Leslie Lott

Health Care With Harm: A Study of the Initiative To Shut Down Henry Ford
Hospitals Medical Waste Incinerator in
Detroit, Michigan

TABLE OF CONTENTS Max Ortiz/ Detroit News

PROBLEM

BACKGROUND

KEY ACTORS

DEMOGRAPHICS

STRATEDGIES

SOLUTIONS

RECOMMENDATIONS

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 Countys 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 Countys 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 incinerators 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 Michigans largest polluters, for burning waste send

tons of lead, dioxins, and other toxins into the atmosphere (http://www.ecocenter.org/health.html).

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 are 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 incinerators 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/cchw/campaign/Profiles.html).

Environmental Justice

Since the mid- 1980s 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. 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 Fords 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
Fords 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 EPAs 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.

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. In 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 have been to 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, therefore reducing the risk of dioxin production

(HCWH 1999).

Back to Table of Contents

Background

The Henry Ford Health Care System was founded in 1915 to provide comprehensive health care

for residents of Detroit and southeast Michigan Henry Ford Hospital has 900 beds and an education and

research complex on site. Currently there are only two processes which produce emissions on the site of

the facility: a medical waste incinerator, fuel fired steam boilers and emergency boilers. The incinerator

was installed in 1980 (Velick 2000).

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 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.

The USEPA states in their draft of the Dioxin Reassessment which 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 is 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 Districts Council did not start actively working on this campaign until late 1996-early 1997

when the facility failed an opacity test, 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.

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 Fords

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 member 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 Fed 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

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 collation would be the best

tactic to use to effectively use community resources in the area to lobby for the shutdown of the

incinerator and drastic changes in waste management practices.

The hospital, despite hearing the Coalitions demand for HFHS to shut down the incinerator

decided that spending $2.1 million dollars on upgrading on upgrading the incinerator to comply with new

Fed Regulations was the best option (Bates-Rudd Hospital Claims 1999). Mike Whelan, Henry Ford

Hospitals 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).

Back to Table of Contents

Key Actors

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 executives became very responsive and open to meeting with the coalition to discuss their

concerns and questions about the operating of the incinerator.

 James Williams, VPCC member
Photo by Daniel Mears/ Detroit News
Virginia Park Citizens 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 opposed 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, organized the usage of yard signs

which said Shut It Down, HENRY FORD and encouraged the community to come to public hearings

and rallies.

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 Citizens 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 (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 1960s. 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 Fords 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 Fords 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 Centers 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 Centers staff

members who focus on their medical waste project, Tracey Easthope and Mary Beth Doyle were also

instrumental in shutting down the University Of Michigans 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 Centers 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).

The following chart represents a summary of information based on 1990 Census data for all four

zip codes.
 Zip Codes Total % of People of % of

Population Color in Pop. 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

Back to Table of Contents

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. to

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 Citizens 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).

Back to Table of Contents

Solutions

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 EPAs 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.

Back to Table of Contents

Recommendations

The community members involved in the effort to shut down Henry Fords 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.

The struggle to shut down Henry Fords 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.

Back to Table of Contents

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
Bryant, Bunyan. Environmental Advocacy: Working For Economic and Environmental Justice. An
Unpublished book. 2000.
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.
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. Everyones 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 Centers 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)

Back to Table of Contents