Target practice

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Dr. Hazel Holman was one of 34 veterinary practices targeted by Massachusetts environmental regulators in a medical-waste compliance crackdown.

Blandford, Mass. — When Dr. Hazel Holman showed a state environmental regulator into her rural Massachusetts practice last year, she noted the inspector's easygoing manner as he ran down a compliance checklist.

Several citations and $26,000 in fines later, the small-animal veterinarian with just 1,800 clients has an altered view of that visit. Holman, who with the help of an attorney got her penalty dropped to $3,000 and has an appeal pending, is one of 34 veterinary practices targeted so far by the Department of Environmental Protection's (DEP) Western Regional Office since October 2006. The agency, on a mission to clean up ecological contaminates generated by veterinary medicine, refuses to release totals of fines administered. Yet it's clear that rural practices, namely those tied to septic systems, are vulnerable to DEP visits.

Dr. Hazel Holman, Blandford, Mass.

DEP Section Chief Saadi Mota-medi, whose signature appears on many of the 26 inspection-related cases obtained by DVM Newsmagazine via a Freedom of Information Act request, refused to comment about his office's latest target, the veterinary medical sector. Such crackdowns aren't unique to Massachusetts, with governmental officials and environmentalists becoming increasingly wary of health hazards tied to medical waste, citing reports of antibiotics, mercury and infectious agents leaching into national water supplies. While the U.S. Environmental Protection Agency governs many medical waste streams, state regulators generally cover infectious materials disposed of by small businesses, including veterinary medical practices.

Inspections often are considered invaluable for ensuring regulatory compliance, yet detractors argue that the DEP officials made no effort to alert Massachusetts veterinarians before embarking on its four-county probe of practices. The DEP's interpretation of state environmental laws is overbroad and far too restrictive, critics contend. Specific rules do not exist for veterinary medicine, although a related DEP fact sheet was issued after the start of inspections.

"The way the law is written, anything that doesn't come out of a kitchen and bathroom is considered industrial waste and needs to be connected to hazardous waste-holding tanks," says Holman, fined for improperly disposing of X-ray silver and several more minor infractions. "So if the DEP came back in here today, they could shut me down. That's very frightening to me. Until they change that language, I'm not going to sleep at night. I could never afford such a huge expense; it would put me out of business."

In an area where practices are small and clients are scarce, rural Massachusetts veterinarians find themselves facing state-government fines for alleged environmental infractions. Originally penalized $26,000 for improperly disposing of X-ray solution, Dr. Hazel Holman fears further repercussions despite a reduced assessment. "Six surgeries is a busy day around here," she says. "I can hardly afford to fight something like this."

Bargaining chips

DEP spokeswoman Eva Tor explains that the state's hazardous-waste laws have been in place "for a long time" and such strict interpretations are not anticipated. As for penalties, they're calculated in state regulations, with a $25,000 statutory maximum for first-class violations that include the discharge of hazardous materials into the environment.

The DEP's settlement assessment system, while complicated, is negotiable, she adds.

"The majority of the clinics did not have serious problems, and our fines aren't finalized," Tor says. "We prefer to negotiate settlement agreements and a return to compliance with those parties that are cited in enforcement conferences."

Seeking clarification

There's a lot of flexibility in those meetings, insiders agree. But gray areas of the state's medical waste laws concern Susan Weinstein, a lawyer and executive director of the Massachusetts Veterinary Medical Association. She plans to meet with DEP officials for clarification.

"You can rinse off a vial and have some powder on your hands, and state regulations say that water should be piped separately to a holding tank. No one has a good answer for getting rid of medications," she says. "The bottom line is that regulations can't be such that they put responsible veterinary practices out of business. The number of things that need to be different is growing. There has to be a reasonable means of compliance, and it needs to be outlined in the law. We're getting questions almost daily on this."

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Gianluca Bini, DVM, MRCVS, DACVAA
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