“Health Care With Harm”
A Study of the Initiative
To Shut Down Henry Ford Hospital’s Medical Waste Incinerator in
by Leslie LottTable of Contents |
Max Ortiz/ Detroit News 9/22/00 |
| PROBLEM |
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| BACKGROUND |
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| KEY ACTORS |
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| DEMOGRAPHICS |
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| STRATEGIES |
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| SOLUTIONS |
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| RECOMMENDATIONS |
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| REFERENCES | |
| Back
To Environmental Justice Case Studies |
Problem
The effects of incineration have plagued both
Virginia Park, as well as other Detroit residents for years. Wayne County’s reliance on incineration for
medical and municipal waste is evident in the location of three incinerators
within an area of less than three miles of each other: Henry Ford Medical Waste
Incinerator, Detroit Municipal Incinerator, and Hamtramck Medical Waste
Incinerator. Many citizens have
referred to this area as Wayne County’s “toxic triangle of incineration”( Pers.
Comm. Cedar 2000). The Henry Ford Medical Waste Incinerator is located on the
premises of Henry Ford Hospital in a mixed business and residential area on
West Grand Boulevard in Detroit, Michigan.
Public Health
Since the incinerator’s inception in
1980, citizens have made repeated complaints because of foul smells and thick
black smoke, which penetrate the Virginia Park neighborhood on a daily basis (Bates-Rudd “Hospital to Close” 1999).
The United States Environmental Protection Agency (USEPA) states that
medical waste incinerators have been some of Michigan’s largest polluters,
for burning waste sends tons of lead, dioxins, and other toxins into the atmosphere
(http://www.ecocenter.org/).
For years, Virginia Park Residents, particularly children
and the elderly, have been suffering from respiratory illnesses and other
related heart conditions (http://www.essential.org/cchw/campaign/Profiles.html).
Residents have been plagued with nausea and headaches that miraculously disappeared
when the incinerator was closed for maintenance reasons in late 1999.
David Josar reports that, Michelle Gertz, 44, is becoming increasingly
convinced that the incinerator in her neighborhood is not so safe.
Her children, Brian, 10, and Brittany, 8, have chronic headaches and
stomachaches which she suspects are caused by the toxins and respiratory irritants
that permeate into the environment from the incinerator’s smokestacks (“Incinerator
Worries” 1999). “There have been twenty-one
recorded deaths related to respiratory and other health problems on Poe Street,
located directly across the street from the incinerator" (http://www.essential.org/).
Environmental Justice
Since the mid- 1980’s it has become
increasingly apparent that there is a disproportionate impact of environmental
toxins and pollution on individuals who reside in poor and minority communities
than those who live in other areas. A study conducted by the United Church of
Christ concluded that in communities with two or more commercial hazardous waste
facilities, the number of minorities was three times higher than in communities
without hazardous waste facilities (Bryant 2000). Many believe that the disproportionate impact of hazardous waste
facilities on people of color may be due to environmental racism. Environmental racism is the deliberate
targeting of people of color communities for toxic waste facilities and the
official sanctioning of a life threatening presence of poisons and pollutants
in people of color communities (Bryant 2000).
Henry Ford Hospital is located in an area where
people of color make up ninety-one percent of the population, with
African-Americans making up the largest number of that percentage
(http://www.uscensus.gov). The Henry
Ford Health System that operates Henry Ford’s Hospital has two other hospitals
in predominately Caucasian suburbs.
Currently, these suburban hospitals do not incinerate their medical
waste, but send it to an autoclave in Toledo, Ohio, where it is steam
sterilized ( Simmons 1999). Donele Wilkens of Detroiters Working For
Environmental Justice asserts, “Detroit residents are already exposed to more
harmful pollutants than their suburban neighbors (Seigel 1999).” To neighbors, community leaders, and
environmental groups, this is clearly an issue of environmental racism and
injustice. However, in January 2000, in
response to a letter written by the Coalition to Shut Down Henry Ford’s Medical
Waste Incinerator, Steve Velick, the Chief Executive Officer of the hospital at
the time denied this as being an environmental justice issue. He states, “Cottage and Wyandotte [two of
the hospitals located in the suburbs] stopped incinerating waste because their
facilities did not generate enough waste to justify the costly incinerator
upgrades required to meet the EPA’s newest standards” (2000). “Nevertheless,
community leaders want to know why the hospital chooses one method in a white,
suburban community and a different one in an African-American community (Holden
and Simmons 1999).”
Role Of Health Care
Health care professionals and their institutions pledge
to provide services that defend human beings against illness. Furthermore, health systems serve to incorporate
vital public health principles in the daily operations of their facilities,
including taking an active role in disease prevention (Michigan Environmental
Justice Coalition 1999). The Health
Care Without Harm Organization(HCWH) explains, “ [y]et, unknown to many of
us, the purchasing and waste disposal practices of health care institutions
often undermine their own purpose, and our expectations of them, by contributing
to sickness (HCWH 1999).” Further,
health professionals have taken the Hippocratic Oath of ‘first, do no harm,’
and practices such as incineration are directly inflicting harm on communities
that health care providers claim they strive to protect (http://www.ecocenter.org).
Alternatives to Incineration
Community leaders maintain that
there are affordable, safe and more efficient alternatives that are now being
used by an increasing number of hospitals. However, relying on incineration for
the disposal of medical waste from hospitals is slowly becoming a rarity in
southeast Michigan, particularly Wayne County.
A 1998 survey of twenty-five Wayne County hospitals found that Henry
Ford Hospital is the only one still burning their waste in an incinerator on-site. One third of these hospitals send their
waste a steam based autoclave in Toledo (Seigel 1999). Various technologies, such
as autoclaving, both sterilize and reduce the volume of medical waste without
incineration. Currently, autoclaves
are the most common treatment alternative in the United States. An autoclave destroys infectious agents
through a process of steam sterilization. However this process does not burn
waste, thereby reducing the risk of dioxin production (HCWH 1999).
Background
The Henry Ford Health Care System was founded in
1915 to “provide comprehensive health care for residents of Detroit and
southeast Michigan (Velick 2000).” Henry
Ford Hospital has 900 beds and an education and research complex on site. The incinerator, to burn the hospital’s
medical waste, was installed in 1980. Until
recently, Henry Ford Hospital incinerator burned approximately 600 million
pounds of medical and solid waste annually. While the waste stream includes used surgical dressings, latex
gloves, old medicines, and amputated body parts, it is mainly comprised of
discarded paper and plastics that could be recycled or disposed as ordinary hospital
waste (Pers. Comm. Holden 2000). The
Center For Disease Control (CDC) estimates that only six percent of the waste
stream is infectious and only two percent of the hospital medical waste stream
is any significant threat to human and should be burned in a crematorium or
other incinerator. The rest of the waste or more than ninety percent can be
handled in the same way solid waste is handled by reducing, reusing, and
recycling (http://www.ecocenter.org/health.html). Excessive burning of plastics, paper, and other non-infectious
wastes results in the emission of dioxins, furans, arsenic, lead, mercury,
cadmium, carbon monoxide, acid gases, and toxic particulates (HCWH 1999).
The USEPA states in their draft of the Dioxin
Reassessment that hospital incinerators are one of the three largest sources of
dioxins to the environment. Their
research findings show that dioxins not only cause cancer, but may lead to
developmental and immune system problems to those who are exposed to these
toxins over an extended period of time.
Additionally, the EPA asserts that medical waste incinerators are the
second leading source of mercury, which is a neurotoxin. Incinerators also emit
pollutants and particulates that are respiratory irritants that can
exacerbate problems for asthma sufferers
( HCWH 1999).
The citizens whom inhabit the area
surrounding the incinerator can attest that they have seen the effects of these
toxins on themselves, their family, and the community at large. A 1998 Wayne State University Report found
that Michigan residents living near pollution sources, such as incinerators,
have lower birth rates and higher rates of cancer. A five year Michigan Department of Community Health study shows
that the rate of children hospitalized for asthma is at least three times higher
in a cluster of inner city zip codes surrounding Henry Ford Hospital than in
Wayne County, outside of Detroit.
Additionally, the report asserts that asthma rates among
African-American children are increasing.
For further evidence, a report commissioned by the New York University
Research Program focused on Ambulatory Care Sensitive Conditions in Michigan
from 1983 through 1994 sites that in the four zip codes surrounding the
incinerator, the average number of hospital emissions of children aged zero
through four are at numbers four times the state average (1998).
Community
Organization
Although the incinerator has been criticized since
its inception, a neighborhood residents of the Virginia Park District’s Council
did not start actively working on this campaign until late 1996, early 1997
when the facility failed an opacity test, which was the only restriction on
particulate air emissions for medical waste incinerators in Michigan at that
time (Pers. Comm. Holden 2000). Opacity
measures and limits the amount of particulate content of what is coming out of
a smokestack and provides no limitations on toxin levels. Failure of this test brought some community
attention to the incinerator and provided an opportune time for community
leaders to begin a dialogue with the Health System (Pers. Comm. Doyle 2000).
In August 1997, the EPA released the first federal
standards and guidelines (the MCAT rule) regulating hospital and medical waste
incinerators. Existing facilities will
have three to five years to comply with these rules (HCWH 1999). At the time of the release of these guidelines,
Henry Ford’s incinerator did not comply with the new federal standards for
emissions. Wayne County granted a
consent order approving the renewal of their permit contingent on reducing
pollution to levels acceptable to the USEPA.
The Consent Order includes limits on final emissions and stack testing
to confirm that the incinerator is operating in compliance. Waste changing rate
has been reduced from 1800 pounds per hour to 1000 pounds per hour. Additionally, certain pollutants will be
monitored by a Continuous Emissions Monitoring System (Wayne County Dept. of
the Environment 2000).
Community members, and other environmental
organizations realized that HFHS would be making critical decisions during the
next few months, which would decide how the incinerator would operate in the
future. The Sierra Club and the Ecology
Center, in particular, were unwilling to approve letting the incinerator
continue to operate at these Federal levels.
Both groups believe that Federal guidelines compromised with environmental
safety by not providing adequate protection of the health of the community by
allowing tons of toxins to be released into the environment each year. These
groups felt that complying just to these standards was not doing enough. Employing a waste reduction program, phasing out
mercury based products and attempting to reuse and recycle many of the
products thrown into the waste stream quickly were placed on the agenda as
well. Community members claim that the “hospital
has an obligation not only to live up to the letter of the law(and whatever
loopholes may be in it) but to live up to the Hippocratic Oath” (Seigel 1999).
So, community health and environmental organizations from around the greater
Detroit Area decided that forming a coalition would be the best tactic to
ensure efficient use of community resources in the area to lobby for the
shutdown of the incinerator and drastic changes in waste management practices
of Henry Ford Hospital (Pers. Comm. Doyle 2000).
The hospital, despite hearing the Coalition’s demand
for HFHS to shut down the incinerator decided that spending $2.1 million dollars
on upgrading the incinerator to comply with new Fed Regulations was the best
option (Bates-Rudd “Hospital Claims” 1999).
Mike Whelan, Henry Ford Hospital’s Vice President of Support Services,
claimed the “hospital did a very extensive study evaluating fifty-two
alternatives….[and] they claimed that other methods of dealing with medical
waste would have raised expenses and health costs or would have required the
waste to be transported through residential areas, creating safety problems for
the community (Seigel 1999).”
Henry Ford Hospital
Henry
Ford Hospital has been operating an on site medical waste incinerator since 1980. The board of executives, including Nancy
Schlicting have always maintained that the “all scientific and technical
standard indicate that incinerator is safe to operate and the WCDEQ has
confirmed it meets all air quality standards”(Schlicting 2000). They cite examples that show their attempt to
be a “good corporate citizen” such as spending two million dollars to upgrade
the incinerator to meet USEPA “stringent” air quality standards. Further, issues of potential
environmental injustices have been repeatedly denied. However, the hospital executive’s became very responsive and open
to meeting with the coalition to discuss their concerns and questions about the
operating of the incinerator (Pers. Comm. Doyle).
James Williams, VPCC member Photo by Daniel Mears/ Detroit News 5/7/00
Virginia Park Citizen’s
Council(VPCC)
Virginia Park Citizens Council is a local
neighborhood council that has actively opposed an incinerator being located in
their community since 1996. One of the most vocal members of this organization
is resident James Williams who was incensed by the unequal treatment of residents
in his area as compared to suburban residents. He also has become increasingly
convinced that the incinerator located across the street from his home may be
causing some of his health problems. “I
want to be a good neighbor to the hospital, not a patient in it (Barry 2000).” Williams and other council members have been
a liaison between the neighborhood residents and the coalition at large. VPCC helps to educate their neighbors of the
potential health effects of incinerator and encourage them to attend town
meetings and rallies to ensure that their voices would be heard by the HFHC. Also, they organized the usage of yard signs
which said “Shut It Down, HENRY FORD” and encouraged the community to come to
public hearings and rallies (Pers. Comm. Holden 2000).
Coalition To Shut Down Henry
Ford Medical Waste Incinerator
This coalition was established over four years ago
and involves over thirteen community, public health, and environmental organizations
including: Virginia Park Citizen’s District Council; Detroiters Working For
Environmental Justice; Southeast Michigan Group of the Sierra Club; the Ecology
Center; the Sugar Law Center for Economic and Social Justice; the National
Wildlife Federation; and the Michigan Chapter of the American Lung
Association. Additionally two local
grassroots community groups focusing on shutting down incinerators in their own
communities, Hamtramck Environmental Action Team and Clean Air Please! Of
Madison Heights, offered support as well.
The coalitions received political endorsement from two local
governmental officials: Wayne County Commissioner Jewel Ware and State
Representative Hansen Clarke. The primary goals of the coalition are to (1)
shut down the medical waste incinerator, (2) prevent HFHS from sending their
waste to a commercial incinerator (i.e. Hamtramck Commercial Medical Waste
Incinerator), (3) reduce the waste stream and its toxicity and (4) start a
extensive recycling program on site (Pers. Comm. Doyle 2000)
Southeast
Branch of the Sierra Club
Anna
Holden, who is the chair of the Southeast Branch, is the lead member and
spokeswomen for the Coalition. Anna has
been an active part of both the civil rights and environmental movements since
the early 1960’s. In 1999, she
published two articles about the campaign to shut down the incinerator in an
attempt to raise even more national public awareness of health and
environmental justices issues. Both her
dedication and experience with similar campaigns makes her a valuable asset to
this struggle. Finally, as an
organization, the Sierra Club provided financial resources and a well renowned
name, adding legitimacy to the cause.
Detroiters
Working For Environmental Justice (DWFEJ)
DWEFEJ has emphasized the apparent environmental
injustice occurring in the Virginia Park neighborhood. Donele Wilkens, director of DWEFEJ, has
become the “face of the coalition” due to her eloquent and powerful speaking
ability. She explains, “Environmental
racism is real. In neighborhoods across
Detroit and around the nation, it is destroying the health of our people”
(Wilkens and Sullivan 2000). Through the effort DWEJ, the Coalition has
received national attention through hosting a press conference in Detroit “declaring a national state of emergency on
environmental racism and economic injustice” that focused on local
environmental injustices, including Henry Ford’s Incinerator. The keynote speaker for this event was Damu
Smith of Greenpeace USA, who was instrumental in the struggle to prevent the
Shintech Corporation from placing a hazardous waste facility in a predominately
African-American neighborhood in Louisiana.
This press conference enabled the Coalition began to publicize their
concerns and efforts under the umbrella of the national environmental justice
movement.
Jewel Ware, Wayne County
Commissioner
Jewel
Ware joined the coalition in 1998 when she was informed of the health threats
that community members in her district were experiencing due to location of Henry
Ford’s incinerator in their neighborhood.
As a prominent local official, she has the respect of many local
community leaders and enlisted local
ministers to endorse a series of advertisements in local newspapers, demanding
that Henry Ford shut down its incinerator.
Also in 1999, Ware sponsored several town meetings that helped to
facilitate an active dialogue between that addressed the questions and concerns
of citizens in the area. Ware stated in
September 1999, “Henry Ford Hospital likes to boast about its leadership in
medicine. [Failure to comply with
opacity and cadmium] tests show that Henry Ford also leads as a polluter. As a health care provider, it ought to be
ashamed that its incinerator poses such a serious health hazard to the public”
(Josar “Environmentalists” 1999).
The Ecology Center
The
Center’s Environmental Health Project has focused on a medical waste project
that promotes environmentally responsible health care and provides technical
assistance to community and local officials.
Specifically, this project attempts to educate the community of the
harmful health effects of incineration and advocates the shut down of all
incinerators in the southeast Michigan area. Their activism brought much needed
resources into the campaign including experts on public health, researchers,
and past experience in campaigns to shut down incinerators. The Ecology Center’s staff members who focus
on their medical waste project, Tracey Easthope and Mary Beth Doyle were also
instrumental in shutting down the University Of Michigan’s medical incinerator
while the Henry Ford campaign was beginning to become more aggressive. Additionally Tracey Easthope is an
important member of the campaign for she is a scientific expert on incineration
and its potential effects on public health.
With the Center’s connections to the national Health Care Without Harm
Organization, Health System officials experienced national public relations
embarrassment as being a health care provider that is inflicting harm on the
very individuals it strives to keep healthy.
Back to Table of Contents
Demographics
In
order to somewhat accurately portray the demographics of the area, the four zip
codes (48202, 48206, 48208, 48201) located around
the Henry Ford Hospital were chosen for analysis. The population of these four
zip codes combined is 93, 962. Of these
individuals, 85, 868 are people of color who are largely African-American. Thus, the percentage of people of color in
this area is ninety-one percent of the total population. Additionally, sixty percent of the families
that live within a two and a half mile radius of the incinerator are at or near
the poverty level (about $15,000 per year for a family of four)
(http://www.essential.org/cchw/campaign/Profiles.html).
The
following table represents a summary of information based on 1990 Census data
for all four zip codes.
|
Zip Codes |
Total Population |
% of People of Color in Pop. |
% of
Households >$15,000/year |
|
|
48202 |
24,565 |
91% |
58% |
|
|
48201 |
16, 221 |
75% |
79% |
|
|
48206 |
38, 035 |
99% |
56% |
|
|
48208 |
14, 925 |
92% |
65% |
|
|
Source:
1990 U.S. Census Data |
||||
Strategies
Coalition Building
Establishing a coalition in 1998 provided a
strong and threatening presence that demanded the opinions and concerns about
incineration be heard. Connecting
individuals from diverse backgrounds and resources provided a variety of
perspectives and a significant amount of human resources that are needed for
this campaign to be a success.
Drawing Support From
National Non-Government Organizations
Making connections with nationally known
organizations such as Sierra Club, Health Care Without Harm, Detroiters Working
For Environmental Justice and Greenpeace provided national attention,
resources, and legitimacy to this campaign.
Civil Disobedience
Nonviolent rallies have been one of the primary methods used by the coalition
to gain public awareness of the harmful effects of the incinerator on the
residents of the community. Although
these four rallies received little media attention, they became a public
relations embarrassment to HFHS.
Constant Community Pressure
In the beginning of the campaign the coalition target of influence was
the board of executives and the public relations department in a broad
sense. When letters and phone calls to
the board were not causing executives to desire to meet with coalition members
to discuss their concerns, the community decided it needed to formulate a
different, more effective approach.
Eventually it was decided that they would target a specific executive within
HFHS who possessed power within the health system, would respond to pressure,
and had the insight and conscience to realize it was in the hospitals best
interest to shut down the incinerator.
This woman was Nancy Schlicting, Senior Vice President of the Henry Ford
Health System. Citizens demanded that
their opinion be heard by making hundreds of phones calls and supplying a daily
shipment of postcards to her office.
Additionally, Virginia Park Citizen’s Council began to solicit bold, red
yard signs stating “Shut it Down, Henry Ford” which were prominently placed in
lawns around the facility.
Media Attention
The coalition had limited coverage by the mainstream media, so
leafleting, direct contact with citizens, town meetings and speakers at
community meetings helped spread to the community at large. Postcards were distributed and signed by
neighbors and other concerned South Eastern Residents urging HFHS to shut down
its incinerator. In November 18,the
same day as the “Great American Smokeout” protesters received some media
attention when they demanded that Henry Ford “Stop Smoking” (Seigel 1999). Coalition members also placed a huge
banner on the front of a church across the street from the incinerator that
stated “Henry Ford, Stop Smoking” which remained in that same position on the
church for months. By in large, most of
the publicity came from public radio, alternative community newspapers, and
radio/television stations targeting African-American communities (Simmons and
Holden 1999).
On February 4, 2000, Henry Ford
Health System officially announced that it was “committed to phasing out
incineration over a reasonable period of time (Schlicting 2000).” The Coalition to Shut Down Henry Ford
Incinerator congratulated Henry Ford but plan to “press for a definitive and
expeditious time line to achieve the shutdown”. In less than four years, the Coalition was successful in
achieving their main goal. This type of
outcome is unprecedented but Coalition members and HFHS admit that community
pressure and acute knowledge of the science and technology of medical waste
incinerators was what eventually caused Nancy Schlicting, executive Vice
President to make this decision (Doyle “Cleaner Air” 2000). Schlicting states herself in a letter to the
Michigan Environmental Justice Coalition that “[u]fortunately we have to deal
with negative news coverage and community concerns about it. This is taking time away from our core
mission. We are concerned about our
reputation and relationship to the community we are dedicated to serve
(Schlicting 2000).” Mary Beth Doyle, a
representative of the Ecology center stated in an interview “when you drive to
work every day seeing more and more signs on neighbors lawns and a huge banner that
is demanding the health system that you are an executive vice president for to ‘stop
smoking’ I believe it would tend to wear on your nerves (Pers. Comm 2000).”
The most incredible victory of this
battle was that Henry Ford did not have to shut down their incinerator at
all. In 1998, the hospital spent 2.1
million dollars in improving pollution control that included a monitoring
system and an air scrubber designed to remove chemicals from smoke. This retrofit was commissioned in response
to the EPA’s MCAT rule. Additionally,
in 1999 reported incinerator emissions were ten times better than the
Environmental Protection Safety Standards required by law. The incinerator, at
the time of its decided closure, was under compliance of all laws regulating hospital
and medical waste incinerators (Schlicting 2000).
Recommendations
The community members involved in the effort to shut
down Henry Ford’s Medical Waste incinerator have been successful in achieving
their main goal. At this point, Henry
Ford Health System has committed to ceasing operation of their incineration
facility on June 30, 2001. However,
many of the members of the coalition believe that this is not the end of the
struggle. In particular the Ecology
Center, Sierra Club, and the National Wildlife Federation want to ensure that
the Health System will begin to make an effort to significantly decrease the
amount of their waste stream and its levels of toxicity. Additionally, much emphasis has been made on
helping the hospital set up extensive recycling programs. As part of the discussion at the time when
Henry Ford announced that they were going to phase out incineration in February
2000, they also proposed building a recycling center, along with the autoclave
on the site where the incinerator used to be.
However, after hiring an environmental consulting firm that many in the
coalition believe to be pro-incineration, HFHS decided that the facility would
be too costly.
This new update has been a minor
defeat, but the Coalition has responded by encouraging HFHS to hire Resource
Recovery Systems, a firm that focuses on planning for large scale recycling
programs within industries. However,
this firm has little experience working with hospitals, which may become a
problem in the later months.
Additionally, the National Wildlife Fund is pushing the hospital to
commit to a mercury abatement plan.
Currently, HFHS has decided that it may consider replacing its incinerator
with an onsite autoclave ( Pers. Comm. Holden 2000).
The struggle to shut down Henry
Ford’s Medical Waste Incinerator provides hope and a model for all communities
struggling to shut down a hazardous waste facility in their own
neighborhood. It is a reminder that
citizens themselves are advocates and that are able persuade industry to commit
to ending many of the environmental and economic injustices of the world.
References
Personal Communications
Cedar, Rob.
Hamtramck Environmental Action Team.
Personal Communication on 16 October 2000.
Doyle, Mary
Beth. The Ecology Center. Personal Communication on 18 October
2000.
Holden,
Anna. Southeast Branch of the Sierra
Club. Personal Communication on 21
November 2000.
Journals, Magazines, Books and Newspapers
Barry, John
B. “Unjust Burden: Sierra Club Joins
Growing Movement For Environmental Justice.”
The Planet June 2000.
Bates-Rudd, Rhonda.
“Henry Ford to Shut Down Incinerator.”
Detroit News 23 Feb.
2000. Metro.
Bates-Rudd,
Rhonda. “Hospital Claims Its Air is
Cleaner.” Detroit News 15 December 1999.
Metro.
Bates-Rudd, Rhonda.
“Hospital to Close Incinerator After Neighbors Complain.” Detroit News
29 Mar. 2000. Metro.
Bryant, Bunyan. Environmental Advocacy: Working For Economic
and Environmental Justice. An
Unpublished book. 2000.
Doyle, Mary Beth.
“Cleaner Air Coming To Detroit.” From the Ground Up. April/ May 2000.
Holden, Anna,
and Charles E. Simmons. “Community
Health and Environmental Justice: Burning Issues in Detroit.” Everyone’s
Backyard: Journal of the Grassroots Movement for Environmental Justice.” Fall 1999.
Josar,
David. “Environmentalists: Close Waste
Incinerator.” Detroit News 22 Sept.
1999. Metro.
Josar,
David. “Incinerator worries
neighbors.” Detroit News 26 July
1999. Metro.
Seigel,
Ron. “Demonstrators Charge Medical
Waste Incinerator Causes Secondhand Smoke.”
Michigan Citizen 28 Nov.-4 Dec. 1999.
Simmons, Charles
E. “Environmental Justice and Human
Rights.” Michigan Citizen 26 Sept.-2
Oct. 1999.
Letters
Michigan
Environmental Justice Coalition. Letter
to Walter Douglas, Vice Chair Public Responsibility Committee, Henry Ford
Health System. 15 June 1999.
Schlicting,
Nancy M. Letter to Alison Horton,
Michigan Environmental Justice Coalition.
18 February 2000.
Velick, Steven. Letter
to Honorable Jewel Ware, Wayne County Commissioner. 19 Jan. 2000.
Pamphlets and Press Releases
Health Care Without Harm. Health Care Without Harm:
The Campaign For Environmentally
Responsible Health Care. Falls Church. 1999.
Wayne County Department of Environment. Air Quality Management Division. Community
Bulletin.
Detroit. 2000.
Wilkens, Donele and Quita Sullivan. “Local Groups Join In Issuing A
Declaration.” Press Release.
18 Jan. 2000.
World Wide Web Resources
Unknown. <http://www.essential.org/cchw/campaign/Profiles.html
> (19 Sept. 2000).
Unknown. “The Ecology Center’s Medical Waste
Project.” The Ecology Center < <http://www.ecocenter.org/health.html
> ( 24 Sept. 2000).
United States.
U.S. Census Bureau. http://www.census.gov (19 Sept. 2000)