Getting Burned

A North St. Louis medical-waste incinerator has spewed dioxin for a decade. Nearby residents say it's time to fight the fire.

Jun 21, 2000 at 4:00 am
East of North Broadway, the back streets flood after a hard rain. Each low-lying avenue parallels, crosses or dead-ends at the Norfolk Southern railyards, where slow-moving freights lumber through a landscape of gravel, rusty cyclone fences and discarded automobile tires.

This is the locale where infectious medical waste from the entire St. Louis metropolitan area is burned. The incinerator that handles the gargantuan task is housed in a plain-looking prefabricated building surrounded by a white stucco wall with blue trim. There are shrubs and landscaping rocks near the entrance. Uniformly shaped Bradford pear trees line the periphery of the property. Compared with its surroundings, the place almost looks pleasant -- except for the off-white plume of smoke coming from the smokestack.

The facility, which was originally built by a subsidiary of Browning-Ferris Industries (BFI), has been quietly releasing pollutants into the air for the past 10 years. Stericycle Inc., the new owner, is continuing the practice. Nobody knows the precise amount of dioxin and heavy metals emitted by the incinerator. But this much is clear: When things go wrong, as they frequently do, noxious chemicals dodge safety controls for hours on end, according to company records filed with the St. Louis Division of Air Pollution Control.

At a certain hour, on a certain day, the incinerator encountered "draft problems." Or "the motoring coupling on the quencher pump failed." Scrubber pumps burned out. Fans quit working. Troubleshooting these glitches has caused others technical difficulties. Dealing with fire itself can set off an unexpected series of repercussions.

Take March 14, 1997, for instance: It must have sounded like a bombing off inside the primary combustion unit that day. "It is our best guess that one or more compressed gas cylinders were slipped into the waste stream and exploded inside the incinerator," says the incident report. "This caused damage to several devices including the scrubber damper modulation motors, which control the draft. The failures of these motors caused the dampers to close, which tripped the fan emergency controls and shut the fan off. This caused the bypass stack to open."

On another occasion, when the fan went down for an eight-hour repair job, the incident report casually notes, the "estimated quantity of pollutants emitted to the atmosphere (is) unknown."

None of these recurring accidents is known to neighbors, who are clueless about what goes on inside the company's walls, as they were when the incinerator began operations. The granting of a liquor license to a neighborhood tavern received more public scrutiny than the opening of the incinerator. One day back in 1990, truckloads of biohazardous waste just started rumbling down Carrie Avenue and smoke appeared on the horizon.

"It was sneaky, the way they did it, because nobody knew about it," says Bernice Mathews, a longtime resident of the area. "They just built it. I didn't know a thing about it. Then BFI sold it to this company, and God knows what they're burning now."

The U.S. Environmental Protection Agency (EPA) knows this much: Dioxin causes cancer, and exposure risks are 10 times greater than previously estimated. Earlier this month, the agency released a draft of its reassessment on the dangers of dioxin. The warning comes as tougher medical-waste-incineration rules are slated to take effect in Missouri later this year.

In St. Louis County, the Stericycle incinerator would already be prohibited from operating because of a strict local law that has been on the books for nearly a decade.

Mathews and about 40 of her neighbors have signed petitions asking that the city of St. Louis enact a similar law. The initiative has the endorsement of Ald. Freeman Bosley Sr. (D-3rd Ward), who has pledged to introduce the legislation before the St. Louis Board of Aldermen.

"Hell, I didn't even know the damn thing was there," says Bosley. "When the Metropolitan Sewer District (treatment plant) goes awry down there, it smells like lightning hitting the outhouse. But here you have no idea of what's going on with it. There is no way that we have of being able to monitor what it is that they're burning. You don't even know you're breathing the stuff. That's why I don't want it here. It doesn't belong in a populated area. I'm intent on getting rid of it."

St. Louis Mayor Clarence Harmon, says a spokesman, is waiting to see the legislation before deciding whether to back it. Dionne Flowers, the Democratic alderwoman of the 2nd Ward, where the incinerator is located, has taken a similar position. On Friday, she got the aldermen to back a resolution asking the EPA to test soil samples around the incinerator.

Mathews, who is 75 years old, is concerned about the effects that the incinerator may have on the young people in the neighborhood. She says the health risks they face are directly tied to their economic plight. "Let's face it: They're poor people. I'm sure if they weren't poor, they wouldn't live down here. Me, I'm too damn old to move."

When Mathews and her husband settled here, she swore she would only stay a couple of months. But there was a housing shortage after the war. So the couple reluctantly moved on to Ouida Avenue. It was never exactly a desirable place to live, but over time she grew to love her home and took pride in it. Mathews raised a son and two nieces on Ouida. She recalls the neighborhood as being like a small town, nestled at the foot of the hill below O'Fallon Park. The lives of her German and Irish neighbors may have been thrown together by circumstance, but they all shared a sense of community.

The railroad drew a hodgepodge of businesses to the area, and gradually the residential character of the neighborhood began to change. A lumberyard, welding-fabrication shop and junkyard cropped up on various corners. Purex Corp. built a detergent factory nearby and later sold it to Dial Corp. The industrial encroachment didn't trouble Mathews too much, though, until the incinerator operator fired up its kilns over on McKissock Avenue.

All told, the Stericycle incinerator serves about 5,000 customers, according to a company estimate. Of that number, about 200 are considered large-volume generators. Stericycle's leading clients include Monsanto Co. and BJC Health System, with 13 hospitals in Missouri and Illinois. Washington University Medical School, another longtime customer, announced plans this week to suspend using the incinerator for the time being.

The waste is imported from medical institutions, nursing homes and doctor's offices within a 200-mile radius of the city, arriving by the truckload from St. Louis, St. Charles and Jefferson counties in Missouri and St. Clair County, Ill. Some of the biohazardous materials are hauled from as far away as Cape Girardeau. Other, more distant points of origin are vaguely categorized as "out of state," according to records on file at the St. Louis Division of Air Pollution Control. The facility also burns more than 150 tons of "international garbage" each year from passenger airlines serving St. Louis.

The contents of the infectious rubbish include human organs, animal carcasses and other biological-research waste. Although this debris is a distasteful byproduct of modern science and medicine, it is not the primary source of pollution emitted by medical waste incinerators. That distinction belongs to poly-vinyl chloride (PVC) plastics. PVC is used to manufacture blood bags, IV bags and tubing, and myriad other disposable hospital products. Hospitals consume millions of pounds of PVC materials each year. The ubi-quitous plastic is used to manufacture about one quarter of all medical goods, including surgical gloves, scrub suits, overshoes, aprons, drapings, mattress covers, diapers, wound dressings, syringes, bedpans, food-service equipment and product packaging.

What makes the burning of PVCs dangerous is that they are formulated from chlorine -- a main ingredient of dioxin. Because of the health-care industry's reliance on these products, medical waste contains a higher percentage of PVCs than municipal waste. Combustion of PVCs creates dioxin.

Although many questions remain, the dangers of incinerator emissions have been known for some time. Scientific studies over the past decade have documented the toxic byproducts of incineration and linked them to human disease and mortality, specifically the deadly effects of air pollution on the human cardiopulmonary system.

Stericycle's St. Louis facility is capable of burning approximately 1,200 pounds of waste per hour around the clock. Factoring in maintenance and unexpected malfunctions, the incinerator still manages to burn an estimated 750,000 pounds of materials every month, or about 9 million pounds per year. The plant disperses 3.5 tons of particulate matter into the air annually.

Once inhaled, these micron-sized particles either collect in the lungs or pass into the bloodstream and move to other parts of the body. Particles from incinerators typically are laden with heavy metals such as mercury and lead. Over time, the ingestion of these airborne pollutants contributes to chronic health problems, including heart and respiratory diseases.

Incineration also creates a plethora of cancer-causing agents, including an assortment of dioxins. After years of debate, the EPA has formally declared that the most potent form of dioxin -- 2,3,7,8 tetra-chloro dibenzo dioxin (TCDD) -- is the cause of several forms of cancer. The latest EPA findings indicate that one out of every 100 people who eat meat and dairy products -- fatty foods known to contain dioxin -- run a risk of cancer. That projection is 10 times greater than previous EPA estimates. Dioxin wreaks havoc on human reproductive, developmental, metabolic and immunological systems.

Once released into the air, water or soil, dioxin becomes extraordinarily persistent, moving up the food chain and eventually accumulating in human tissue. Fetuses and infants are particularly vulnerable because dioxin is capable of passing through the placenta and is present in breast milk. In other words, everybody is overexposed to dioxin from the moment of conception.

Medical-waste incineration only compounds the dioxin problem.

The city of St. Louis has done nothing to stop the burning of medical waste within its boundaries because all the proper forms have been filled out and permits granted. Stericycle, in this case, has essentially been issued a license to pollute within the limits of the law. Industry sources and government officials emphasize that the volume of refuse burned at the site is inconsequential compared with the mountains of trash constantly generated in the St. Louis area. Using the same logic, they argue that the unknown quantities of toxins coming from the incinerator's smokestack are minuscule in relation to automobile emissions, the major cause of air pollution. Placing the onus elsewhere and debating the relative hazards of the technology are standard ways of defending incineration.

Tim Dee, the commissioner of the Division of Air Pollution Control, says he'll enforce whatever the law the Board of Aldermen passes. But for now, Stericycle is in compliance with all current regulations. If the facility encounters malfunctions, as it has in the past, Dee says the city will make every effort to cooperate with Stericycle. "We don't just whack somebody with a big 2-by-4 because of a single problem. What we do is allow them to correct it."

The incinerator operator is comfortable with this arrangement. "We run the incinerator consistent with every condition that's imposed on us by the city of St. Louis," says Richard Geisser, a Stericycle vice president. "I think, from Stericycle's perspective, we do an excellent job in controlling the emissions from our incinerators, well below what many of the other commercially operating incinerators do around the country."

Indeed, Stericycle plans on spending $500,000 to install additional pollution-control devices, including a new wet scrubber, to ensure that its incinerator meets the new pollution standards that go into effect in Missouri on Sept. 1. "We haven't been required to test for dioxins and furans at this stage of the game," says Geisser. "It's not that we've been given any free license here. No one has really been asked to do that. This is why the new regulations are coming in. We're confident that we're (already) meeting them, but we're going to take it to the next level by upgrading it."

However well-intentioned Stericycle's efforts may be, there is a loophole in the forthcoming regulations: The requisite emissions test will be conducted under optimum conditions that won't necessarily reflect the normal operations at the incinerator. Ted Schettler, a Boston physician and public-health expert who has studied incineration issues for years, has seen the same paradoxical circumstances before.

"A lot of studies have been done, both with incinerators in the field and laboratory incinerators, showing that if you really create optimum burn conditions, you can minimize the amount of dioxin you make," says Schettler. "However, when incinerators operate on a day-to-day basis, it's rarely the case that they are operating continuously at optimal combustion conditions. Yet they can create those conditions for the test burn. It tells you nothing about what is going on the rest of the year. That has always been the problem."

Permitting the incinerator to continue operating will lead to the further importation of waste from out of state, Schettler says. "It's like sending sewage sludge from New York to Sierra Blanca, Texas," says Schettler. "If the city allows an incinerator to burn in St. Louis, it will become increasingly more attractive to people who are looking to get rid of their waste. So the inner city becomes the dumping grounds for other people's garbage. Of course, the incinerator operator likes that because they make a lot of money at it."

When a mishap occurs, the existing city law requires that it be self-reported -- a regulatory process comparable to a reckless driver's issuing himself a ticket after a traffic accident. If it is a serious enough infraction, the matter may be referred by the city to the Missouri Department of Natural Resources (DNR), which can then request that the state attorney general prosecute the case. Instead, the 24-hour-a-day burning cycle goes unabated, despite Division of Air Pollution Control records, which indicate that the McKissock Avenue incinerator has experienced frequent problems.

During these emergencies, smoke bypasses the pollution-control devices and goes directly up a dump stack, spewing untreated toxic matter into the air. A piece of hardware breaks, a fuse blows, the system fails and thousands of pounds of toxic ash escape into the atmosphere. The incident is duly noted on a standardized form, submitted to the city's air-pollution-control office and promptly filed. There are no federal or state investigations, no fines, no prosecutions. The issuance of a warning is a rarity, whereas mechanical malfunctions are relatively commonplace.

The last half of 1996 appears to have been a particularly troublesome time. A warning letter from the city cites a dozen malfunctions transpiring within a five- month period. "Of these, there were at least six instances that, in my opinion, would not have occurred if proper maintenance had taken place," wrote Ronald Steinkamp, chief enforcement officer for the city. "We here in the Air Pollution Control Enforcement Section are somewhat concerned that known, potential breakdown situations are not being addressed during nonoperational shutdown periods, but rather allowed to deteriorate and malfunction during incineration cycles, thus requiring the bypass of the scrubber." The letter urges the incinerator operator to reevaluate its lax maintenance procedures and warns that the city will "take any enforcement action at its disposal" to ensure that BFI complies.

The stern warning carried little weight, however. Although federal regulations set limits on some poisonous gases and particulate matter released from incinerator smokestacks, there is no way of enforcing the law. If and when the polluter chooses to report the toxic release, the pollutants have already been dispersed by the wind.

In a prepared statement, BJC states that burning its waste at the Stericycle incinerator "offers the best solution available," although it is not ruling out the future use of other alternative technology (see sidebar). "I don't know how long this argument has been going on, but it's well over 10 years," says John Allman, BJC's environmental engineer. "We just make sure that we do it legal. It (incineration) is the most effective. It doesn't exclude anything. It is the technology that we elect to use."

Dan Berg, a recent graduate of the Washington University School of Medicine, became aware of BJC's burning practices when he began studying the issue late last year as a part of his medical training. As a 28-year-old medical student, he had elected to find out what kind of impact the hospital network had on the environment, a subject overlooked by most physicians. After he discovered that the BJC system was shipping its infectious waste to be burned in North St. Louis, Berg was struck by the seriousness of the situation.

"As I researched it more, I came to realize that this is a huge issue," says Berg. "It's a big public-health issue, and it's also an issue of justice. The reason that they are using this (incinerator) in North St. Louis is because everyone else has gotten rid of them. This would be illegal in St. Louis County. But because it's where it is, it's legal."

The academic project grew into an activist movement, after Berg aligned himself with Health Care Without Harm, a national network of health professionals who oppose medical-waste incineration. The young resident physician has also gained the support of the St. Louis Medical Waste Incineration Group, an ad hoc committee that includes the Association for Community Organizations for Reform Now (ACORN), the Missouri Coalition for the Environment, the Gateway Greens and the Sierra Club. As a part of his campaign, Berg has canvassed the neighborhood next to the incinerator, petitioned the city and written letters to Monsanto and the Washington University School of Medicine. In late April, he helped organize a public meeting on the topic.

Medical-waste incinerators all over the country are being closed because of pollution problems, Berg says. There has been a 50 percent reduction in the last 10 years, and another 40 percent are expected to shut down over the course of the next decade, he says. As the number of small hospital incinerators have declined, the demand for large commercial burners has been stimulated.

Stericycle's $410 million buyout of BFI's medical-waste trade last year catapulted the Lake Forest, Ill.-based company to the status of industry leader. The company now boasts more than 235,000 customers in 46 states, five Canadian provinces and the U.S. territory of Puerto Rico. Since the buyout, revenues have doubled, to $132.8 million in the last year. First-quarter earnings this year of $77.7 million represented a 225 percent increase over 1999's. As part of the BFI deal, Stericycle acquired the St. Louis incinerator and a dozen others nationwide, including one in Clinton, Ill., and another in Kansas City.

Berg believes that the consolidation of the medical-waste industry does not bode well for residents living near Stericycle's operation here. The North St. Louis site could become the equivalent of a national clearinghouse for medical waste, he says. Upgrading pollution controls won't prevent dioxin from being emitted, particularly when emergency bypasses take place.

Given Stericycle's checkered environmental-safety record, Berg's concerns seem reasonable. Five years ago, newspapers reported that Rhode Island fined the company $3.3 million for "knowingly" exposing its workers to the hepatitis B virus. Stericycle ultimately negotiated a $400,000 settlement in that case. The wrongdoing came to light after former employees informed the Rhode Island Department of Environmental Management of substandard conditions at Stericycle. A subsequent investigation uncovered hundreds of violations, including the falsification of records and failure to treat waste properly. The state also cited Stericycle for allowing workers to be sprayed with medical waste. The regulatory action came a year after the U.S. Occupational Safety and Health Administration (OSHA) sanctioned Stericycle for other safety violations at the same facility. OSHA had previously cited the company for problems at a radioactive-waste-disposal plant it formerly operated in West Memphis, Ark. In 1997, the Washington state Department of Labor and Industries cited Stericycle for failing to protect its workers from biohazardous waste, after three employees at the company's Morton, Wash., facility contracted full-blown tuberculosis and 13 others tested positive for the disease.

"There's no such thing as a clean incinerator," says Berg. "Even if you have the cleanest incinerator, you can't help but produce dioxin. What we're saying is, we want the same law that they have in St. Louis County in the city. There is no reason why people in the city should suffer higher rates of pollution just because of where they live."

Former St. Louis County Councilwoman Geri Rothman-Serot, who sponsored the restrictive county ordinance, is appalled that St. Louis has neglected to face the issue. "The fact that the city still gets away with this is just horrifying to me," says Rothman-Serot. "I would sincerely hope that they would take a good look at what the county has done and come along with (us)."

Stericycle's predecessor, BFI, began blowing smoke up its North Side stack in 1990, at about the same time that St. Louis County residents were rallying against a proposed medical-waste incinerator at St. John's Mercy Medical Center in suburban Creve Coeur. Opponents from the upscale community of Westwood filed a lawsuit against the city of Creve Coeur and the hospital to stop construction. When St. John's opened a new cancer-information center, dozens of protesters showed up at the event and accused the hospital of bankrolling a technology that caused cancer. Demonstrators released hundreds of helium-filled balloons into the air with cards attached that explained the dangers of incineration.

The St. Louis County Council got the message: Property owners in West County didn't want an incinerator in their neighborhood. An ordinance restricting incineration was drafted by an attorney, who was married to the plaintiff in the incinerator suit. Rothman-Serot pushed for passage of the bill. Despite hard lobbying by the hospital industry, the legislation passed.

The county law, one of the toughest in the nation, set limits for dioxin, mercury and other pollutants. It also mandated that incinerator smokestacks be designed more than 250 feet high, making construction costs prohibitively expensive. In addition, the statute required that waste generators reduce the volume sent to the incinerator by 10 percent a year for five years.

The law accomplished its intended end. There are no medical-waste incinerators in St. Louis County today.

But it's a long way from Ballas Road to McKissock Avenue, and the distance between the two addresses is measured in dollars. An estimated 800 people live close by the city incinerator, according to census data. The median value of the homes in the immediate area is about $10,000. Most of the small brick and frame houses are more than 60 years old. Those living nearest to Stericycle's plant are mainly white. Residents who live in the surrounding community are predominantly black. The two groups share one common bond -- they're poor. More than a third of the residents lack a high-school diploma. The median family income for those living nearest the incinerator hovers at a little over $12,000.

On the other hand, Creve Coeur, where St. John's Mercy is located, is an affluent enclave surrounded by other tony municipalities. Nearly 40 percent of the professional and managerial class who live there have college degrees. Annual median family income for these suburbanites is estimated at more than $78,000 a year, according to census data. The median home value is almost $200,000.

In 1992, shortly after its efforts failed in Creve Coeur, St. John's banded together with a score of other area hospitals and began pushing for a regional incinerator in Midtown St. Louis. The plan, which had the blessing of the Hospital Association of Metropolitan St. Louis, would have involved the construction of a 17,000-square-foot facility on Clayton Avenue between Sarah Street and Vandeventer Avenue. The Missouri Hospital Association and Associated Industries of Missouri (AIM) also supported the incinerator. Moreover, when the DNR attempted to impose a stricter law governing incinerator emissions, the two lobbying organizations went to court and had the statute overturned. Medical-waste-incinerator advocates also urged the state Legislature to pass an exemption allowing the proposed St. Louis incinerator to operate with a buffer zone of only 50 feet instead of the required 300 feet.

By 1994, however, a coalition of environmental and community organizations had formed to stop the Midtown incinerator plan. A phone bank was set up and press releases sent out. Opposition broadened with the addition of trade unionists and civil-rights activists. Public demonstrations drew attention to the proposal, and in a matter of months, ACORN, the Coalition for the Environment and the Gateway Greens had defeated the hospital industry's plan. But their call for a city ordinance mirroring the county law never became a reality.

The debate over medical-waste incineration in eastern Missouri dates back to 1987, when a Canadian corporation opened a medical-waste incinerator in the tiny Ozark burg of Bunker, Mo. To pursue its agenda, Decom Medical Waste Systems Inc. of Toronto hired the mayor of Bunker and put him on the payroll. The locals opposed the burner, lawsuits were filed and the state ultimately revoked Decom's operating permit, but not before Decom's emissary, the mayor, attempted to curry favor with several state lawmakers by sending them hefty campaign contributions. After his generosity went unrewarded, the company attempted to set up shop at 5501 Hall St. in North St. Louis in 1990. Residents objected to the plan at a public meeting, and the city refused to issue a zoning permit. Curiously, the outcry over Decom's proposal didn't extend to BFI's incinerator, which was granted permission to operate around the same time. The McKissock Avenue incinerator has been releasing dioxin and other pollutants into the air ever since.

The EPA's latest estimates have rated medical-waste incinerators as the third-largest source of dioxin emissions, responsible for approximately 17 percent of the total amount released into the air in the United States. Previous estimates had rated medical-waste incinerators as the largest emitters of dioxin in the country. The drop can be attributed to the elimination of thousands of hospital incinerators. In 1995, the EPA estimated that approximately 2,400 medical-waste incinerators remained in operation, a reduction of about 50 percent since 1987. Until recently, only about two dozen of those burners have had their emissions analyzed, so the full extent of the pollution is unmeasured.

In 1990, the U.S. Congress acknowledged the threat posed by incineration and amended the Clean Air Act to address the problem. The amended federal law mandated that the EPA strictly regulate the releases of dioxin, mercury and other toxins from incinerators, including the medical-waste variety, within two years. It has taken another decade for regulations to be hashed out. The new rules, which are scheduled to go into effect in Missouri on Sept. 1, will finally require that medical-waste incinerators be tested for dioxin emissions.

The term "dioxin" actually refers to a family of more than 200 related chemicals, including polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans and polychlorinated biphenyls, or PCBs. In addition to incineration, dioxin is created as an inadvertent byproduct in the manufacture of chlorine-containing pesticides, herbicides and wood preservatives. It is also produced during the bleaching of paper with chlorine.

Although dioxin levels have been on the decline in recent years, medical-waste incinerators continue to be a main producer of the toxin. Dioxin is arguably the most dangerous chemical on earth. Its toxicity levels are measured in picograms -- trillionths of a gram. The EPA now acknowledges that the most potent form -- 2,3,7,8 tetra-chloro dibenzo dioxin (TCDD) -- causes cancer in human beings, including lung cancer and lymphomas. Other scientific studies have linked the chemical to thyroid abnormalities, diabetes, endometriosis, impaired neurological development, childhood learning disorders, immune deficiencies, reduced sperm counts, reduction in the size of genital organs, decreased fertility, ovarian dysfunction and feminized hormonal and behavioral responses.

It has taken the EPA nine years to reassess the scientific data on dioxin. "It was a humongous undertaking. It's based on hundreds, if not thousands, of public studies," says Linda Birnbaum, a leader of the EPA's effort. "We had to wait until the data was mature. In other words, there is a tremendous amount of additional data which has become available in the past several years. The bottom line is that we think that dioxin is about 10 times riskier than we have previously estimated for cancer," says Birnbaum. "The change in the risk estimate is based on better understanding of science related to the animal data and the availability of new human epidemiological studies."

As a result of industrial accidents, the effects of dioxin and its chemical cousins have been noted in medical and scientific journals for the more than 50 years: PCB exposure at Monsanto's Anniston, Ala., plant in the 1930s; an explosion at the same company's herbicide factory in Nitro, W.Va., in 1949; a PCB leak at a Japanese rice factory in 1968; the contamination of Seveso, Italy, in 1976; and the dioxin contamination of dozens of sites in eastern Missouri, including the entire town of Times Beach, in the early 1970s. In addition, scientists analyzed the effects on veterans exposed to Agent Orange, a dioxin-laden defoliant used during the Vietnam War.

But until the release of the latest EPA report, many of the epidemiological studies have been downplayed, altered or suppressed by chemical-industry lobbyists. Environmentalists have long suspected that the EPA's own hesitance to confront the issue is because of the powerful influence of those same forces.

After years of debate, the National Academy of Science (NAS) concluded in 1993 that Agent Orange exposure was responsible for increased rates of soft-tissue sarcoma, lymphoma and Hodgkin's disease among Vietnam vets. The NAS study also suggested that dioxin exposure may be tied to lung, larynx, trachea and prostate cancers, as well as myeloma.

Despite this scientific evidence, the EPA delayed releasing its own report on the dangers of dioxin for another seven years. During that entire time, the incinerator on McKissock Avenue kept burning.

On a Saturday afternoon, two girls sit in the shade on the curb at the corner of Pope and Prescott Avenues. Over on Carrie Avenue, a boy sprawls out on a front porch. A breeze is blowing to the east on this day, so the children are not being exposed fully to the incinerator emissions. Some days are worse than others east of North Broadway. It all depends on which way the wind blows and what's being burned. The city acknowledges that its northeast quadrant is plagued by higher levels of pollution, and there is no dispute that the medical-waste incinerator adds to the overall problem. This leaves the residents who live nearby feeling betrayed.

Alma Meziere owns two properties on Ouida Avenue. She is 65 years old and has lived on the street almost half her life. She sees and feels the effects of pollution daily. "My house, the one with white siding, has some type of soot on it," Meziere says. "Every time you take your car out and wash it, the next day the soot is all over it. I've had a garden down here for 27 or 28 years. Now I'm beginning to wonder, do I eat these tomatoes? Or how about the lettuce?

"We have a lot of people down here with breathing problems," says Meziere, clearing her own throat. "We have young children down here who are just coming up. But they (city officials) don't give us the right time of day, and we're taxpayers. We're being walked on. There are a lot of people down here who are poor. But the thing of it is, they're trying to get by and live the best they can. And they don't deserve to be guinea pigs.

"It can't be healthy," says Meziere of the incinerator. "I could move out to Florissant and still get the results of this thing down here. The smokestack is too low. Even if it was high, what goes up must come down -- that's the law of gravity."

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