Used needles, bodily fluids and blood-soaked body tissue are among the medical wastes from Pinellas hospitals that have been improperly hauled to the county dump during the past 19 months.
State health officials say the violations are the result of sloppiness by hospitals, not criminal intent.
Still, while no comparative numbers are kept, they believe the 60 violations in Pinellas the past two years is by far the largest number of violations of any county in the state.
"We're very concerned," said Eric Grimm, environmental manager for the Department of Health and Rehabilitative Services in Tallahassee, the agency that monitors biomedical waste. "We have offered anything we can do besides becoming nurses and picking it up ourselves."
State and county laws require that all biomedical waste be taken to any of more than 40 specially licensed incinerators in the state. This includes bloody material, which is supposed to be put in special red plastic bags. Disposing of biomedical waste at county landfills violates state and county regulations.
Throwing it away properly is more expensive than dumping it at the landfill or incinerator.
But there's a reason for the difference: Biomedical waste can carry diseases such as Hepatitis B and the HIV virus that can easily be transmitted to sanitation workersand garbage haulers, who can then infect the general population.
Dumping regular waste at the incinerator costs anywhere from 2 to 10 cents a pound, depending on how much hospitals pay private haulers to pick up their trash. Hospitals contacted by the Times spend between 16 and 23 cents per pound to dispose of thousands of tons of biomedical waste each year at incinerators throughout the state. St. Anthony's Hospital in St. Petersburg, for example, allotted $21,760 in 1994 for 94,632 pounds of biomedical waste, said hospital spokeswoman Mary Estes.
Only Bayfront Medical Center has its own incinerator, which burns waste from All Children's Hospital as well.
Local environmental health inspectors say Pinellas County has more violations than other counties because of aggressive enforcement, including searches of every waste delivery from a medical facility, and because of the numerous medical facilities in the county.
The inspections in Pinellas happen every morning on the tipping floor at the county's waste-to-energy incinerator at 3095 114th Ave. N. That's where a solid waste enforcement officer looks closely at stacks of garbage, searching for any evidence of medical waste: syringes, needle containers, special medical red bags and blood-soaked materials.
Enforcement officers also leave the dump and occasionally inspect hospitals and doctors' offices, sometimes sifting through dumpsters at odd hours.
"We're monitoring closer than any other counties are," said Richard J. French Jr., environmental administrator in the HRS Pinellas County Public Health Unit.
Pinellas officials became more aggressive when they noticed several violations in a short period last year, said Brian Amrstrong, the head of the solid waste enforcement division.
Armstrong has kept a special list of the times biomedical waste has been found since April 1994.
Hospitals accounted for 52 of those 60 discoveries. The rest came from nursing homes or private doctors' offices.
Most of the discoveries consisted of blood-saturated materials, needles, intravenous bags and tubing and other dirty medical waste.
The most recent violation occurred when inspectors found a red bag Oct. 20 in a delivery from St. Petersburg General Hospital, Armstrong said.
No matter what materials are found, such dumping is illegal because human blood and other bodily fluids can transmit diseases, said Grimm of HRS in Tallahassee.
"You have people walking around out there," he said. "We have stories of syringes getting jammed into the conveyer belts, reports of heavy equipment flinging needles up when they run over them. A lot of it is public perception, but there are some risks there."
In Pinellas County, the worst offender has been Morton Plant Hospital, with 11 citations from state officials since April 1994 totalling $18,000 in fines. The hospital's most recent violation was eight months ago.
Two times in 1994, solid waste inspectors discovered human flesh in the Morton Plant trash delivery.
On Aug. 12, two placentas were found in plastic bags in the hospital's trash delivery, and on Aug. 9, an officer found "two separate pieces of what appeared to be human body parts, along with blood saturated wipes, gauze and sheets," according to the HRS files.
"Morton Plant got looked at very closely," said Ed Smolik, director of facility services at the hospital. "We are a large medical facility. We are a multicampus medical facility. I think frankly we were a facility that is easy to look at. Our garbage is easy to spot."
Inspectors say they look at everyone with equal vigor.
But hospital executives say they've taken care of the problem with new policies costing as much as $70,000 to enact.
"The basic issue is that human error occurs," Smolik said. "We responded in the best way we knew, which was to take it very seriously."
Morton Plant isn't the only repeat offender.
The hospital's new corporate partner, Mease Hospital, had five incidents from its Dunedin and Countryside facilities. On one of those occasions, Jan. 24, inspectors found one full container of needles and another box containing a broken test tube with blood in it.
That came about three months after an officer discovered a clear plastic bag from Mease-Dunedin with loose blood and "an unknown piece of human flesh," according to the HRS administrative complaint.
In all, 13 Pinellas hospitals have been cited at least twice since April 1994 for throwing away biomedical waste in the general trash system.
Eight other counties have incinerators, but they don't all require inspections of every delivery from a medical facility as Pinellas does.
Like Pinellas, Hillsborough County searches every delivery from a medical facility, but HRS officials have responded to reports of biomedical materials just six times since the first of last year, said Barbara Hart, an environmental specialist there. Only one of those turned out to be actual biomedical waste.
HRS officials monitoring Hernando and Citrus counties say they have not had any medical waste turn up at their landfills since the beginning of last year. In Pasco County, HRS has two reports of biomedical waste being shipped to the incinerator.
Although Pinellas may have more violations than other places, officials here say the explanation _ vigorous enforcement procedures _ should please residents.
If county officials find improper garbage during their routine search of a medical facility's trash, the punishment can range from a warning to a $2,500 fine, depending on how many previous citations the facility has and how serious the violation is. Cases also are sent to the Sheriff's Office for further investigation.
"Our bottom line is we're not here to see how many people we can arrest," said Armstrong, the head of Pinellas County's solid waste enforcement division. "We're here to get it stopped."
Inspectors say since the county became more assertive about medical waste last year, the hospitals have worked hard to comply. In the past three months, there have only been six violations countywide.
"The hospitals are doing a very good job of policing themselves," Armstrong said.
As part of the fix-it process, county Biomedical Waste Coordinator William Bongiovanni has spent time in several hospitals leading training sessions for employees. He has personal incentive to make sure hospitals take care of the problem: Bongiovanni and hospital representatives must report to the incinerator anytime an officer finds biomedical waste.
Hospital officials say they have spared no expense in correcting the problem.
"We now consider all trash coming from a patient floor or clinical area biohazardous waste and dispose of it in that manner," said Tim Strouse, vice president of All Children's Hospital in St. Petersburg. "It is expensive, but we thought it was necessary."
Here is a list of the hospitals cited since April 1994 for improperly disposing of biomedical waste at the Pinellas County incinerator, according to the state Department of Health and Rehabilitative Services. Citations are issued any time county inspectors find infectious waste or medical materials such as hospital red bags.
HOSPITAL CITATIONS FINES
Morton Plant 11 $18,000
Mease-Dunedin 4 10,000
All Children's 4 7,500
Columbia Largo 4 5,500
Columbia Edward White 4 3,550
Columbia Northside 4 2,800+
University General 4 0
St. Anthony's Hospital 3 0
St. Petersburg General 3 0
Sun Coast 3 0
Bayfront 2 0
Gulf Coast++ 2 0
Seminole Hospital 2 0
and Women's Center
Mease-Countryside 1 0
Palms of Pasadena 1 0
Other+++ 8 0
TOTAL 60 $47,350
+ Administrative hearing reduced fines from $5,300.
++ Closed in June.
+++ Small facilities, such as nursing homes and private doctor's offices; each had one violation.