NACWA Comments on ELG Preliminary Plan December 31, 2007

EXECUTIVE COMMITTEE

PRESIDENT Christopher M. Westhoff

Assistant City Attorney

Public Works General Counsel

City of Los Angeles

Los Angeles, CA

VICE PRESIDENT

Marian Orfeo

Director of Planning

& Coordination

Massachusetts Water

Resources Authority

Boston, MA

TREASURER

Kevin L. Shafer

Executive Director

Milwaukee Metropolitan

Sewerage District

Milwaukee, WI

SECRETARY Jeff Theerman

Executive Director

Metropolitan St. Louis

Sewer District

Saint Louis, MO

PAST PRESIDENT Dick Champion, Jr.

Director

Indep endence Water Pollution

Control Department

Independence, MO

EXECUTIVE DIRECTOR

Ken Kirk December 31, 2007

Attn: Docket ID EPA-HQ-OW-2006-0771

Water Docket Environmental Protection Agency 1200 Pennsylvania Ave., NW Washington, DC 20460-0001 Submitted via: www.regulations.gov

Dear Sir or Madam:

These comments are submitted on behalf of the Natio nal Association of Clean Water Agencies (NACWA) regarding the Preliminary 2008 Effluent Guidelines Program

Plan . NACWA represents the interests of nearly 300 pub licly owned wastewater treatment works (POTWs) nationwide. NACWA’s member s serve the majority of the sewered population in the United States, and co llectively treat and reclaim more than 18 billion gallons of wastewater each day.

NACWA’s comments address the detailed study that EP A is conducting for the Health Services Industry, which is focusing on dent al mercury and unused pharmaceuticals. While NACWA members themselves ar e not the sources of mercury, pharmaceuticals, or hundreds of other poll utants, they are committed to preventing the discharge to wastewater of as many p ollutants as is feasible, or to removing as much of these pollutants as is feasible from the wastewater. NACWA’s members have been actively exploring options for re ducing the quantities of mercury and pharmaceuticals that are discharged int o the sewer system. Although NACWA supports national efforts to address mercury and pharmaceutical discharges, establishing effluent guidelines for th e Health Services Industry is not a practical way to address the large number of discha rgers in the category and would not result in substantial water quality improvement s. The comments below detail NACWA’s reasons for recommending options other than national pretreatment standards for controlling mercury and unused pharma ceutical discharges into the

sewer system.



### Dental Mercury Dental Mercury NACWA’s Mercury Workgroup was formed more than a de cade ago to work on the issue of mercury in municipal wastewater effluent a nd biosolids. With over 60 members from the municipal wastewater community acr oss the country, this Workgroup has since developed several critical reso urces on the subject and

continues its dedicated work to assist POTWs in con trolling mercury discharges.NACWA Comments on ELG Preliminary Plan Page 

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For example, in 2006, the Workgroup released NACWA’s white paper, Controlling Mercury in Wastewater Discharges from Dental Clinics (attached). This paper was designed to educate co mmunities and states considering their options for controlling mercury d ischarges from dental clinics, the single largest s ource of mercury in wastewater, and focused on the various c ontrol options available. NACWA’s members have lea rned a great deal through actual implementation of best management practices, numeric limits, and separator requirements for dentists, and the paper enables ot her POTWs to learn from these experiences.

NACWA’s comments below are intended to provide EPA, as it considers mercury discharges from the Health Services Category, with additional insight into eff orts of the nation’s POTWs to identify sources and reduce releases of mercury into the environment. While NA CWA believes that an overall national strategy on m ercury is needed, the Association does not believe that na tional pretreatment standards for dental clinics, w hether best management practices, mandatory amalgam separator i nstallation, or numeric limits, are necessary or appropriate. Local efforts that are tailored to sp ecific community and water quality needs are alread y having tremendous success at reducing the controllable sou rces of mercury.



### NACWA Mercury Study The NACWA Mercury Workgroup’s most recent effort wa s designed to examine the effectiveness of practica l and reasonable measures of controlling mercury disc harged to the POTW collection system, such as denta l amalgam separator installation, on the ability of P OTWs to meet strict effluent mercury limits. NACWA is pleased to provide EPA with the Draft Final Report from that effort. For this study, the influent, ef fluent, and biosolids mercury concentrations from twelve U.S. a nd Canadian POTWs that were in various stages of requiring dental facilities to install amalgam sepa rators were measured on a monthly basis from July 2 003 through July 2006 to evaluate the impact of separat or installation and other potential factors. Infor mation on other source control efforts and operational activi ties at the sampled POTWs was also collected in an effort to shed light on numerous issues related to controllin g mercury releases by POTWs to the environment.

The results from the study are briefly summarized i n the Executive Summary:

According to the results, separator installation do es not generally appear, at least within the timefr ame of this study, to significantly reduce effluent mercury concentration s. However, amalgam separator installation does ge nerally appear to result in reductions in biosolids mercury concentrations. Therefore, despite the variabilit y and uncertainties described in this report, the data strongly support a conclusion that the use of separators can decrea se the amount of particulate mercury entering POTWs, thereby decreas ing the amount of mercury that would be removed by plant processes and deposited in the biosolids.

Overall, the results of the study indicate that man y factors, not just amalgam separator installation, influence mercury concentrations at POTWS. Factors including legacy contributions of mercury from historic disc harges will make it difficult for a facility to predict wi th certainty that amalgam separators will decrease mercury concentrations without also exploring the other pot ential contributors to current mercury levels. Tho ugh the study results indicate that even POTWs with demonst rably successful amalgam separator programs may not be able to consistently meet current or imminent efflu ent limits (e.g., 1.3 nanograms per liter in the Gr eat Lakes), these local efforts do appear to be having a measur able effect on the quantity of mercury being discha rged to

POTWs.NACWA Comments on ELG Preliminary Plan Page 

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NACWA encourages EPA to examine the entire report a nd appendices, which include numerous observations regarding the complexities of assessing mercury lev els in POTW influent and effluent that will be rele vant for any assessment of the Health Services Category.



### Targeted, Water Quality-Based Source Control Effort s Treating effluent to remove mercury is extremely ch allenging and can cost on the order of $21 million per pound of mercury removed, yet result in minimal env ironmental benefit considering the relative magnitu de of the reductions. POTWs across the country have ther efore focused on source control efforts to reduce t he mercury entering their treatment plants. Using the ir authority under the Clean Water Act to control i ndustrial and commercial discharges to their plants, POTWs ha ve developed a wide range of programs to address mercury discharges from dental clinics, hospitals, and other sources. These programs range from volun tary best management practices (BMPs) to mandatory insta llation of amalgam separators to issuance of discha rge permits with numeric limits for mercury dischargers . These efforts have been very effective at reduci ng the amount of mercury entering wastewater treatment pla nts.

The number of these local programs designed to cont rol mercury discharges to POTWs has increased dramatically since the Mercury Workgroup was formed . Driven first by the need to meet extremely low m ercury effluent limits in the Great Lakes region, local ef forts are now being designed and implemented across the country to best meet the needs of the community and water quality. In 2006, NACWA developed a brochur e (attached) highlighting some of these successful me rcury control programs from around the country.

As the number of local and state level efforts has grown, NACWA and its members have increasingly work ed in cooperation with the American Dental Association (A DA) and its members. The two national organization s have coordinated their work on several mercury-rela ted studies and several new state and local-level p rograms have been developed where POTW and dental organizat ion have worked together to find a program that wor ks effectively for everyone. Whether collaborative or more regulatory in nature, these targeted source c ontrol

efforts will continue to work to best address the n eeds of each community as well as protect water qua lity.



### More National Leadership, Not Pretreatment Standard s Needed While NACWA has worked to preserve this successful, local-driven approach to using the water quality b ased elements of the Clean Water Act to address specific water quality needs, the Association has also advo cated for a coordinated national approach to addressing all mer cury issues. Legacy issues such as abandoned mine discharges, as well as air deposition of mercury an d other diffuse sources of mercury, continue to be the major contributors of mercury in the environment. Nation al Effluent Guidelines clearly play a critical role for water quality for some industries, but history has shown us that for a category as large and diverse as the health services category, local approaches work best.

While dental clinics are the major source of mercur y for most POTWs, and the number of programs design ed to address this source is increasing rapidly, it is of ten the uncontrollable sources of mercury that prev ent POTWs from meeting stringent effluent limits. In fact, i n at least one case, a POTW has demonstrated that i t would not be able to meet the Great Lakes mercury limits even if it eliminated all dental clinic discharges. NA CWA examined the ability of POTWs to meet increasingly stringent effluent limits in two earlier studies, Evaluation of Domestic Sources of Mercury (August 2000), and a report prepared under coopera tive agreement from EPA to evaluate the effectiveness of pollution prevention programs at controlling mercury discharges to waste water treatment plants, Mercury Source Control and Pollution Prevention Pro gram Evaluation (March 2002). NACWA hasNACWA Comments on ELG Preliminary Plan Page 

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provided both of these reports to EPA in the past, but is transmitting them again with these comments to ensure they are considered during the review of the Health Services Category.

The major findings from the domestic sources report are still relevant today:

• Significant amounts of mercury at the average conce ntration of 138 parts per trillion were consistentl y found in strictly domestic wastewater in various pa rts of the country. This was wastewater that conta ined no industrial or commercial inputs, including denta l offices. POTWs typically remove 97 percent of mercury that is discharged into sewage systems.

• Several common household and toiletry items were fo und to contain substantial concentrations of mercur y when examined using sensitive analytical techniques . Although these products individually do not contribute significantly to a total concentration i n wastewater, their cumulative effect accounts for approximately 15 percent of the mercury concentrati on in domestic wastewater.

• Although several sources contributing to the domest ic mercury concentrations have been identified, hum an wastes (feces and urine) from individuals with dent al amalgam fillings are believed to be the most significant source — greater than 80 percent. Thes e results were corroborated by the results from che mical toilet and septic wastes that showed that a signifi cant portion of the mercury in domestic wastewater is from uncontrollable sources such as dental amalgam fillings.

• While controlling human waste is impractical, the l ong-term outlook is promising inasmuch as the trend in dental health is for fewer cavities, resulting in s hrinking populations of individuals with significan t amounts of dental amalgam over time. (Dental healt h practitioners are also now increasingly relying o n alternatives to amalgam, e.g., composite resins.)

• Based on this information, domestic waste contribut es appreciable concentrations of mercury to POTW

influent wastestreams and must be considered when a ddressing mercury control strategies and the likelihood of virtual elimination of mercury. Back ground mercury concentrations averaging more than 1 00 parts per trillion can be expected in POTW wastewat er influents, even if complete elimination of indus trial point source discharges is accomplished.

The March 2002 report found that domestic sources s ignificantly contributed to mercury entering POTWs, and that without addressing those contributions, POTWs would likely not be able to meet some of the more stringent effluent mercury limits. State governmen ts in many cases have enacted laws designed to phas e out products containing mercury, to foster pollution pr evention programs intended to keep mercury from ent ering the environment, and to address other sources of me rcury, but there has been no coordinated leadership at the federal level to devise a plan for addressing the b roader issue of mercury pollution.

Clearly, the biggest challenge to achieving meaning ful reductions of mercury in the nation’s waters is presented by the air deposition of mercury from coal-fired ut ilities and other sources in this country and world wide. Contributions of mercury from POTWs nationwide to t he water environment are dwarfed by the massive quantities of mercury entering via air deposition. EPA’s own total maximum daily load (TMDL) program hasNACWA Comments on ELG Preliminary Plan Page 

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recognized this fact and has established special pr ocedures for handling mercury TMDLs. Special listi ng categories and consideration for de minimis contributions of mercury recognize that the nation ’s mercurycontaminated waters will only improve when non-wate r related programs begin to address the bigger prob lem.

This multi-state and even global issue cannot be so lved through the current patchwork of controls. Ra ther, there needs to be a broad, innovative strategy at t he national level that focuses on source control an d moves beyond traditional pollution controls.



### Next Steps

Much of the valuable information NACWA has to offer on the subject of mercury discharges from the Heal th Services Category resides in the expertise of the A ssociation’s Mercury Workgroup. NACWA would like t o facilitate a discussion among EPA’s effluent guidel ines staff and members of its Workgroup to ensure t hat this information is fully utilized as EPA continues its review of the category.



### Unused Pharmaceuticals Unused Pharmaceuticals

NACWA’s Emerging Contaminants Workgroup is examinin g the issue of pharmaceuticals in wastewater and providing the NACWA membership with information and resources to assist their source control efforts. As with most contaminants, keeping pharmaceuticals out of the sewer system is more effective than removin g them at the wastewater treatment facility. Many ph armaceuticals pass through wastewater treatment pla nts and are discharged with the effluent into the recei ving waters. Although the effects of pharmaceutica ls in the environment on human health are still being determi ned, evidence indicates that endocrine-disrupting compounds from pharmaceuticals and other sources ca n affect aquatic life. Efforts to reduce pharmaceu ticals entering the sewer system and the environment are, therefore, vital.

EPA reports in the 2008 Preliminary Effluent Guidelines Plan that there are over 475,000 facilities in the Heal th Services Industry. Establishing effluent guidelin es for such a large number of facilities would crea te a tremendous burden on POTW pretreatment programs, wh ich would also face technical challenges implementing the guidelines. Analytical methods fo r measuring pharmaceuticals in POTW influent, efflu ent, and sludge have not been perfected yet. EPA’s Offi ce of Science and Technology has experienced this c hallenge as it seeks to measure contaminants of emerging con cern (CECs) as part of its ongoing POTW study. EPA found it necessary to develop methods for 74 pharma ceuticals and, in its fact sheet on the POTW study, states that “the key technical challenge is to accurately identify CECs when they occur in the presence of so many other physical objects and chemicals found in sanit ary sewage.” Also, it is currently impossible to s eparate the amount of pharmaceuticals that are disposed into wa stewater from the amount that is excreted by humans using the pharmaceuticals at those same sources. M easuring pharmaceutical disposal from health care facilities would therefore be extremely difficult, and pretreatment programs would need to rely on dis posal reports from the facilities, making verification di fficult or impossible.

Rather than establishing effluent guidelines to red uce the amount of unused pharmaceuticals entering t he

wastewater stream, EPA should work with other feder al agencies to develop clear, consistent guidelines or best management practices for disposal of unused pharmac euticals. Flushing unused pharmaceuticals down the toilet was long a recommended practice, and many he alth care facilities continue to follow this practi ce. In 2006, a NACWA member surveyed the nursing homes and long-term care facilities in its service area on t heirNACWA Comments on ELG Preliminary Plan Page 

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pharmaceutical practices. From the 45 responses, 6 7 percent of the unused pharmaceuticals were dispos ed of into sewer system, 27 percent went into the garbage , and 6 percent were returned to pharmacies. Many hospice programs also still recommend flushing of all unuse d prescription drugs after the death of a patient. Changing these behaviors is critical, but national pretreatm ent standards are not the best tool for doing so.

No information is available yet on whether federal guidelines issued by the White House Office of Nati onal Drug Control Policy (ONDCP) in February 2007 have i nfluenced the disposal practices for unused pharmaceuticals in the Health Services Industry. T hese guidelines recommend disposing of unused, unne eded, or expired prescription drugs in the trash, but als o advise that certain drugs still be flushed down t he toilet, including a list of 13 specific drugs and any other drugs with patient information that gives instruct ions for this type of disposal. While the guidelines were d eveloped by ONDCP in partnership with EPA and the Department of Health and Human Services (HHS), the recommendation to flush certain drugs is at odds wi th EPA’s goals of reducing pharmaceuticals in the envi ronment. NACWA is also concerned that the guidelin es send a mixed message to health care facilities, hos pice programs, and consumers, and that flushing wil l still be considered the easiest method of disposal for all d rugs.

EPA should continue to work with the ONDCP, HHS, an d the Drug Enforcement Agency (DEA) to develop alternative methods for drug disposal, including dr ug take-back programs. Pharmaceutical take-back programs have been instituted on a local and region al basis in many areas, and many NACWA members have spent thousands of dollars to establish and support these programs and ensure that these drugs do not end up in the environment. Take-back programs have not be en possible in many areas, however, because of requirements for the handling of controlled substan ces under current DEA regulations, which prohibit a nyone other than the person that the drugs were prescribe d for to possess the drugs for any reason. For dru g takeback programs, these regulations mean that local la w enforcement must be present at collection sites t o prevent violation of federal law, making take-back programs unfeasible in many areas. EPA should work with ot her federal agencies to change these guidelines for con trolled substances and establish national guideline s to enable local drug take-back programs and other sour ce control efforts to succeed. This coordination a nd additional, consistent federal guidance is what com munities need, not new pretreatment standards.

If you have any questions, please contact me at 202 /296-9836 or cfinley@nacwa.org

.

Sincerely,

Cynthia A. Finley Director, Regulatory Affairs

Attachments: 2006 NACWA white paper, Controlling Mercury in Wastewater Discharges from D ental Clinics 2007 draft final report of NACWA Dental Amalgam Stu dy 2006 NACWA brochure on successful mercury control p rograms 2000 report, Evaluation of Domestic Sources of Mercury

2002 report, Mercury Source Control and Pollution Prevention Pro gram Evaluation