY.”
The bags of biomedical waste – which may include used needles, blood, and other bodily fluids – were mixed with other material, including bags marked as bird feed. A flock of chickens was in the pit, with hundreds of other chickens roaming about the rest of the landfill.
Typically, the Department of Environmental Health incinerates medical and other infectious waste before disposing it at the landfill. This is in keeping with section 6(5) of the Public Health (Infectious Waste) Regulations, which states, “Infectious waste may be disposed of in a sanitary landfill after it has been treated. Incineration and steam sterilization are the primary treatment methods.”
However, the incinerator at the Cayman Brac landfill has been broken since April 11. When the Compass inquired into what was being done to ensure that the medical waste is being disposed of safely, the Department of Environmental Health responded that it is placing the waste in a trench.
“The Department of Environmental Health has prepared a trench of 10×10 ft dimensions for the storage of biomedical waste. This trench is layered with soil as often as is practicable,” the Department of Environmental Health, which is responsible for disposing of the waste, told the Compass last week. “The DEH’s top priority is to protect the environmental health of our citizens, businesses, visitors, and employees. To this end, plans are currently under way to increase the level and frequency of coverage within this area. The most recent delivery of medical waste was yesterday (Wednesday, May 2, 2018). The trench is scheduled to be covered with another layer of soil on Thursday, May 3, 2018.”
The department also said parts to fix the incinerator are being sourced from overseas, but did not say when the incinerator will be back up and running.
The Health Services Authority, for its part, stated that it follows local regulatory standards and international best practice in the disposal of medical waste generated at all its facilities, including Faith Hospital.
“The Faith Hospital bags the medical waste and assembles it in a designated area for handling and disposal by the Department of Environmental Health (DEH),” the Health Services Authority stated, later adding, “Treating waste is not the remit of the HSA. I would suggest reaching out to the DEH for further comment.”
The Department of Environmental Health did not respond to questions about how – given that the waste is not being treated in the incinerator – the medical waste is being disposed of in accordance with the public health regulations.
Health and Environment Minister Dwayne Seymour did not respond to calls or messages seeking comment.
The disposal of untreated medical waste at landfills poses a health risk to residents, and especially to workers at landfills, according to public health experts. Risks include that workers could be cut and exposed to infectious diseases.
In the case of the Cayman Brac landfill, the public health risk is compounded by the presence of hundreds of chickens, which can potentially spread diseases they contract from the medical waste.
“Chickens can carry a variety of infectious diseases that they could pick up from medical waste, including salmonellosis, campylobacteriosis and bird flu, but likely many others if they are actually feeding on the waste,” said Tim Ford, a professor of environmental health sciences at the University of Massachusetts Amherst. “Another concern is if the landfill is unlined is transmission of a wide variety of pathogens to groundwaters, antimicrobial and virulence genes, etc.”
Biomedical waste should be stored in a manner and location that protects it from water, precipitation, wind and animals, and does not provide a breeding place or food source for insects or rodents, according to a guide published by the Connecticut Department of Energy and Environmental Protection.