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Proper Disposal of Medical Waste and Its Challenges: February 2003 Amid frequent outbreaks of nosocomial infections and infection incidents among waste disposal workers, highly infectious medical waste was designated as "infectious waste" under the Specially Controlled Waste category in July 1992. This designation covered items such as blood-soaked gauze, syringe needles, and scalpels, while less infectious waste remained classified as regular medical waste. Concurrently, new licensing requirements for disposal companies and mandatory use of waste manifests were implemented. According to a 1998 Ministry of Health survey, infectious waste discharged from medical institutions reached 150,000 tons, with approximately 6,000 licensed collection/transport companies and 400 licensed treatment facilities. However, improper treatment and illegal dumping of infectious waste persisted. As recently as summer 2002, Japan's largest illegal dumping incident was uncovered near the border of
Aomori and Iwate Prefectures. The illegally dumped industrial waste totaled approximately 820,000 cubic meters, significantly exceeding the volume in the Toshima Incident in Kagawa Prefecture (500,000 cubic meters). Tracing the waste back to its sources using manifests revealed that among the 2,600 waste-generating entities, medical institutions accounted for the largest share at 355. Most were operators in the Tokyo metropolitan area, with national and university hospitals featuring prominently on the list.

Proper disposal of 1 kg of infectious waste via incineration is said to cost at least ¥100 for incineration fees and ¥150-200 for transportation costs, including specialized sealed containers. However, since infectious waste was designated as such in 1992, new processors entered the market in succession, intensifying competition and leading to a price dumping war among operators. Until recent years, prices of 50 to 60 yen per kg—only slightly higher than the standard industrial waste disposal cost of 20 yen per kg—were rampant. This price is simply not feasible for proper disposal.

Movement Toward Proper Treatment Intensifies Due to this failure to bear proper treatment costs, the infectious waste treatment market has not developed healthily. However, the situation is changing. Starting in 1996, the National Industrial Waste Federation launched the "Proper Treatment Program," where processors self-check based on a proper treatment checklist and publish the results. Furthermore, coinciding with the strengthened producer responsibility under the revised Waste Management and Public Cleansing Act, the Tokyo Medical Association established a "Medical Waste Consultation Desk" and started educational workshops for special management industrial waste managers at medical institutions. Additionally, the Japan Medical Association Research Institute (http://www.jmari.med.or.jp/) began offering the "Japan Medical Association Research Institute Certified Infectious Waste Safe Disposal Promotion Specialist Training Course" starting in March 2003.

Furthermore, since 1996, the Japan Industrial Waste Treatment Promotion Center has operated a certification system for collection and transport containers used in infectious waste disposal, ensuring they are suitable for proper treatment. As of December 2002, the following containers are registered: plastic containers from Tensho Electric Industry (Mippel), Idemitsu Plastics (Medipell), Asahi Pritec (Disposal BOX), Gifu Plastics (Respell), and Kodama Resin Industry (Medical Box); paper containers from Kusaka Industry (Mercon Clean) and Niigata Paper Container Industry (Cerapcapsule). While the cost of a 20-liter plastic container is approximately ¥3,000, which is somewhat high, preventing widespread adoption, these containers are essential consumables for proper disposal. Consequently, their adoption is gradually increasing across companies. The Fuji System Pack Group has launched the "Mippear Association," holding study sessions for information exchange primarily with 50 re
lated processing companies nationwide. Meanwhile, the Idemitsu Group is accelerating adoption efforts, such as publishing the medical waste information magazine "Medimaru."

New Processing Technologies Replacing Incineration If processing costs stabilize at appropriate levels, the market is projected to reach approximately 45 billion yen in processing fees alone. This opens business prospects not only for intermediate processing operations but also for processing equipment, transport/collection containers, and related sectors. With an aging population, waste generation is increasing from elderly health facilities, nursing homes, home healthcare, and general households, suggesting further market expansion.

In the intermediate treatment sector, Aso Mine (Fukuoka Prefecture) began trial operations in January 2002 at the Kitakyushu Eco-Town with its medical waste recycling plant, "Econovate Hibiki." The 8,500-square-meter site houses a crusher, high-frequency heating sterilizer, sorting machine, solid fuel production machine, and molding machine, with a processing capacity of 24 tons per day. It collects over 5,000 tons of medical waste annually from contracted medical institutions. After crushing and sterilizing the waste, it is sorted by material type. Plastics suitable for material recycling are reground into collection containers within the plant for reuse at the contracting hospitals. Other materials are converted into solid fuel at the plant for use in Aso Group cement factories. Iron and glass components are also utilized as cement raw materials. Meanwhile, the processing equipment is not only used by processors advancing proper treatment but also by...