The EPA first issued new performance standards for medical waste incineration in 1986 and then again in 1997 to curb pollutants, which prompted many hospitals to shut down their incinerators. Hospitals turned to autoclaving and steam sterilization, which can only treat limited aspects of medical waste and do not provide any volume reductions.

Over 2,300 medical waste incinerators have closed since 1997 and currently 57 (31 are operated by hospitals) are still online. EPA officials estimate that the new rules passed recently will cost roughly $15.5 million. If that was divided evenly over the 57 locations, that’s over $270,000 per location.

Reducing medical waste incineration is just one side; waste still needs to be thermally treated. At least 14 states have statues requiring incineration of trace-chemotherapy agents and pathological waste – both waste streams can be treated by Plasma Thermal Destruction and Recovery (PTDR).