National Emission Standards for Hospital Ethylene Oxide Sterilizers, 73611-73625 [E7-25233]
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Federal Register / Vol. 72, No. 248 / Friday, December 28, 2007 / Rules and Regulations
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[FR Doc. E7–24950 Filed 12–27–07; 8:45 am]
BILLING CODE 6560–50–P
ENVIRONMENTAL PROTECTION
AGENCY
40 CFR Part 63
[EPA–HQ–OAR–2005–0171; FRL–8512–1]
RIN 2060–AM14
National Emission Standards for
Hospital Ethylene Oxide Sterilizers
Environmental Protection
Agency (EPA).
ACTION: Final rule.
AGENCY:
SUMMARY: EPA is issuing national
emissions standards for new and
existing hospital sterilizers that emit
hazardous air pollutants and are area
sources within the meaning of Clean Air
Act section 112(a)(2). The final rule is
based on EPA’s determination as to
what constitutes the generally available
control technology or management
practices for the hospital sterilizer area
source category.
This action is being finalized as part
of EPA’s obligation to regulate area
sources listed for regulation pursuant to
Clean Air Act section 112(c)(3).
DATES: The final rule is effective on
December 28, 2007.
ADDRESSES: EPA has established a
docket for this action under Docket ID
No. EPA–HQ–OAR–2005–0171. All
documents in the docket are listed in
the Federal Docket Management System
index at https://www.regulations.gov.
Although listed in the index, some
information is not publicly available,
e.g., confidential business information
or other information whose disclosure is
restricted by statute. Certain other
material, such as copyrighted material,
is not placed on the Internet and will be
publicly available only in hard copy
form. Publicly available docket
materials are available either
electronically through
www.regulations.gov or in hard copy at
the EPA Docket Center in the EPA
Headquarters Library, Room Number
3334 in the EPA West Building, located
at 1301 Constitution Ave., NW.,
Washington, DC. The EPA/DC Public
Reading Room hours of operation are
8:30 a.m. to 4:30 p.m. Eastern Standard
Time (EST), Monday through Friday,
excluding legal holidays. The telephone
number for the Public Reading Room is
(202) 566–1744. For the Air and
Radiation Docket and Information
Center, the telephone number is (202)
566–1742, the fax number is (202) 566–
9744, the Web site is https://
www.epa.gov/oar/docket.html, and the
e-mail address is a-and-rDocket@epa.gov.
FOR FURTHER INFORMATION CONTACT: Mr.
David Markwordt, Office of Air
Planning and Standards, Sector Policies
and Programs Division, Coatings and
Chemicals Group (E143–01),
Environmental Protection Agency,
Research Triangle Park, NC 27711,
telephone number: (919) 541–0837; fax
number: (919) 541–0246; e-mail address:
markwordt.david@epa.gov.
SUPPLEMENTARY INFORMATION: Outline.
The information presented in this
preamble is organized as follows:
I. General Information
A. Does this action apply to me?
B. Where can I get a copy of this
document?
C. Judicial Review
II. Background Information for Final Area
Source Standard
III. Summary of the Final Rule and
Significant Changes Since Proposal
A. What is the affected source and the
compliance date?
B. What is required by the management
practice?
C. What are the testing and initial
compliance requirements?
D. What are the notification,
recordkeeping, and reporting
requirements?
IV. Exemption of Certain Area Source
Categories From Title V Permitting
Requirements
V. Summary of Comments and Responses
A. Proposed Alternative 1: Management
Practice
B. Proposed Alternative 2: No Control
C. Add-on Controls
VI. Summary of Environmental, Energy, Cost,
and Economic Impacts
VII. Statutory and Executive Order Reviews
A. Executive Order 12866: Regulatory
Planning and Review
B. Paperwork Reduction Act
C. Regulatory Flexibility Act
D. Unfunded Mandates Reform Act
E. Executive Order 13132: Federalism
F. Executive Order 13175: Consultation
and Coordination with Indian Tribal
Governments
G. Executive Order 13045: Protection of
Children From Environmental Health
Risks and Safety Risks
H. Executive Order 13211: Actions
Concerning Regulations That
Significantly Affect Energy Supply,
Distribution, or Use
I. National Technology Transfer and
Advancement Act
J. Executive Order 12898: Federal Actions
to Address Environmental Justice in
Minority Populations and Low-Income
Populations
K. Congressional Review Act
I. General Information
A. Does this action apply to me?
The regulated categories and entities
potentially affected by these final
standards include:
NAICS1 code
Category
General Medical and Surgical Hospitals .............................................................................................
Specialty (Except Psychiatric and Substance Abuse) Hospitals ........................................................
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1 North
73611
622110
622310
Example of potentially
regulated entities
Hospital sterilizers.
Hospital sterilizers.
American Industrial Classification System.
This table is not intended to be
exhaustive, but rather provides a guide
for readers regarding entities likely to be
affected by this action. To determine
whether your facility is regulated by this
action, you should examine the
applicability criteria in 40 CFR 63.10382
of subpart WWWWW (National
Emissions Standards for Hospital
Ethylene Oxide Sterilizers). If you have
any questions regarding the
applicability of this action to a
particular entity, consult either the air
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permit authority for the entity or your
EPA regional representative as listed in
40 CFR 63.13 of subpart A (General
Provisions).
B. Where can I get a copy of this
document?
In addition to being available in the
docket, an electronic copy of this final
action is also available on the
Worldwide Web through the
Technology Transfer Network (TTN).
Following signature, a copy of this final
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action will be posted on the TTN’s
policy and guidance page for newly
proposed or promulgated rules at the
following address: https://www.epa.gov/
ttn/oarpg/. The TTN provides
information and technology exchange in
various areas of air pollution control.
C. Judicial Review
Under section 307(b)(1) of the Clean
Air Act (CAA), judicial review of this
final rule is available only by filing a
petition for review in the United States
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Court of Appeals for the District of
Columbia Circuit by February 26, 2008.
Under section 307(d)(7)(B) of the CAA,
only an objection to this final rule that
was raised with reasonable specificity
during the period for public comment
can be raised during judicial review.
This section also provides a mechanism
for EPA to convene a proceeding for
reconsideration, ‘‘[i]f the person raising
an objection can demonstrate to the EPA
that it was impracticable to raise such
objection within [the period for public
comment] or if the grounds for such
objection arose after the period for
public comment (but within the time
specified for judicial review) and if such
objection is of central relevance to the
outcome of the rule.’’ Any person
seeking to make such a demonstration to
us should submit a Petition for
Reconsideration to the Office of the
Administrator, U.S. EPA, Room 3000,
Ariel Rios Building, 1200 Pennsylvania
Ave., NW., Washington, DC 20460, with
a copy to both the person(s) listed in the
preceding FOR FURTHER INFORMATION
CONTACT section, and the Associate
General Counsel for the Air and
Radiation Law Office, Office of General
Counsel (Mail Code 2344A), U.S. EPA,
1200 Pennsylvania Ave., NW.,
Washington, DC 20460. Moreover,
under section 307(b)(2) of the CAA, the
requirements established by this final
rule may not be challenged separately in
any civil or criminal proceedings
brought by EPA to enforce these
requirements.
II. Background Information for Final
Area Source Standard
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Sections 112(c)(3) and 112(k)(3)(B) of
the CAA instruct EPA to identify not
less than 30 hazardous air pollutants
(HAP) which, as a result of emissions
from area sources,1 present the greatest
threat to public health in the largest
number of urban areas, and to list
sufficient area source categories to
ensure that sources representing 90
percent of the 30 listed HAP (the ‘‘urban
HAP’’) are subject to regulation.
Consistent with these provisions, in
1999, in the Integrated Urban Air Toxics
Strategy (64 FR 38706, 64 FR 38715–
716, July 19, 1999), EPA identified the
30 urban HAP and listed the source
categories that account for 90 percent of
the urban HAP emissions.2
1 An area source is a stationary source of HAP
emissions that is not a major source. A major source
is a stationary source that emits or has the potential
to emit 10 tons per year (tpy) or more of any HAP
or 25 tpy or more of any combination of HAP.
2 Since its publication in the Integrated Urban Air
Toxics Strategy in 1999, the area source category
list has undergone several amendments.
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Under CAA section 112(d)(5), the
Administrator may, in lieu of standards
requiring maximum achievable control
technology (MACT) under section
112(d)(2), elect to promulgate standards
or requirements for area sources ‘‘which
provide for the use of generally
available control technologies or
management practices by such sources
to reduce emissions of hazardous air
pollutants.’’ As explained in the
proposed national emission standards
for hazardous air pollutants (NESHAP),
we are setting standards for the Hospital
Sterilizers Area Source category
pursuant to section 112(d)(5) of the
CAA. See 71 FR 64907, November 6,
2006.
III. Summary of the Final Rule and
Significant Changes Since Proposal
This section summarizes the final rule
and identifies and discusses the
significant changes since proposal. For
changes that were made as a result of
public comments, we have provided
detailed explanations of the changes
and the rationale in the responses to
comments in section V of this preamble.
A. What is the affected source and the
compliance date?
This final rule applies to any existing
or new hospital ethylene oxide
sterilization facility that is an area
source of HAP. The owner or operator
of an existing area source must comply
with this area source NESHAP by
December 29, 2008. The owner or
operator of a new area source must
comply with this area source NESHAP
by December 28, 2007 or upon initial
startup, whichever is later.
B. What is required by the management
practice?
In our November 6, 2006 proposal, we
proposed two alternative emission
standards for this area source category.
As Alternative 1, we proposed to require
that the affected source, as defined
above, sterilize full loads of medical
items having common aeration times
except during emergency circumstances
that dictate the use of less than full
loads to protect human health. As
Alternative 2, we proposed a finding
that there are no generally available
control technologies or management
practices (GACT) within the meaning of
CAA section 112(d)(5) for the Hospital
Sterilizers Area Source category. As
explained in more detail in section V of
this preamble, based on the comments
and information we received during the
public comment period, we conclude
that the management practice described
in Alternative 1 reflects GACT for this
area source category, and we, therefore,
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adopt Alternative 1 as the standard for
area source hospital ethylene oxide
sterilization facilities.
Specifically, the final rule requires
that a hospital ethylene oxide
sterilization facility sterilize full loads
of items having a common aeration time
except where medical necessity dictates
the use of less than a full load to protect
human health. As explained in more
detail in section V.A.3 of this preamble,
the determination that a medical
necessity exists must be made by a
hospital central services staff,3 a
hospital administrator, or a physician
on duty. This management practice
applies to all affected sources. As
explained in more detail in section
V.A.2 of this preamble, sources may
demonstrate compliance with this
requirement by operating their
sterilizers with an air pollution control
device and providing the certification
required in this final rule.
C. What are the testing and initial
compliance requirements?
There are no performance test
requirements for the management
practice standard. Affected sources are
required to submit an Initial
Notification of Compliance Status that
notifies EPA that they operate a
sterilizer covered by the rule and certify
that they are operating their sterilizers
in accordance with the requirement of
the rule.
In the preamble to the proposed rule,
we acknowledged that some hospitals
operate their sterilizers with add-on
controls and that such controls achieve
reductions in ethylene oxide emissions
that are at least equivalent to the
ethylene oxide reductions resulting
from the management practice.
Therefore, the final rule includes the
use of a control device as an alternative
compliance option for the management
practice requirement. Specifically, a
source may demonstrate compliance by
certifying that it is operating its
sterilizer(s) with an air pollution control
device. The source must certify that it
is running the sterilizer(s) in accordance
with any applicable State and/or local
regulations, or, if there are no such
regulations, with manufacturers’
specifications.
D. What are the notification,
recordkeeping, and reporting
requirements?
As mentioned above, affected sources
must submit an Initial Notification of
Compliance Status that includes the
3 Hospital central services staffs are healthcare
professionals, including managers and technicians,
who are either directly involved in or responsible
for sterile processing at a hospital.
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required compliance certification
described above. The final rule does not
require ongoing reporting.
Except for hospital ethylene oxide
sterilization facilities that demonstrate
compliance by using add-on controls,
affected sources must maintain on site
records of the date and time of each
sterilization operation. If less than a full
load is sterilized due to medical
necessity, the operator must record this
as well. These sterilization records must
be kept in a form suitable and readily
available for expeditious review. They
must be kept for 5 years and at least the
most recent 2 years on site.
IV. Exemption of Certain Area Source
Categories From Title V Permitting
Requirements
Section 502(a) of the CAA provides
that the Administrator may exempt an
area source category from title V if he
determines that compliance with title V
requirements is ‘‘impracticable,
infeasible, or unnecessarily
burdensome’’ on an area source
category. See CAA section 502(a). In
December 2005, in a national
rulemaking, EPA interpreted the term
‘‘unnecessarily burdensome’’ in CAA
section 502 and developed a four-factor
balancing test for determining whether
title V is unnecessarily burdensome for
a particular area source category, such
that an exemption from title V is
appropriate. See 70 FR 75320, December
19, 2005 (Exemption Rule).
The four factors that EPA identified in
the Exemption Rule for determining
whether title V is ‘‘unnecessarily
burdensome’’ on a particular area source
category include: (1) whether title V
would result in significant
improvements to the compliance
requirements, including monitoring,
recordkeeping, and reporting, that are
proposed for an area source category (70
FR 75323); (2) whether title V
permitting would impose significant
burdens on the area source category and
whether the burdens would be
aggravated by any difficulty the sources
may have in obtaining assistance from
permitting agencies (70 FR 75324); (3)
whether the costs of title V permitting
for the area source category would be
justified, taking into consideration any
potential gains in compliance likely to
occur for such sources (70 FR 75325);
and (4) whether there are
implementation and enforcement
programs in place that are sufficient to
assure compliance with the NESHAP for
the area source category, without relying
on title V permits (70 FR 75326).
In discussing the above factors in the
Exemption Rule, we explained that we
considered on ‘‘a case-by-case basis the
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extent to which one or more of the four
factors supported title V exemptions for
a given source category, and then we
assessed whether considered together
those factors demonstrated that
compliance with title V requirements
would be ‘unnecessarily burdensome’
on the category, consistent with section
502(a) of the Act.’’ See 70 FR 75323.
Thus, in the Exemption Rule, we
explained that not all of the four factors
must weigh in favor of exemption for
EPA to determine that title V is
unnecessarily burdensome for a
particular area source category. Instead,
the factors are to be considered in
combination, and EPA determines
whether the factors, taken together,
support an exemption from title V for a
particular source category.
In the Exemption Rule, in addition to
determining whether compliance with
title V requirements would be
unnecessarily burdensome on the
hospital sterilizer area source category,
we considered, consistent with the
guidance provided by the legislative
history of CAA section 502(a), whether
exempting the Hospital Sterilizer Area
Source category would adversely affect
public health, welfare, or the
environment. See 70 FR 15254–15255,
March 25, 2005.
In the proposed rule, we evaluated the
four factors described above in relation
to the Hospital Sterilizer Area Source
category and explained our proposed
conclusion that the factors collectively
demonstrated that compliance with title
V requirements would be unnecessarily
burdensome for the source category.
Among other things, we explained in
the preamble to the proposed rule, that
title V permitting would not result in
significant improvements to the
compliance requirements for the
Hospital Sterilizer Area Source category.
In the proposal, we further explained
that title V permitting may impose a
significant burden on facilities within
this source category, some of which are
small businesses. We explained that, for
many facilities, the cost of obtaining a
title V permit may far exceed the cost of
complying with the final rule without
significant gains in compliance. Based
on the above analysis, we proposed that
title V permitting would be
‘‘unnecessarily burdensome’’ for
hospital sterilizer area sources. We also
proposed that the exemptions from title
V would not adversely affect public
health, welfare, and the environment.
In response to the proposed rule, we
received two comments concerning the
proposed title V exemption. However,
as discussed in more detail in section
V.A.7 of this preamble, neither
comment addressed the above-
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mentioned factors that we considered in
proposing the title V exemption.
Accordingly, our assessment of these
factors remains unchanged in light of
these comments. We, therefore, finalize
the proposed exemption for the Hospital
Sterilizer Area Source category in this
rule. Hospital sterilizer area sources are
not required to obtain title V permits
solely for purposes of being the subject
of this final NESHAP; however, if they
are otherwise required to obtain title V
permits, such requirements are not
affected by this exemption.
V. Summary of Comments and
Responses
The hospital sterilizer area source rule
was proposed on November 6, 2006 (71
FR 64907). The 60-day comment period
ended on January 5, 2007, and we
received a total of 10 comment letters on
the proposed NESHAP. Comments were
received from one industry trade
association, a representative of one
affected facility, representatives from
two affected Federal agencies, one
sterilant manufacturer, three State and
local air pollution control agencies, one
State agency association, and one
private citizen. This final rule reflects
our consideration of all of the comments
received on the proposed action. This
section summarizes the significant
comments received on the proposed
NESHAP and our response thereto. A
summary of all of the minor comments
and EPA’s response thereto are
presented here in this preamble and in
the Response to Comments Document
(RTC Document), which is available in
Docket No. EPA–HQ–OAR–2005–0171.
A. Proposed Alternative 1: Management
Practice
1. Management Practice Approach
Comment: Two commenters
supported promulgation of the
management practice approach, i.e.,
Regulatory Alternative 1. One of the
commenters noted that EPA recognizes
that, by minimizing ethylene oxide use
with the management practice, hospital
ethylene oxide sterilization facilities
also minimize ethylene oxide emissions.
Both commenters expressed that the
proposed management practice
alternative ensures that hospitals
sterilize the most number of medical
devices per pounds of ethylene oxide
emitted, and it is consistent with
hospital practices.
Two commenters stated that the
management practice is common sense.
One commenter argued that EPA’s
proposed GACT were neither acceptable
nor consistent with legal requirements.
Another commenter stated that EPA’s
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alternatives do not reflect what many
sterilizers have achieved (using control
technology) and are capable of
achieving cost effectively.
Response: As previously mentioned,
we are setting standards for hospital
sterilizer area sources based on GACT
(i.e., generally available control
technologies or management practices)
pursuant to section 112(d)(5) of the
CAA. As several commenters noted, the
management practice for running
sterilizers with full loads will ensure
that hospitals sterilize the most number
of medical devices per pounds of
ethylene oxide emitted. We believe that
the comments indicating that the
management practice is common sense,
consistent with current operating
practices at many hospitals, and costeffective, all support our determination
that this management practice
represents a generally available
management practice that is used to
control ethylene oxide emissions from
area source hospital sterilizers. We,
therefore, disagree with the comment
that the management practice
requirement in this final rule is not
consistent with legal requirements. In
addition, for a detailed discussion on
EPA’s consideration of the existing
control technologies, please see section
V.C of this preamble.
2. Exemption of Certain Sources From
the Rule
Comment: One commenter
recommended that EPA exclude
controlled sources (i.e., sources with
add-on control) and sources that use an
ethylene oxide concentration of less
than 10 percent from all requirements
associated with Alternative 1 should
EPA adopt that alternative. The
commenter expressed that Alternative 1
imposes no additional substantive
requirements on controlled sterilizers
and would only add administrative
burdens with no additional
environmental benefits. The commenter
also asserted that sources that use an
ethylene oxide concentration of less
than 10 percent can be excluded with
no detrimental effect.
Response: EPA disagrees that this rule
contains no substantive requirements on
controlled sterilizers. As we clarify in
the final rule and in section III.B of this
preamble, all area source hospital
sterilizers, including sources with addon controls, are subject to the
requirements in this final rule.
However, the final rule provides certain
compliance options. Specifically, the
final rule provides sources with add-on
controls the option of demonstrating
compliance with the management
practice requirement by certifying that
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they will continue to operate their
sterilizers with such control.
EPA also rejects the recommendation
of excluding from this rule sources that
use an ethylene oxide concentration of
less than 10 percent. We recognize that
there are hospital sterilization facilities
that use sterilant gas blends with low
ethylene oxide concentrations.
However, we have no information
suggesting that facilities using low
ethylene oxide sterilant gas blends emit
negligible amounts of ethylene oxide.
On the contrary, it is our understanding
that there is little difference in the
amount of ethylene oxide usage (and,
therefore, ethylene oxide emissions)
between operating a sterilization cycle
with pure ethylene oxide as opposed to
using sterilant gas blend with less than
10 percent ethylene oxide. When we
listed the Hospital Sterilizer Area
Source category, we included hospital
ethylene oxide sterilization facilities
using sterilant gas blends and the
commenter did not provide any
information that suggests these facilities
should not be part of the source
category. Further, we have analyzed the
costs and impacts associated with the
management practice that we are
finalizing and we believe the costs are
reasonable. See section V.C.1 of this
preamble. For the reasons stated above,
we reject the commenter’s
recommendation to exclude from this
regulation sources using sterilant gas
blends with less than 10 percent
ethylene oxide concentration.
3. Exception to the Management
Practice Requirement
Comment: One commenter stated that
EPA would need to establish, based on
comments received and then propose
again for comment, examples of
definitions of circumstances that would
be acceptable for an exemption to the
full load requirement. Another
commenter observed that hospitals try
to minimize their use of ethylene oxide
and avoid exceptions to full load runs.
Although the commenter stated that
generating and managing an inclusive
list of all the exceptions to running a
full load may be difficult, it provided
examples for such exceptions.
Specifically, the commenter stated that,
on some days, a hospital may receive
back from surgery just a few devices that
must be ethylene oxide-sterilized and
returned as soon as possible to surgery
for cases scheduled for the next
morning. The commenter stated that, in
these instances, the hospital can be
forced to run a sterilizer with less than
a full load. The commenter also stressed
that hospital surgical needs can be
unpredictable.
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The commenter stated that hospitals
have reduced their use of ethylene oxide
to sterilize medical devices (and its
ethylene oxide emissions) by switching
to single-use devices or alternative
sterilizing and disinfection
technologies, or by consolidating
ethylene oxide sterilization. The
commenter noted that, ironically, a
hospital may increase the frequency
with which it needs to run a partially
loaded ethylene oxide sterilizer as a
result. The commenter, however,
emphasized that even with occasional
running of less than full loads, there has
been a continuing decline in hospital
ethylene oxide use and emissions.
Another commenter similarly noted
that hospitals currently strive to run full
loads unless it is medically necessary to
run less than a full load. According to
the commenter, often the medical
devices processed by the hospital
ethylene oxide sterilizer are expensive
and hospitals can only afford to retain
a minimal number of such devices. The
commenter further noted that some of
the devices are older devices and cannot
be replaced. The commenter stated that
these devices are typically utilized in
surgical areas and, at times, these
devices may need to be used on
consecutive days. The commenter stated
that the ethylene oxide sterilizer load is
processed at the end of the day so the
devices will be ready for surgery the
following day. According to the
commenter, by waiting to run a
sterilization cycle until the end of the
day, the sterilizer load has a chance to
fill up. The commenter noted, however,
that if a medical device is needed the
following day, the load will be
processed even though the load is not
full. The commenter stated that the
determination to process a load is based
on the needs of the patient.
Response: According to the
comments, hospitals deviate from the
full-load management practice only
when patient safety may be at risk. EPA
agrees that medical necessity warrants
operating a partially loaded ethylene
oxide sterilizer. To accommodate
patient needs, we have incorporated in
the final rule an exception based on
medical necessity.
EPA also agrees with the comment
that developing a comprehensive list of
medically necessary circumstances
warranting sterilization of a partial load
is difficult. EPA is concerned that such
a list may inadvertently exclude some
justified circumstances. Further, as
reflected in our final rule, we believe
that the decision to run a partially
loaded sterilizer due to medical
necessity should be made by authorized
hospital personnel who have knowledge
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of patients’ medical needs instead of by
EPA. However, to assure that hospitals
run sterilizers in full loads except
during medically necessary
circumstances, the final rule requires
that facilities document and maintain
records of every sterilization cycle,
including each partially loaded
sterilization, and confirm that it was
medically necessary.
Comment: One commenter noted that
many university hospitals develop new
and unique surgical procedures and
devices that may need to be sterilized in
partial loads to comply with the more
stringent requirements for sterilizing a
new instrument.
Response: We believe that it is
medically necessary to allow hospitals
to sterilize medical devices that are
under research and development
without a full load. The novelty or
uniqueness of the design in some
instances require different sterilizing
parameters than those used for regular
medical devices. In addition, unlike
medical devices that are regularly used
for patient care, new and experimental
medical devices that are under research
and development do not have
established or known sterilization
cycles. Therefore, they may compromise
the effectiveness of sterilizing other
devices in the same loads. However,
hospitals generally do not possess
enough medical devices that are under
research and development to fully load
a sterilizer. To avoid compromising the
sterilization process of medical devices
regularly used for patient care, we
believe that it is medically necessary to
allow hospitals to sterilize medical
devices that are under research and
development in separate and partial
loads. Hospitals may invoke the medical
necessity exception in the final rule
when sterilizing devices that are under
research and development.
4. National or Urban
Comment: Three commenters
recommended that EPA apply this rule
nationwide. Two of the commenters
noted that hospital parking areas are
typically close to the hospital and that
visitors and employees are, therefore,
exposed to emissions from hospital
ethylene oxide sterilizers regardless of
the hospital’s location (i.e., urban or
rural). One commenter stated that the
impacts of ethylene oxide emissions are
localized and would be similar for most
urban and rural areas. According to the
commenter, hospitals are typically
located in residential areas, whether or
not they are in urban areas, and that
populations residing nearby would
likely be exposed to the ethylene oxide
emissions from a hospital ethylene
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oxide sterilization facility. Another
commenter further stated that hospitals
clearly serve more sensitive populations
who could be more susceptible to
impacts from exposure to ethylene
oxide. The commenter similarly noted
that the impacts of ethylene oxide
emissions are very local and would be
roughly the same for both urban and
rural areas, except perhaps for hospitals
located in areas with a high population
density.
Two commenters noted that the cost
(of controlling a sterilizer) to a facility
is the same for a rural hospital and an
urban hospital. The commenters stated
that, because the cost and impact are the
same, there does not appear to be any
rationale for treating rural hospitals
differently from urban hospitals.
Response: We agree that a nationwide
approach is appropriate given the facts
and circumstances of this particular area
source category. A rule of nationwide
applicability is particularly appropriate
here because requiring controls
nationwide provides for equitable
emission reductions. Control costs are
not expected to differ in rural versus
urban settings, therefore, the control’s
cost-effectiveness is the same, and
economic impacts are equally
distributed. Furthermore, because
hospitals are generally located in
densely populated areas, we expect
negligible difference in the scope of this
rule’s coverage between a national and
an urban (i.e., Urban-1 and Urban-2
areas) rule.4 We have received no
comments recommending that we limit
this rule’s applicability only to hospitals
in Urban-1 and Urban-2 areas.
5. Compliance Date
Comment: One commenter stated that
EPA’s proposal that a source comply
with the management practices within 1
year after the effective date of the final
rule may not be a sufficient period of
time. The commenter stated that two
scenarios could result for medical
facilities under the management
practice alternative. According to the
commenter, one scenario could be that
medical facilities may need to purchase
smaller ethylene oxide sterilizers to turn
around medical instrumentation and
equipment without having to purchase
more of these medical items, and this
4 In the Integrated Urban Strategy, EPA defined
‘‘urban areas’’ to include Urban-1 and Urban-2
areas. (64 FR 38724). The Urban-1 and Urban-2
definitions are based on the United States Census
Bureau’s most current decennial census data.
Urban-1 areas are counties with metropolitan
statistical areas with a population greater than
250,000. Urban-2 counties are all other counties
where more than 50 percent of the population is
designated urban by the United States Census
Bureau.
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could involve construction projects/
costs to make ready additional space to
accommodate the new sterilizers. The
commenter stated that the other
scenario could be that medical facilities
may need to purchase additional
medical instrumentation and equipment
to allow for sufficient availability while
waiting for enough items to accumulate
to run a full load in an ethylene oxide
sterilizer. The commenter suggested that
EPA consider the costs of additional
ethylene oxide sterilizer equipment and
related construction, as well as the
additional medical instrumentation and
equipment costs in any proposed rule
by EPA.
Response: EPA does not believe that
the management practice requirement in
Alternative 1 will result in either of the
scenarios described above. The
management practice requires sterilizing
full loads except during medically
necessary circumstances, i.e., necessary
to protect human health. As discussed
above, this exception to running
sterilizers in full loads is based on
patient needs. Under the final rule,
whether a medically necessary
circumstance exists must be determined
by an authorized hospital personnel.
The final rule, however, requires only
that the hospital personnel consider
whether sterilizing a partial load is
necessary to protect human health; the
personnel are not required to consider
whether there are viable alternatives to
running a partial load, such as
purchasing additional sterilizer
equipment or medical devices, before
invoking the exception to the
management practice requirement.
Therefore, we do not expect any need
for construction and/or capital
expenditures associated with such new
purchases, as the commenter suggested.
We have received no other comments
suggesting that hospitals may have
difficulty achieving compliance with
the management practice alternative
within 1 year, as we proposed. We,
therefore, retain the 1-year compliance
deadline in the final rule.
6. Recordkeeping
Comment: In the proposed rule, EPA
solicited comments on whether to
require recordkeeping under Alternative
1. We received six comments on
recordkeeping. One commenter asked
that EPA specify what recordkeeping
would entail if less than full loads were
run and what EPA would propose to be
done with these records. Another
commenter stated that, regardless of the
size of the load, all items sterilized are
recorded following the Association for
the Advancement of Medical
Instrumentation standard, Ethylene
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Oxide Sterilization in Health Care
Facilities: Safety and Effectiveness,
ANSI/AAMI ST 41:1999. According to
the commenter, the sterilizer records
under this standard include the
following: Load or lot number; item
description and quantity; the
department; the name of the sterilizer
operator; aeration time and temperature;
results of the biological monitoring
(which is processed with each load to
ensure that sterilization has occurred);
chemical indicator results; and reports
of nonresponsive chemical indicators.
Two commenters stated that hospitals
keep a record of each load they run for
traceability. Two commenters stated
that hospitals could probably add a few
more items of information to their
records to comply with EPA’s
requirements. These commenters
recommended that EPA’s recordkeeping
requirements be consistent with
hospitals’ current practice in
maintaining records of sterilized loads.
Two commenters indicated that some
State programs require keeping
sterilization records, and one
commenter stated that some States have
required such recordkeeping for many
years. The commenters indicated that
some hospitals keep such records
through computerized recordkeeping
systems while others use handwritten
records. The commenters believed that
these requirements are not likely to be
overly burdensome or costly to the
facilities.
Response: In light of the comments
indicating that hospitals are already
keeping records of each sterilization
cycle and that such recordkeeping
provisions are not overly costly or
burdensome, we are requiring affected
facilities to keep sterilization records in
the final rule. Specifically, the final rule
requires that a facility record the date
and time of each sterilization cycle,
whether each sterilization cycle
contains a full load of items, and, for
each partial load, state that it was
medically necessary. Based on
information provided during the
comment period, we believe that this
recordkeeping requirement is consistent
with hospitals’ current practice. We also
believe the time required to keep these
records would be offset by the time
saved by the reduced cycles run.
7. Title V Permitting
Comment: One commenter favored
title V permitting. The commenter
stated that, by requiring title V permits,
title V funds could be used to assure
compliance. The commenter noted that,
according to an EPA Regional office,
title V funds cannot be used for non-title
V programs. The commenter stated that
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if, from a national perspective, EPA
prefers to exempt area sources such as
these from title V permitting, EPA
should explain the level of effort they
expect from State and local agencies,
and develop a funding mechanism for
that effort. The commenter further noted
that, in this case, the commenter’s State
already has operating permits for
affected facilities and that there would
be little cost involved in updating these
permits to reflect the Federal rule
during the normal permit renewal
process.
Response: As discussed in the
preamble to the proposed rule, EPA
considered four factors in determining
whether title V is ‘‘unnecessarily
burdensome’’ for a particular area
source category. Based on its
consideration of these factors, EPA
concluded that the requirements of title
V would be unnecessarily burdensome
for area source hospital ethylene oxide
sterilization facilities. Among other
things, EPA concluded that title V
permitting would not result in
significant improvements to the
compliance requirements for the
hospital ethylene oxide sterilization
area source category and that title V
permitting would likely impose a
significant burden on facilities within
the source category, some of which are
small businesses. The Agency also
found that, for many facilities, the cost
of obtaining a title V permit may far
exceed the cost of complying with the
final rule without significant gains in
compliance. EPA further determined
that the proposed exemptions from title
V would not adversely affect public
health, welfare, and the environment.
Although the commenter advocates
title V permitting, the commenter failed
to address EPA’s application of the four
factors described above, and its
conclusion that the proposed
exemptions would not adversely affect
public health, welfare, and the
environment. Indeed, none of the
commenters disagreed with any of
EPA’s proposed findings described
above and in the proposed rule that
served as the basis for the proposed title
V exemption.
Instead of challenging EPA’s
application of the four factors relevant
to determining whether title V
requirements would be unnecessarily
burdensome on a particular area source
category, the commenter focuses on the
fact that, in its State, area source
hospital sterilizers have State operating
permits and that adding the
requirements of this rule to those
permits would involve little costs. The
fact that title V permitting may not be
burdensome or costly in one State does
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not reflect the burden or costs
associated with title V permitting
nationwide. Once again, the commenter
has not identified any flaws in EPA’s
application of the four factor test
described above, which involve an
assessment of the costs of title V
reporting for the entire source category.
Therefore, for the reasons discussed
above and in the proposed rule, we are
exempting area source hospital ethylene
oxide sterilization facilities from the
requirements of title V in this final rule.
The commenter apparently favored
title V permitting based on its belief that
‘‘by requiring title V permits, EPA
would allow title V funds to be used to
assure compliance.’’ The commenter
requested that EPA explain the level of
State and local efforts that may be
involved in implementing and enforcing
the requirements of the final rule and
develop a funding mechanism for that
effort. We expect such effort to be
minimal. We believe that the
management practice and the associated
recordkeeping requirements in this final
rule are straightforward and can,
therefore, be easily implemented and
enforced. Further, according to the
comments received, the management
practice requirement is consistent with
hospital practices and hospitals are
already keeping records of sterilization
cycles. In light of the above, we do not
anticipate that State and local agencies
would need to spend a significant level
of effort to implement and enforce this
rule. EPA, however, remains committed
to working with State and local agencies
to implement this rule. State and local
agencies that receive grants for
continuing air programs under CAA
section 105 should work with their
project officers to determine what
resources are necessary to implement
and enforce this area source standard.
EPA will continue to provide the
resources appropriated for CAA section
105 grants consistent with the statute
and the allotment formula developed
pursuant to the statute.
Comment: One commenter agreed
with EPA’s proposal that title V permits
are not necessary for area sources. The
commenter noted that some hospitals,
however, already have or are covered by
title V permits, and that any rulemaking
has the potential to impose additional
permit modification costs. The
commenter asserted that EPA should
minimize title V permitting cost impacts
by adding a provision in this rule stating
that an existing title V permit does not
have to be reopened or revised to
address the requirements of this rule
until the next time the permit is
renewed, reopened, or revised for
another reason. The commenter
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alternatively proposed that EPA
consider an exemption similar to that
which was included in 40 CFR
63.7881(c)(3) of the recently finalized
amendments to the Site Remediation
NESHAP.
Response: The commenter requested
that EPA prescribe in this rule the time
for reopening and revising existing title
V permits for area source hospital
sterilizers. CAA section 502(a)
authorizes EPA to exempt an area
source category from title V permitting
if the Administrator finds that
compliance with title V is
impracticable, infeasible, or
unnecessarily burdensome on such
category; however, to the extent that
some sources within this area source
category are already otherwise required
to obtain title V permits, CAA section
502(a) does not authorize EPA to affect
in any way these sources’ existing
obligations under title V, including
when the permits must be renewed. As
discussed above, pursuant to CAA
section 502(a), EPA has determined that
the requirements of title V would be
unnecessarily burdensome for area
source hospital ethylene oxide
sterilization facilities. Accordingly, this
final rule exempts area source
sterilization facilities from the
obligation to obtain title V permits for
purposes of being subject to the
requirements of this rule. The
commenter, however, is requesting that
EPA prescribe in this rule the time for
reopening and revising existing title V
permits for area source hospital
sterilizers. The commenter’s request is
unrelated to and beyond the scope of
EPA’s authority to issue this area source
rule pursuant to CAA sections 112(c)(3)
and 112(d)(5). The request is also
beyond the scope of EPA’s authority
under CAA section 502(a) to exempt
area sources from title V permitting. We,
therefore, reject the commenter’s request
to include its recommended language in
this final rule.
B. Proposed Alternative 2: No Control
Comment: One commenter
recommended that EPA select
Regulatory Alternative 2 (the no
additional control alternative). The
commenter stated that hospitals have
strong economic incentives to operate
sterilizers with a full load because doing
so reduces both material and labor costs.
According to the commenter, because
economics already drive hospital
ethylene oxide sterilization facilities to
implement the management practice,
Alternative 1 is unlikely to result in
significant emission reduction. The
commenter states that it has encouraged
its facilities to switch to alternative
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sterilization methods and, therefore,
there are not many ethylene oxide
sterilizers at its facility.
Response: As previously mentioned,
we included two regulatory alternatives
in the proposed rule. As Alternative 1,
we proposed to require that hospitals
sterilize full loads of medical items
having common aeration times except
during emergency circumstances that
dictate the use of less than full loads to
protect human health. However, at the
time of the proposal, we had limited
information to conclude that the
proposed management practice in
Alternative 1 reduced ethylene oxide
emissions or was cost-effective.
Therefore, we included an alternative
proposal (Alternative 2) that there are
no GACT within the meaning of CAA
section 112(d)(5) for the Hospital
Sterilizers Area Source category. We
also solicited comments on the costs
and emission reduction estimates for the
management practice.
As explained in more detail in section
V.A.1 of this preamble, we have since
received comments indicating that the
management practice minimizes
ethylene oxide emissions by minimizing
ethylene oxide use and that the practice
is cost-effective. We, therefore, conclude
that the management practice
requirement we proposed as Alternative
1 reflects a generally available
management practice within the
meaning of CAA section 112(d)(5) for
this area source category.
The commenter apparently agreed
that the management practice is costeffective. It stated that hospitals have
economic incentives to run the
sterilizers full because it reduces both
labor and material costs. The
commenter, nevertheless, recommended
Alternative 2, claiming that Alternative
1 may not achieve significant reduction
since it is already being implemented.
However, the CAA does not require a
GACT standard to achieve any specific
level of emission reduction.
As explained above, we have
determined that the management
practice that we proposed as Alternative
1 represents GACT for this area source
category. The commenter offered no
information suggesting otherwise.
Having determined that our proposed
Alternative 1 represents GACT, we can
no longer conclude that there are no
GACT within the meaning of CAA
section 112(d)(5). We, therefore, reject
the commenter’s recommendation that
we adopt the no control option
(Alternative 2) in this final rule.
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C. Add-on Controls
1. Cost Considerations
Comment: Four commenters
recommended that EPA require add-on
controls for the area source hospital
ethylene oxide sterilizers. Two
commenters noted that, in the preamble
to the proposed rule, EPA stated that the
two predominant types of control
devices (i.e., acid-water scrubbers and
catalytic oxidation units) reduce
emissions by approximately 99 percent.
One of these two commenters also noted
that, according to the National
Toxicology Program, researchers have
demonstrated that the application of
these control technologies to hospital
sterilizers effectively reduce ethylene
oxide concentrations. This commenter,
therefore, concluded that proven control
technology is readily available to
control ethylene oxide emissions from
hospital sterilizers and that application
of this technology is practicable,
feasible, prudent, and not unnecessarily
burdensome. Two commenters drew the
same conclusion, noting that the control
technologies have been required by
some State programs for many years.
One commenter similarly stated that if
more than half of the sources already
have add-on controls, it suggests that
these controls are practical and feasible.
One commenter expressed that, with
nearly half of the hospitals using addon controls, it is hard to understand
EPA’s rationale in the proposed rule
that add-on controls are too costly. One
commenter suggested that, if cost is to
be considered, EPA should consider a
full array of alternatives, including the
cost of alternatives to sterilization and
alternative means of sterilization, and
compare them to the cost of controlling
ethylene oxide sterilization. The
commenter stated that the proposed rule
presumes ethylene oxide sterilization
must be preserved. The commenter
noted that in the Hospital, Medical,
Infectious Waste Incinerator (HMIWI)
standard, however, EPA recognized that
there were alternatives to incineration of
the wastes and, therefore, required
emission controls that were not
necessarily cost-effective. The
commenter recommended that the same
approach should be applied here.
One commenter stated that installing
control would be an unnecessary cost to
hospitals providing no benefits. The
commenter observed that hospital
ethylene oxide sterilization has declined
due to Occupational Safety and Health
Administration regulations, new
sterilization methods, and new designs
and materials used in medical devices.
The commenter, however, emphasized
that ethylene oxide sterilization is a
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necessity in hospitals. The commenter
explained that the medical devices
processed by ethylene oxide are
expensive and that hospitals can only
afford minimal amounts on hand. The
commenter further explained that some
of the medical devices are old and
cannot be replaced. The commenter
noted that these devices are typically
utilized in surgical areas. The
commenter stated that EPA’s rationale
makes clear that existing ethylene oxide
emission control technology will not
provide the type of cost-benefit needed
to justify new hospital investment in the
control devices. The commenter noted
that the cost of add-on control would
include not just the cost of the device,
but also the cost of installation, facility
modification, annual testing of control
devices, and utility and maintenance.
Response: CAA section 112(d)(5)
provides that, with respect to area
source categories listed pursuant to
CAA section 112(c), the Administrator
may, in lieu of MACT, promulgate
standards or requirements which
provide for the use of GACT. As
explained in the preamble to the
proposed rule, EPA is issuing the
standards for the hospital sterilizers area
source category under CAA section
112(d)(5).
In determining what constitutes
GACT for a particular area source
category, EPA evaluates the control
technologies and management practices
that reduce HAP emissions and are
generally available for the area source
category. The legislative history
supporting CAA section 112(d)(5)
provides that EPA may consider costs in
determining what constitutes GACT for
the area source category.5
In considering costs, the commenters
who recommended add-on control
focused mainly on the actual costs to
hospitals and asserted that such control
is likely not too costly if many hospitals
are using it under existing State or local
requirements. As we stated in the
preamble to the proposed rule, EPA
recognizes that over half of the hospitals
use add-on controls. However, the
actual cost to individual hospitals is but
one cost factor that we considered in
this rulemaking. We also noted that the
total annualized cost for add-on
5 Additional information on the definition of
‘‘generally available control technologies or
management practices’’ (GACT) is found in the
Senate report on the 1990 amendments to the CAA
(S. Rep. No. 101–228, 101st Cong. 1st session. 171–
172). That report states that GACT is to encompass:
* * * methods, practices and techniques which are
commercially available and appropriate for
application by the sources in the category
considering economic impacts and the technical
capabilities of the firms to operate and maintain the
emissions control systems.
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controls, which we estimated to be $8.5
million, exceeds the total annualized
cost for the management practice, which
we estimated to range from $32,000 to
$61,000, by more than 100 fold. In
addition, we considered the costeffectiveness of the add-on controls.
See, e.g., Husquavarna AB v. EPA, 439
U.S. App. DC 118, 254 F.3d 195, 201
(DC Cir. 2001) (finding EPA’s decision
to consider costs on a per ton of
emissions removed basis reasonable
because CAA section 213 did not
mandate a specific method of cost
analysis). EPA’s cost analysis for the
add-on controls showed poor costeffectiveness. Specifically, EPA’s costeffectiveness estimate for add-on
controls was $200,000 per ton of
ethylene oxide reduced. This costeffectiveness excludes monitoring,
recordkeeping, and reporting costs.
We also considered alternatives to
ethylene oxide sterilization, as one
commenter suggested. We learned from
several commenters that, although
ethylene oxide sterilization in hospitals
has declined, it remains a necessity for
certain medical devices that cannot be
easily replaced or sterilized by other
means. We agree with these commenters
that, in light of the declined level of
ethylene oxide sterilization and the lack
of alternatives for sterilizing certain
unique and expensive medical devices,
the benefit of requiring add-on control
is outweighed by the various costs
associated with such control. Based on
the foregoing, we determined that addon controls do not represent GACT for
this area source category.
One commenter argued that EPA
required add-on control in the HMIWI
standard that were not necessarily costeffective and that EPA should take the
same approach in this final rule.6 The
HMIWI standard, however, was
promulgated pursuant to section 129 of
the CAA, which requires that EPA
establish standards that reflect the
MACT. Consistent with the
requirements of CAA section 129, EPA
issued the original HMIWI standards
based on MACT. CAA section 129(a)(2)
does not allow EPA to consider costs in
setting the floor for control. By contrast,
EPA is issuing this final rule pursuant
to CAA section 112(d)(5), which allows
EPA to consider costs, including costeffectiveness, in establishing GACT.
Thus, the HMIWI rule is not relevant,
6 40 CFR part 60, subpart Ce—Emission
Guidelines and Compliance Times for Hospital/
Medical/Infectious Waste Incinerators (constructed
on or before June 20, 1996).
40 CFR part 60, subpart Ec—Standards of
Performance for Hospital/Medical/Infectious Waste
Incinerators for Which Construction is Commenced
After June 20, 1996.
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because in that rule, EPA, by statute,
could not consider costs.
2. Best Available Control Technology
(BACT) or MACT
Comment: One commenter stated that,
because ethylene oxide is a known
human carcinogen, its emissions should
be controlled using the BACT. The
commenter stated alternatively that, due
to the widespread use of control on
hospital sterilizers, the MACT floor
level of control would be add-on
controls under CAA section 112(d)(2).
The commenter stated that, based on the
experience in its State, the MACT floor
and associated recordkeeping are
feasible and prudent and, therefore,
none of EPA’s proposals are in
accordance with legal requirements. The
commenter claimed that the proposed
NESHAP must be revised to represent
MACT floor of add-on emission control
and recordkeeping as required by law.
Response: CAA section 112(c)(2)
requires that EPA establish emission
standards under CAA section 112(d) for
the categories listed under CAA section
112(c), including area source categories
listed pursuant to CAA section
112(c)(3). As mentioned above, EPA
may issue standards for listed area
source categories based on MACT (CAA
section 112(d)(2)) or GACT (CAA
section 112(d)(5)). CAA Section 112(d)
does not contain a standard based on
BACT. Therefore, EPA rejects the
commenter’s request to require the use
of BACT because such standard is not
authorized by the CAA.
The commenter also argued
alternatively that neither of EPA’s
proposed alternatives was in accordance
with legal requirements and that EPA
must issue a MACT standard as required
by law. The commenter, however, did
not identify any legal requirement that
allegedly is not satisfied by EPA’s
proposed alternatives or requires EPA to
issue a MACT standard for the Hospital
Sterilizer Area Source category. On the
contrary, the commenter noted that
‘‘EPA is ’exercising discretion’ in
promulgating standards or requirements
under section 112(d)(5) of the CAA.’’
Although the commenter acknowledged
that EPA has discretion under CAA
section 112(d)(5) to issue a GACT
standard in lieu of a MACT standard for
listed area source categories, it claimed
that, based on its State’s experience
with regulating and controlling ethylene
oxide emissions from hospital
sterilizers, the MACT floor and
associated recordkeeping are feasible
and prudent. The commenter argued
that, therefore, neither of EPA’s
proposals is acceptable in accordance
with legal requirements and that EPA
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must issue a MACT standard as required
by law.
The commenter’s argument seems to
imply that EPA must first find that a
MACT standard is infeasible,
imprudent, or otherwise inappropriate
before the Agency can legally issue a
GACT standard for an area source
category pursuant to section 112(d)(5) of
the CAA. However, there is no such
requirement under the CAA. In fact, the
CAA does not contain any condition
precedent for issuing a GACT standard
under CAA section 112(d)(5). CAA
section 112(d)(5), which is entitled
‘‘Alternative standard for area sources,’’
provides:
With respect only to categories and
subcategories of area sources listed pursuant
to subsection (c) of this section, the
Administrator may, in lieu of the authorities
provided in paragraph (2) and subsection (f)
of this section, elect to promulgate standards
or requirements applicable to sources in such
categories or subcategories which provide for
the use of generally available control
technologies or management practices by
such sources to reduce emissions of
hazardous air pollutants. (Emphasis added).
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There are two critical aspects to CAA
section 112(d)(5). First, CAA section
112(d)(5) applies only to those
categories and subcategories of area
sources listed pursuant to CAA section
112(c). The commenter does not dispute
that EPA listed the Hospital Sterilizer
Area Source category pursuant to CAA
section 112(c)(3). Second, CAA section
112(d)(5) provides that, for area sources
listed pursuant to CAA section 112(c),
EPA ‘‘may, in lieu of ’’ the authorities
provided in CAA section 112(d)(2) and
112(f), elect to promulgate standards
that provide for the use of generally
available control technologies or
management practices (GACT). Section
112(d)(2) provides that emission
standards established under that
provision ‘‘require the maximum degree
of reduction in emissions’’ of HAP (also
known as MACT).7 Webster’s dictionary
defines the phrase ‘‘in lieu of’’ to mean
‘‘in the place of’’ or ‘‘instead of.’’ See
Webster’s II New Riverside University
(1994). Thus, CAA section 112(d)(5)
authorizes EPA to promulgate standards
that provide for the use of GACT instead
of issuing MACT standards. The statute
does not set any condition precedent for
issuing standards under CAA section
112(d)(5) other than that the area source
7 CAA section 112(d)(5) also references CAA
section 112(f). See CAA section 112(f)(5) (entitled
‘‘Area Sources’’ and providing that EPA is not
required to conduct a review or promulgate
standards under CAA section 112(f) for any area
source category or subcategory listed pursuant to
CAA section 112(c)(3) and for which an emission
standard is issued pursuant to CAA section
112(d)(5)).
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category or subcategory at issue must be
one that EPA listed pursuant to CAA
section 112(c), which is the case here.
Had Congress intended that EPA first
conduct a MACT analysis for each area
source category and only if cost or some
other reason made applying the MACT
standard inappropriate for the category
would EPA be able to issue a standard
under CAA section 112(d)(5), Congress
would have stated so expressly in CAA
section 112(d)(5). Congress did not
require EPA to conduct any MACT
analysis, floor analysis, or beyond-thefloor analysis before the Agency could
issue a CAA section 112(d)(5) standard.
Rather, Congress authorized EPA to
issue GACT standards for area source
categories listed under CAA section
112(c)(3), and that is precisely what
EPA has done in this rulemaking.
Although EPA has no obligation to
justify why it is issuing a GACT
standard for an area source category as
opposed to a MACT standard, we did so
in the proposed rule. See 71 FR 64910,
November 6, 2006. As explained in the
proposed rule, we determined that the
MACT floor level of control would be
add-on controls if we were to develop
this area source rule based on CAA
section 112(d)(2). As explained in more
detail in section V.C.1 of this preamble,
we took costs into consideration and
determined that the benefit of requiring
add-on controls is outweighed by the
costs associated with such control. We
believe the consideration of costs is
especially important for the wellcontrolled area sources at issue in this
final action because, given current wellcontrolled levels, a MACT floor
determination, where costs cannot be
considered, could result in only
marginal reductions in emission at very
high costs.
3. Consideration of Health Impacts or
Risks
Comment: According to one
commenter, EPA’s decision not to
require add-on control appears to be
based on cost-effectiveness without
much regard for heath impact or risk.
The commenter argued that an
appropriate analysis would consider the
health impacts where people are
exposed. Four commenters identified
health risks from ethylene oxide
exposure as a basis for requiring add-on
control. The commenters noted that
ethylene oxide is a carcinogen and
described in detail health effects from
ethylene oxide exposure. In addition,
one commenter stated that, since these
sterilization units are located in
hospitals which are densely populated
with staff and patients, extra care
should be taken to assure their health
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and safety. One commenter expressed
concern that people living, working, and
visiting the vicinity of the uncontrolled
sources (i.e., those that do not have addon controls) are not afforded the same
level of protection as those near
controlled sterilizers.
Two commenters stated that hospital
ethylene oxide emissions are minimal
and declining and that the potential
risks of ethylene oxide emissions, based
on the EPA analysis, are also minimal.
Accordingly, both commenters stated
that there is no benefit for installing
ethylene oxide emission control
equipment, and one commenter stated
that any benefits would be insignificant
and far outweighed by the real costs
associated with the control.
Response: As previously explained,
pursuant to sections 112(c)(3) and
112(k)(3)(B) of the CAA, EPA identified
ethylene oxide as one of 30 HAP that
present the greatest threat to public
health in the largest number of urban
areas and listed Hospital Sterilizers
Area Source as a category needed to
ensure that sources representing 90
percent of area source ethylene oxide
emissions are subject to regulation.
In the 1990 CAA Amendments,
Congress established a two-phase
approach for setting HAP emission
standards. Sierra Club v. EPA, 353 F.3d
976, 980 (D.C. Cir. 2004). The first phase
is the initial standard setting phase,
which is the phase at issue in this
rulemaking.8 In this phase, the
standards are technology-based, and this
is true regardless of whether we issue
MACT standards under CAA section
112(d)(2) and (d)(3), or GACT standards
under CAA section 112(d)(5).9 See
Senate Report at 148 (1989); Sierra Club
v. EPA, 353 F.3d at 980.
In this final rule, EPA is establishing
emissions standards for this area source
category under CAA section 112(d)(5),
which authorizes EPA to set emissions
standards based on GACT for a listed
area source category. The legislative
history describes GACT as ‘‘methods,
practices, and techniques which are
8 The second phase of standard setting involves
a risk-based analysis. Specifically, CAA section
112(f)(2) requires EPA to determine—8 years after
issuance of the initial MACT standard—whether
residual risks remain that warrant more stringent
standards than achieved through MACT. CAA
Section 112(f)(5) provides that the Agency shall not
be required to conduct a residual risk for area
sources for which EPA has issued a GACT standard.
9 CAA Section 112(d)(4) does provide, however,
that with respect to pollutants for which the EPA
Administrator has established a health threshold,
EPA can consider such threshold in setting
standards under CAA section 112(d). Ethylene
oxide is a carcinogen and is, thus, not a pollutant
for which the Administrator has established a
health threshold, and, therefore, CAA section
112(d)(4) is not relevant to this category.
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commercially available and appropriate
for application by sources in the
category considering economic impacts
and the technical capabilities of the
firms to operate and maintain the
emissions control systems.’’ S. Rep. No.
101–228, at 171 (1989) (Senate Report).
Consistent with the statute and the
legislative history, in determining
GACT, we evaluated the control
technologies and management practices
that reduce HAP emissions from the
ethylene oxide Hospital Sterilizer Area
Source category, and we assessed the
costs of implementing such approaches.
We did not consider health impacts or
risks in establishing the emission
standards for the Hospital Sterilizer
Area Source category, as the
commenters recommended, nor were we
required by statute to do so. However,
we note that health risk did play a role
in this process in that the determination
of which pollutants to regulate and from
which categories was governed by the
statutory requirement to regulate
sources accounting for 90 percent or
more of the 30 HAP that present the
greatest health threat in urban areas.
4. Potential Backsliding
Comment: One commenter noted that
many hospital ethylene oxide sterilizers
are controlled (i.e., with add-on
controls) as the result of State and local
programs. The commenter stated that in
the preamble to the proposed rule, EPA
recognizes the contributions of the State
and local programs and is apparently
relying upon them to ensure adequate
control of hospital sterilizers. The
commenter stated that EPA’s proposal to
rely on these programs, in lieu of
Federal requirements, is unwise and
inappropriate. The commenter stated
that the existence of State and local
regulations does not relieve the agency
of its duty to set emissions control
requirements under CAA section 112.
The commenter further noted that many
State and local agencies are not able to
be more stringent than Federal
requirement and that it is conceivable
that some agencies could be required to
change their regulations to be consistent
with those of the Federal government,
resulting in relaxing of existing nonFederal rules. The commenter also
claims that State and local regulations
can change in the future for other
reasons. The commenter stated that, in
the absence of Federal requirements,
there would be nothing to prevent
backsliding by the sources if a State or
local rule is realized or eliminated.
Another commenter stated that for
sources in its State, EPA’s issuance of
this rule means that existing sources
would continue to be subject to the
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State air toxics rule that requires 99
percent control, but new sources would
only be subject to EPA’s requirement.
The commenter stated that this amounts
to backsliding on emission control
requirements and an increase in
emissions.
Response: EPA has not shed its
responsibility to set emission standards
under CAA section 112 because of
existing State and local regulations. On
the contrary, EPA is issuing this final
rule today to regulate ethylene oxide
emissions from hospital sterilizers. As
described above, pursuant to CAA
section 112(d)(5), EPA has established
in this final rule a management practice
requirement that represents GACT for
this area source category. EPA did not
reject the add-on control option in this
rulemaking because it was relying on
existing State and local programs to
require add-on controls, as one
commenter contended. Rather, as
previously explained in section V.C.1 of
this preamble, EPA concludes that addon controls do not represent GACT for
this area source category.
Two commenters expressed concern
that certain States may require that their
existing regulations be relaxed as not to
be more stringent than EPA’s standards.
However, CAA section 112(l) only
prohibits States from setting standards
that are less stringent than EPA’s
standards; the CAA does not affect State
and local emission standards that are
more stringent than the requirements of
this final rule. The issue of potential
backsliding that the commenters raised
is based on State law, which EPA has no
authority to change. We, however,
encourage States to revisit their State
laws to address this concern.
emissions by reducing the amount of
ethylene oxide usage.
Although the final rule does not
require the use of a control device, it
allows the use of a control device as an
alternative compliance option for the
management practice requirement
because the use of a control device
achieves reduction in ethylene oxide
emissions that are at least equivalent to
the ethylene oxide reduction resulting
from the management practice. This is
true even if the control device is used
to control ethylene oxide emissions
from sterilization only. Therefore,
controlling aeration emissions with a
control device is not necessary under
the alternative compliance option.
5. Emissions From Aeration
Comment: One commenter noted that
some sterilizers only operate their
catalytic control devices during the
initial purge of ethylene oxide
(following sterilization) and not during
the entire aeration cycle. The
commenter stated that the control
device should be used for all discharges,
not just the initial purge.
Response: The commenter appears to
be arguing that a control device should
be used to control both sterilization and
aeration ethylene oxide emissions
instead of just sterilization emissions.
The final rule does not, however,
require the use of a control device. EPA
has determined that the management
practice in the final rule represents
GACT and requires that hospitals run
sterilizers in full loads except during
medically necessary circumstances.
This requirement will reduce both
sterilization and aeration ethylene oxide
A. Executive Order 12866: Regulatory
Planning and Review
Under Executive Order 12866 (58 FR
51735, October 4, 1993), this action is a
‘‘significant regulatory action’’ because
it may raise novel legal or policy issues.
Accordingly, EPA submitted this action
to the Office of Management and Budget
(OMB) for review under Executive
Order 12866, and any changes made in
response to OMB recommendations
have been documented in the docket for
this action.
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VI. Summary of Environmental, Energy,
Cost, and Economic Impacts
We estimate that in 2002 there were,
at most, 1,900 hospital area sources that
conduct ethylene oxide sterilization, of
which approximately 630 do not
presently have add-on controls. The
final management practice was
estimated at proposal to reduce the 44
tpy emitted from ethylene oxide
sterilizers by 2 to 9 tpy. We did not
receive any comments that would allow
us to improve this estimate. Several
commenters, however, stated that they
are already employing the management
practice. With the management practice,
we believe there is minimal effect on
either air quality or non-air quality
environmental impacts and there are
negligible energy or economic impacts.
Annualized costs to comply with the
final standards are estimated to range
from $32,000 to $61,000 per year.
VII. Statutory and Executive Order
Reviews
B. Paperwork Reduction Act
The information requirements in this
rule have been submitted for approval to
OMB under the Paperwork Reduction
Act, 44 U.S.C. 3501, et seq. The
information collection requirements are
not enforceable until OMB approves
them.
The recordkeeping and reporting
requirements in the final rule are based
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on the information collection
requirements in the 40 CFR part 63
General Provisions (subpart A), some of
which are incorporated into the final
NESHAP. The ICR document includes
the burden estimates for all applicable
General Provisions. The recordkeeping
and reporting requirements in the
General Provisions are mandatory
pursuant to section 114 of the CAA (42
U.S.C. 7414). All information submitted
to EPA pursuant to the information
collection requirements for which a
claim of confidentiality is made is
safeguarded according to CAA section
114(c) and the Agency’s implementing
regulations at 40 CFR part 2, subpart B.
The final NESHAP for area sources
requires a one-time initial notification
by hospital ethylene oxide sterilization
facilities certifying that the facility is in
compliance with rule requirements and
requires recordkeeping for each
sterilization cycle for sterilizers not
equipped with an air pollution control
device.
The annual burden for the
information collection averaged over the
first 3 years of this ICR is estimated to
total 3,576 labor hours per year at a cost
of $245,000 for the 1,900 existing
hospital sterilizer area sources. Small
annualized capital/startup costs and
small operation and maintenance costs
are associated with the requirements.
No costs or burden hours are estimated
for new area sources because no new
sources are estimated during the next 3
years. Burden means the total time,
effort, or financial resources expended
by persons to generate, maintain, retain,
or disclose or provide information to or
for a Federal agency. This includes the
time needed to review instructions;
develop, acquire, install, and utilize
technology and systems for the purposes
of collecting, validating, and verifying
information, processing and
maintaining information, and disclosing
and providing information; adjust the
existing ways to comply with any
previously applicable instructions and
requirements; train personnel to be able
to respond to a collection of
information; search data sources;
complete and review the collection of
information; and transmit or otherwise
disclose the information.
An agency may not conduct or
sponsor, and a person is not required to
respond to a collection of information
unless it displays a currently valid OMB
control number. The OMB control
numbers for EPA’s regulations in 40
CFR are listed in 40 CFR part 9. When
this ICR is approved by OMB, the
Agency will publish a technical
amendment to 40 CFR part 9 in the
Federal Register to display the OMB
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control number for the approved
information collection requirements
contained in this final rule.
C. Regulatory Flexibility Act
The Regulatory Flexibility Act (RFA)
generally requires an agency to prepare
a regulatory flexibility analysis of any
rule subject to notice and comment
rulemaking requirements under the
Administrative Procedure Act or any
other statute unless the agency certifies
that the rule would not have a
significant economic impact on a
substantial number of small entities.
Small entities include small businesses,
small organizations, and small
governmental jurisdictions.
For the purposes of assessing the
impacts of the area source NESHAP on
small entities, small entity is defined as:
(1) A small business that is a hospital as
defined by NAICS codes 622110 and
622310 whose parent company has less
than $31.5 million in gross revenue
(based on Small Business
Administration (SBA) size standards);
(2) a small governmental jurisdiction
that is a government of a city, county,
town, school district, or special district
with a population of less than 50,000;
and (3) a small organization that is any
not-for-profit enterprise which is
independently owned and operated and
is not dominant in its field.
After considering the economic
impacts of this final rule on small
entities, I certify that this action will not
have a significant economic impact on
a substantial number of small entities.
The final rule requires the use of a
management practice to minimize the
operation of the ethylene oxide
sterilization unit and will, therefore,
have minimal nationwide costs, i.e.,
range from $32,000 to $61,000 per year.
We have determined that less than 3
percent of the hospitals are small
businesses as defined by the SBA. We
have also determined that none of these
small businesses are significantly
impacted by this proposal for none of
them will incur annualized compliance
costs of 0.1 percent of sales or greater.
Although this final rule will not have
a significant economic impact on a
substantial number of small entities,
EPA nonetheless has tried to reduce the
impact of this rule on small entities. The
final rule is designed to harmonize with
existing State or local requirements.
D. Unfunded Mandates Reform Act
Title II of the Unfunded Mandates
Reform Act of 1995 (UMRA), Public
Law 104–4, establishes requirements for
Federal agencies to assess the effects of
their regulatory actions on State, local,
and tribal governments and the private
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73621
sector. Under section 202 of the UMRA,
EPA generally must prepare a written
statement, including a cost-benefit
analysis, for proposed and final rules
with ‘‘Federal mandates’’ that may
result in expenditures to State, local,
and tribal governments, in the aggregate,
or to the private sector, of $100 million
or more in any one year. Before
promulgating an EPA rule for which a
written statement is needed, section 205
of the UMRA generally requires EPA to
identify and consider a reasonable
number of regulatory alternatives and
adopt the least costly, most costeffective, or least burdensome
alternative that achieves the objectives
of the rule. The provisions of section
205 do not apply when they are
inconsistent with applicable law.
Moreover, section 205 allows EPA to
adopt an alternative other than the least
costly, most cost-effective, or least
burdensome alternative if the
Administrator publishes with the final
rule an explanation why that alternative
was not adopted. Before EPA establishes
any regulatory requirements that may
significantly or uniquely affect small
governments, including tribal
governments, it must have developed
under section 203 of the UMRA a small
government agency plan. The plan must
provide for notifying potentially
affected small governments, enabling
officials of affected small governments
to have meaningful and timely input in
the development of EPA regulatory
proposals with significant Federal
intergovernmental mandates, and
informing, educating, and advising
small governments on compliance with
the regulatory requirements.
EPA has determined that the final rule
does not contain a Federal mandate that
may result in expenditures of $100
million or more for State, local, and
tribal governments, in the aggregate, or
the private sector in any one year. Thus,
the final rule is not subject to the
requirements of sections 202 and 205 of
the UMRA. In addition, the final rule
does not significantly or uniquely affect
small governments. The final rule
contains no requirements that apply to
such governments, impose no
obligations upon them, and will not
result in expenditures by them of $100
million or more in any one year or any
disproportionate impacts on them.
Therefore, the final rule is not subject to
section 203 of the UMRA.
E. Executive Order 13132: Federalism
Executive Order 13132, entitled
‘‘Federalism’’ (64 FR 43255, August 10,
1999) requires EPA to develop an
accountable process to ensure
‘‘meaningful and timely input by State
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and local officials in the development of
regulatory policies that have federalism
implications.’’ ‘‘Policies that have
federalism implications’’ is defined in
the Executive Order to include
regulations that have ‘‘substantial direct
effects on the States, on the relationship
between the national government and
the States, or on the distribution of
power and responsibilities among the
various levels of government.’’
This final rule does not have
federalism implications. It will not have
substantial direct effects on the States,
on the relationship between the national
government and the States, or on the
distribution of power and
responsibilities among the various
levels of government, as specified in
Executive Order 13132. The final rule
imposes requirements on owners and
operators of specified area sources and
not State and local governments. Thus,
Executive Order 13132 does not apply
to this final rule.
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F. Executive Order 13175: Consultation
and Coordination With Indian Tribal
Governments
Executive Order 13175, entitled
‘‘Consultation and Coordination with
Indian Tribal Governments’’ (65 FR
67249, November 9, 2000), requires EPA
to develop an accountable process to
ensure ‘‘meaningful and timely input by
tribal officials in the development of
regulatory policies that have tribal
implications.’’ This final rule does not
have tribal implications, as specified in
Executive Order 13175. It will not have
substantial direct effects on tribal
governments, on the relationship
between the Federal government and
Indian tribes, or on the distribution of
power and responsibilities between the
Federal government and Indian tribes,
as specified in Executive Order 13175.
This final rule imposes requirements on
owners and operators of specified area
sources and not tribal governments.
Thus, Executive Order 13175 does not
apply to this final rule.
G. Executive Order 13045: Protection of
Children From Environmental Health
Risks and Safety Risks
Executive Order 13045, ‘‘Protection of
Children from Environmental Health
Risks and Safety Risks’’ (62 FR 19885,
April 23, 1997) applies to any rule that:
(1) Is determined to be ‘‘economically
significant’’ as defined under Executive
Order 12866, and (2) concerns an
environmental health or safety risk that
EPA has reason to believe may have a
disproportionate effect on children. If
the regulatory action meets both criteria,
the Agency must evaluate the
environmental health or safety effects of
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the planned rule on children, and
explain why the planned regulation is
preferable to other potentially effective
and reasonably feasible alternatives
considered by the Agency.
EPA interprets Executive Order 13045
as applying only to those regulatory
actions that are based on health or safety
risks, such that the analysis required
under section 5–501 of the Executive
Order has the potential to influence the
regulation. This final rule is not subject
to Executive Order 13045 because it is
based on technology performance and
not on health or safety risks.
H. Executive Order 13211: Actions
Concerning Regulations That
Significantly Affect Energy Supply,
Distribution, or Use
This final rule is not a ‘‘significant
energy action’’ as defined in Executive
Order 13211, ‘‘Actions Concerning
Regulations That Significantly Affect
Energy Supply, Distribution, and Use’’
(66 FR 28355, May 22, 2001) because it
is not likely to have a significant
adverse effect on the supply,
distribution, or use of energy. Further,
we have concluded that the final rule is
not likely to have any adverse energy
effects because energy requirements
would likely be less than existing levels.
No additional pollution controls or
other equipment that would consume
energy are required by this final rule.
I. National Technology Transfer and
Advancement Act
As noted in the proposed rule,
Section 12(d) of the National
Technology Transfer and Advancement
Act (NTTAA) of 1995 (Pub. L. 104–113,
12(d) (15 U.S.C. 272 note) directs EPA
to use voluntary consensus standards
(VCS) in its regulatory activities, unless
to do so would be inconsistent with
applicable law or otherwise impractical.
VCS are technical standards (e.g.,
materials specifications, test methods,
sampling procedures, and business
practices) that are developed or adopted
by VCS bodies. The NTTAA directs EPA
to provide Congress, through OMB,
explanations when the Agency decides
not to use available and applicable VCS.
This action does not involve technical
standards. Therefore, EPA did not
consider the use of any VCS.
J. Executive Order 12898: Federal
Actions to Address Environmental
Justice in Minority Populations and
Low-Income Populations
Executive Order 12898 (59 FR 7629,
February 16, 1994) establishes Federal
executive policy on environmental
justice. Its main provision directs
Federal agencies, to the greatest extent
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practicable and permitted by law, to
make environmental justice part of their
mission by identifying and addressing,
as appropriate, disproportionately high
and adverse human health or
environmental effects of their programs,
policies, and activities on minority
populations and low-income
populations in the United States.
EPA has determined that this final
rule will not have disproportionately
high and adverse human health or
environmental effects on minority or
low-income populations because it
increases the level of environmental
protection for all affected populations
without having any disproportionately
high and adverse human health or
environmental effects on any
population, including any minority or
low-income population. This final rule
establishes national standards for the
area source category.
K. Congressional Review Act
The Congressional Review Act, 5
U.S.C. 801, et seq., as added by the
Small Business Regulatory Enforcement
Fairness Act of 1996, generally provides
that before a rule may take effect, the
agency promulgating the rule must
submit a rule report, which includes a
copy of the rule, to each House of the
Congress and to the Comptroller General
of the United States. EPA will submit a
report containing this final rule and
other required information to the United
States Senate, the United States House
of Representatives, and the Comptroller
General of the United States prior to
publication of the final rule in the
Federal Register. A major rule cannot
take effect until 60 days after it is
published in the Federal Register. This
action is not a ‘‘major rule’’ as defined
by 5 U.S.C. 804(2). This final rule will
be effective on December 28, 2007.
List of Subjects in 40 CFR Part 63
Environmental protection, Air
pollution control, Hazardous
substances, Reporting and
recordkeeping requirements.
Dated: December 20, 2007.
Stephen L. Johnson,
Administrator.
For the reasons stated in the preamble,
title 40, chapter I, part 63 of the Code
of Federal Regulations is amended as
follows:
I
PART 63—[AMENDED]
1. The authority citation for part 63
continues to read as follows:
I
Authority: 42 U.S.C. 7401, et seq.
2. Part 63 is amended by adding
subpart WWWWW to read as follows:
I
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Subpart WWWWW—National Emission
Standards for Hospital Ethylene Oxide
Sterilizers
Sec.
Applicability and Compliance Dates
63.10382
63.10384
Am I subject to this subpart?
What are my compliance dates?
Standards
63.10390 What management practice
standards must I meet?
Initial Compliance Requirements
63.10400 How do I demonstrate initial
compliance?
63.10402 By what date must I demonstrate
initial compliance?
Notifications, Reports, and Records
63.10430 What notifications must I submit
and when?
63.10432 What records must I keep?
63.10434 In what form and for how long
must I keep my records?
Other Requirements and Information
63.10440 What parts of the General
Provisions apply to me?
63.10442 Who implements and enforces
this subpart?
63.10446 Do title V permitting requirements
apply to area sources subject to this
subpart?
63.10448 What definitions apply to this
subpart?
Table to Subpart WWWWW of Part 63
Table 1 to Subpart WWWWW of Part 63—
Applicability of General Provisions to
Subpart WWWWW
Subpart WWWWW—National Emission
Standards for Hospital Ethylene Oxide
Sterilizers
Applicability and Compliance Dates
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Am I subject to this subpart?
(a) You are subject to this subpart if
you own or operate an ethylene oxide
sterilization facility at a hospital that is
an area source of hazardous air
pollutant (HAP) emissions.
(b) The affected source subject to this
subpart is each new or existing
sterilization facility.
(1) An affected source is existing if
you commenced construction or
reconstruction of the affected source
before November 6, 2006.
(2) An affected source is new if you
commenced construction or
reconstruction of the affected source on
or after November 6, 2006.
23:53 Dec 27, 2007
Jkt 214001
(a) Existing source. If you have an
existing affected source, you must
comply with applicable requirements in
this subpart no later than December 29,
2008.
(b) New source. If you start up a new
affected source on or before December
28, 2007, you must comply with
applicable requirements in this subpart
by December 28, 2007.
(c) New source. If you start up a new
affected source after December 28, 2007,
you must comply with applicable
requirements in this subpart upon
startup of your affected source.
§ 63.10390 What management practice
standard must I meet?
63.10420 How do I demonstrate
continuous compliance with the
management practice requirements?
VerDate Aug<31>2005
What are my compliance
Standards
Monitoring—Continuous Compliance
Requirements
§ 63.10382
§ 63.10384
dates?
You must sterilize full loads of items
having a common aeration time, except
under medically necessary
circumstances, as that term is defined in
§ 63.10448.
73623
§ 63.10402 By what date must I
demonstrate initial compliance?
You must demonstrate initial
compliance with § 63.10390 upon
startup or no later than 180 calendar
days after your compliance date,
whichever is later.
Monitoring—Continuous Compliance
Requirements
§ 63.10420 How do I demonstrate
continuous compliance with the
management practice requirements?
For each sterilization unit not
equipped with an air pollution control
device, you must demonstrate
continuous compliance with the
management practice standard in
§ 63.10390 by recording the date and
time of each sterilization cycle, whether
each sterilization cycle contains a full
load of items, and if not, a statement
from a hospital central services staff, a
hospital administrator, or a physician
that it was medically necessary.
Notifications, Reports, and Records
Initial Compliance Requirements
§ 63.10400 How do I demonstrate initial
compliance?
§ 63.10430 What notifications must I
submit and by when?
(a) You must submit an Initial
Notification of Compliance Status that
includes the information required in
paragraphs (a)(1) through (5) of this
section and the applicable certification
in § 63.10400.
(1) The name and address of the
owner or operator.
(2) The address (i.e., physical
location) of the affected source.
(3) An identification of the standard
and other applicable requirements in
this subpart that serve as the basis of the
notification and the source’s compliance
date.
(4) A brief description of the
sterilization facility, including the
number of ethylene oxide sterilizers, the
size (volume) of each, the number of
aeration units, if any, the amount of
annual ethylene oxide usage at the
facility, the control technique used for
each sterilizer, and typical number of
sterilization cycles per year.
(5) A statement that the affected
source is an area source.
(b) You must submit the Initial
Notification of Compliance Status to the
appropriate authority(ies) specified in
§ 63.9(a)(4). In addition, you must
submit a copy of the Initial Notification
of Compliance Status to EPA’s Office of
Air Quality Planning and Standards.
Send your notification via e-mail to
CCG-ONG@EPA.GOV or via U.S. mail or
other mail delivery service to U.S. EPA,
Sector Policies and Programs Division,
Coatings and Chemicals Group (E143–
01), Attn: Hospital Sterilizers Project
(a) Except as provided in paragraphs
(b) and (c) of this section, you must
demonstrate initial compliance with the
management practice standard in
§ 63.10390 by submitting an Initial
Notification of Compliance Status
certifying that you are sterilizing full
loads of items having a common
aeration time except under medically
necessary circumstances.
(b) If you operate your sterilization
unit(s) with an air pollution control
device pursuant to a State or local
regulation, you may demonstrate initial
compliance with § 63.10390 by
submitting an Initial Notification of
Compliance Status certifying that you
are operating the sterilization unit in
accordance with your State or local
regulation and following control device
manufacturer’s recommended
procedures.
(c) If you operate your sterilization
unit(s) with an air pollution control
device but are not subject to any State
or local regulation, you may
demonstrate initial compliance with
§ 63.10390 by submitting an Initial
Notification of Compliance Status
certifying that you are venting the
ethylene oxide emissions from each
sterilization unit to an add-on air
pollution control device. You must
certify that you are operating the control
device during all sterilization processes
and in accordance with manufacturer’s
recommended procedures.
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Leader, Research Triangle Park, NC
27711.
(c) You must submit the Initial
Notification of Compliance Status no
later than 180 calendar days after your
compliance date, consistent with
§ 63.10402.
§ 63.10432
What records must I keep?
You must keep the records specified
in paragraphs (a) and (b) of this section.
(a) A copy of the Initial Notification
of Compliance Status that you
submitted to comply with this subpart.
(b) Records required by § 63.10420 for
each sterilization unit not equipped
with an air pollution control device.
not transferred to the State, local, or
tribal agency.
(c) The authorities that will not be
delegated to State, local, or tribal
agencies include approval of
alternatives to the applicability
requirements under 40 CFR 63.10382,
the compliance date requirements in 40
CFR 63.10384, and the management
practice standards as defined in 40 CFR
63.10390.
§ 63.10446 Do title V permitting
requirements apply to area sources subject
to this subpart?
§ 63.10434 In what form and for how long
must I keep my records?
(a) Your records must be in a form
suitable and readily available for
expeditious review.
(b) You must keep each record for 5
years following the date of each record.
(c) You must keep each record onsite
for at least 2 years after the date of each
record. You may keep the records offsite
for the remaining 3 years.
You are exempt from the obligation to
obtain a permit under 40 CFR part 70 or
40 CFR part 71, provided you are not
otherwise required by law to obtain a
permit under 40 CFR 70.3(a) or 40 CFR
71.3(a). Notwithstanding the previous
sentence, you must continue to comply
with the provisions of this subpart.
§ 63.10448
subpart?
Other Requirements and Information
§ 63.10440 What parts of the General
Provisions apply to me?
Table 1 to this subpart shows which
parts of the General Provisions in 40
CFR 63.1 through 63.16 apply to you.
§ 63.10442 Who implements and enforces
this subpart?
(a) This subpart can be implemented
and enforced by us, the U.S. EPA, or a
delegated authority such as your State,
local, or tribal agency. If the U.S. EPA
Administrator has delegated authority to
your State, local, or tribal agency, then
that agency has the authority to
implement and enforce this subpart.
You should contact your U.S. EPA
Regional Office to find out if this
subpart is delegated to your State, local,
or tribal agency.
(b) In delegating implementation and
enforcement authority of this subpart to
a State, local, or tribal agency under 40
CFR part 63, subpart E, the authorities
contained in paragraph (c) of this
section are retained by the
Administrator of the U.S. EPA and are
What definitions apply to this
Terms used in this subpart are
defined in the Clean Air Act (CAA), in
40 CFR 63.2, and in this section as
follows:
Aeration process means any time
when ethylene oxide is removed from
the aeration unit through the aeration
unit vent or from the combination
sterilization unit through the
sterilization unit vent, while aeration or
off-gassing is occurring.
Aeration unit means any vessel that is
used to facilitate off-gassing of ethylene
oxide.
Air pollution control device means a
catalytic oxidizer, acid-water scrubber,
or any other air pollution control
equipment that reduces the quantity of
ethylene oxide in the effluent gas stream
from sterilization and aeration
processes.
Combination sterilization unit means
any enclosed vessel in which both the
sterilization process and the aeration
process occur within the same vessel,
i.e., the vessel is filled with ethylene
oxide gas or an ethylene oxide/inert gas
mixture for the purpose of sterilizing
and is followed by off-gassing of
ethylene oxide.
Common aeration time means that
items require the same length of time to
off-gas ethylene oxide.
Full load means the maximum
number of items that does not impede
proper air removal, humidification of
the load, or sterilant penetration and
evacuation in the sterilization unit.
Hospital means a facility that
provides medical care and treatment for
patients who are acutely ill or
chronically ill on an inpatient basis
under supervision of licensed
physicians and under nursing care
offered 24 hours per day. Hospitals
include diagnostic and major surgery
facilities but exclude doctor’s offices,
clinics, or other facilities whose primary
purpose is to provide medical services
to humans or animals on an outpatient
basis.
Hospital central services staff means a
healthcare professional, including
manager and technician, who is either
directly involved in or responsible for
sterile processing at a hospital.
Medically necessary means
circumstances that a hospital central
services staff, a hospital administrator,
or a physician concludes, based on
generally accepted medical practices,
necessitate sterilizing without a full
load in order to protect human health.
State or local regulation means a
regulation at the State or local level that
requires a hospital to reduce the
quantity of ethylene oxide emissions
from ethylene oxide sterilization units.
Sterilization facility means the group
of ethylene oxide sterilization units at a
hospital using ethylene oxide gas or an
ethylene oxide/inert gas mixture for the
purpose of sterilizing.
Sterilization process means any time
when ethylene oxide is removed from
the sterilization unit or combination
sterilization unit through the
sterilization unit vent.
Sterilization unit means any enclosed
vessel that is filled with ethylene oxide
gas or an ethylene oxide/inert gas
mixture for the purpose of sterilizing.
As used in this subpart, the term
includes combination sterilization units.
Table to Subpart WWWWW of Part 63
As required in § 63.10440, you must
comply with the requirements of the
General Provisions (40 CFR part 63,
subpart A) shown in the following table:
TABLE 1 TO SUBPART WWWWW OF PART 63.—APPLICABILITY OF GENERAL PROVISIONS TO SUBPART WWWWW
Applies to subpart WWWWW
pwalker on PROD1PC71 with RULES
Citation
Subject
§ 63.1(a)(1)–(4), (6), (10)–(12), (b)(1), (3)
§ 63.1(a)(5), (7)–(9) .................................
§ 63.1(b)(2) ..............................................
Applicability ............................................
[Reserved].
[Reserved].
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Yes.
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73625
TABLE 1 TO SUBPART WWWWW OF PART 63.—APPLICABILITY OF GENERAL PROVISIONS TO SUBPART WWWWW—
Continued
Citation
Subject
Applies to subpart WWWWW
Explanation
§ 63.1(c)(1)–(2) ........................................
Applicability of this part after a relevant
standard has been set.
Yes ...................
§ 63.10446 of this subpart exempts affected sources from the obligation to
obtain title V operating permits for
purposes of being subject to this subpart.
§ 63.1(c)(3)–(4) ........................................
§ 63.1(c)(5) ..............................................
§ 63.1(d) ...................................................
§ 63.1(e) ...................................................
§ 63.2 .......................................................
§ 63.3 .......................................................
§ 63.4 .......................................................
§ 63.5 .......................................................
§ 63.6(a), (b)(1)–(5), (7) ...........................
[Reserved].
Subject to notification requirements ......
[Reserved].
Emission limitation by permit .................
Definitions ..............................................
Units and abbreviations .........................
Prohibited activities ................................
Construction/reconstruction ...................
Compliance with standards and maintenance requirements.
[Reserved].
Compliance dates for existing sources ..
§ 63.6(b)(6) ..............................................
§ 63.6(c)(1) ..............................................
§ 63.6(c)(2), (5) ........................................
§ 63.6(c)(3)–(4) ........................................
§ 63.6(d) ...................................................
§ 63.6(e)–(h) ............................................
§ 63.6(i)–(j) ...............................................
§ 63.7 .......................................................
§ 63.8 .......................................................
§ 63.9(a) ...................................................
§ 63.9(b) ...................................................
§ 63.9(c) ...................................................
§ 63.9(d)–(j) .............................................
§ 63.10(a)(1)–(2) ......................................
§ 63.10(a)(3)–(4) ......................................
§ 63.10(a)(5)–(7) ......................................
§ 63.10(b)(1) ............................................
§ 63.10(b)(2)–(f) .......................................
§ 63.11 .....................................................
§ 63.12 .....................................................
§§ 63.13–63.16 ........................................
Compliance dates for CAA section
112(f) standards and for area sources
that become major.
[Reserved].
[Reserved].
Alternative nonopacity emission standard.
Compliance extension ............................
Performance testing requirements .........
Monitoring requirements ........................
Applicability and initial notifications addressees.
Initial notifications ...................................
Request for extension of compliance ....
Other notifications ..................................
Recordkeeping and reporting requirements, applicability.
General information ...............................
Recordkeeping and reporting requirements, reporting schedules.
Retention time ........................................
Recordkeeping and reporting requirements.
Control device requirements ..................
State authority and delegations .............
Addresses, Incorporations by Reference, availability of information,
performance track provisions.
[FR Doc. E7–25233 Filed 12–27–07; 8:45 am]
BILLING CODE 6560–50–P
ENVIRONMENTAL PROTECTION
AGENCY
40 CFR Part 65
[EPA–HQ–OAR–2007–0429; FRL–8511–7]
pwalker on PROD1PC71 with RULES
RIN 2060–A045
Revisions to Consolidated Federal Air
Rule; Correction
Environmental Protection
Agency (EPA).
ACTION: Correcting amendments.
AGENCY:
VerDate Aug<31>2005
23:53 Dec 27, 2007
Jkt 214001
No.
Yes.
Yes.
Yes.
Yes.
No.
Yes.
Yes ...................
No.
No.
Yes.
No.
No.
Yes.
No.
Yes.
No.
Yes.
Yes.
No.
Yes.
No.
No.
Yes.
Yes.
SUMMARY: The EPA issued a final rule
on August 27, 2007 (effective date
November 26, 2007) that revised the
General Provisions for Consolidated
Federal Air Rule to allow extensions to
the deadline imposed for source owners
and operators to conduct required
performance tests in specified force
majeure circumstances. The final rule
inadvertently stated that we were
revising paragraph (c) introductory text
when we actually added introductory
text to paragraph (c). The purpose of
this action is to correct this error.
This action merely addresses a
formatting issue. Thus, it is proper to
issue this notice without notice and
comment. Section 553 of the
Administrative Procedure Act (APA), 5
PO 00000
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Subpart WWWWW requires compliance
1 year after the effective date.
U.S.C. 553(b)(B), provides that, when an
Agency for good cause finds that notice
and public procedure are impracticable,
unnecessary, or contrary to the public
interest, the Agency may issue a rule
without providing notice and an
opportunity for public comment. We
have determined that there is good
cause for making this action final
without prior proposal and opportunity
for comment because the change to the
rule is a minor technical correction, is
noncontroversial, and does not
substantively change the agency actions
taken in the final rule. Thus, notice and
public procedure are unnecessary. We
find that this constitutes good cause
under 5 U.S.C. 553(b)(B).
E:\FR\FM\28DER1.SGM
28DER1
Agencies
[Federal Register Volume 72, Number 248 (Friday, December 28, 2007)]
[Rules and Regulations]
[Pages 73611-73625]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-25233]
-----------------------------------------------------------------------
ENVIRONMENTAL PROTECTION AGENCY
40 CFR Part 63
[EPA-HQ-OAR-2005-0171; FRL-8512-1]
RIN 2060-AM14
National Emission Standards for Hospital Ethylene Oxide
Sterilizers
AGENCY: Environmental Protection Agency (EPA).
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: EPA is issuing national emissions standards for new and
existing hospital sterilizers that emit hazardous air pollutants and
are area sources within the meaning of Clean Air Act section 112(a)(2).
The final rule is based on EPA's determination as to what constitutes
the generally available control technology or management practices for
the hospital sterilizer area source category.
This action is being finalized as part of EPA's obligation to
regulate area sources listed for regulation pursuant to Clean Air Act
section 112(c)(3).
DATES: The final rule is effective on December 28, 2007.
ADDRESSES: EPA has established a docket for this action under Docket ID
No. EPA-HQ-OAR-2005-0171. All documents in the docket are listed in the
Federal Docket Management System index at https://www.regulations.gov.
Although listed in the index, some information is not publicly
available, e.g., confidential business information or other information
whose disclosure is restricted by statute. Certain other material, such
as copyrighted material, is not placed on the Internet and will be
publicly available only in hard copy form. Publicly available docket
materials are available either electronically through
www.regulations.gov or in hard copy at the EPA Docket Center in the EPA
Headquarters Library, Room Number 3334 in the EPA West Building,
located at 1301 Constitution Ave., NW., Washington, DC. The EPA/DC
Public Reading Room hours of operation are 8:30 a.m. to 4:30 p.m.
Eastern Standard Time (EST), Monday through Friday, excluding legal
holidays. The telephone number for the Public Reading Room is (202)
566-1744. For the Air and Radiation Docket and Information Center, the
telephone number is (202) 566-1742, the fax number is (202) 566-9744,
the Web site is https://www.epa.gov/oar/docket.html, and the e-mail
address is a-and-r-Docket@epa.gov.
FOR FURTHER INFORMATION CONTACT: Mr. David Markwordt, Office of Air
Planning and Standards, Sector Policies and Programs Division, Coatings
and Chemicals Group (E143-01), Environmental Protection Agency,
Research Triangle Park, NC 27711, telephone number: (919) 541-0837; fax
number: (919) 541-0246; e-mail address: markwordt.david@epa.gov.
SUPPLEMENTARY INFORMATION: Outline. The information presented in this
preamble is organized as follows:
I. General Information
A. Does this action apply to me?
B. Where can I get a copy of this document?
C. Judicial Review
II. Background Information for Final Area Source Standard
III. Summary of the Final Rule and Significant Changes Since
Proposal
A. What is the affected source and the compliance date?
B. What is required by the management practice?
C. What are the testing and initial compliance requirements?
D. What are the notification, recordkeeping, and reporting
requirements?
IV. Exemption of Certain Area Source Categories From Title V
Permitting Requirements
V. Summary of Comments and Responses
A. Proposed Alternative 1: Management Practice
B. Proposed Alternative 2: No Control
C. Add-on Controls
VI. Summary of Environmental, Energy, Cost, and Economic Impacts
VII. Statutory and Executive Order Reviews
A. Executive Order 12866: Regulatory Planning and Review
B. Paperwork Reduction Act
C. Regulatory Flexibility Act
D. Unfunded Mandates Reform Act
E. Executive Order 13132: Federalism
F. Executive Order 13175: Consultation and Coordination with
Indian Tribal Governments
G. Executive Order 13045: Protection of Children From
Environmental Health Risks and Safety Risks
H. Executive Order 13211: Actions Concerning Regulations That
Significantly Affect Energy Supply, Distribution, or Use
I. National Technology Transfer and Advancement Act
J. Executive Order 12898: Federal Actions to Address
Environmental Justice in Minority Populations and Low-Income
Populations
K. Congressional Review Act
I. General Information
A. Does this action apply to me?
The regulated categories and entities potentially affected by these
final standards include:
----------------------------------------------------------------------------------------------------------------
Category NAICS\1\ code Example of potentially regulated entities
----------------------------------------------------------------------------------------------------------------
General Medical and Surgical Hospitals....... 622110 Hospital sterilizers.
Specialty (Except Psychiatric and Substance 622310 Hospital sterilizers.
Abuse) Hospitals.
----------------------------------------------------------------------------------------------------------------
\1\ North American Industrial Classification System.
This table is not intended to be exhaustive, but rather provides a
guide for readers regarding entities likely to be affected by this
action. To determine whether your facility is regulated by this action,
you should examine the applicability criteria in 40 CFR 63.10382 of
subpart WWWWW (National Emissions Standards for Hospital Ethylene Oxide
Sterilizers). If you have any questions regarding the applicability of
this action to a particular entity, consult either the air permit
authority for the entity or your EPA regional representative as listed
in 40 CFR 63.13 of subpart A (General Provisions).
B. Where can I get a copy of this document?
In addition to being available in the docket, an electronic copy of
this final action is also available on the Worldwide Web through the
Technology Transfer Network (TTN). Following signature, a copy of this
final action will be posted on the TTN's policy and guidance page for
newly proposed or promulgated rules at the following address: https://
www.epa.gov/ttn/oarpg/. The TTN provides information and technology
exchange in various areas of air pollution control.
C. Judicial Review
Under section 307(b)(1) of the Clean Air Act (CAA), judicial review
of this final rule is available only by filing a petition for review in
the United States
[[Page 73612]]
Court of Appeals for the District of Columbia Circuit by February 26,
2008. Under section 307(d)(7)(B) of the CAA, only an objection to this
final rule that was raised with reasonable specificity during the
period for public comment can be raised during judicial review. This
section also provides a mechanism for EPA to convene a proceeding for
reconsideration, ``[i]f the person raising an objection can demonstrate
to the EPA that it was impracticable to raise such objection within
[the period for public comment] or if the grounds for such objection
arose after the period for public comment (but within the time
specified for judicial review) and if such objection is of central
relevance to the outcome of the rule.'' Any person seeking to make such
a demonstration to us should submit a Petition for Reconsideration to
the Office of the Administrator, U.S. EPA, Room 3000, Ariel Rios
Building, 1200 Pennsylvania Ave., NW., Washington, DC 20460, with a
copy to both the person(s) listed in the preceding FOR FURTHER
INFORMATION CONTACT section, and the Associate General Counsel for the
Air and Radiation Law Office, Office of General Counsel (Mail Code
2344A), U.S. EPA, 1200 Pennsylvania Ave., NW., Washington, DC 20460.
Moreover, under section 307(b)(2) of the CAA, the requirements
established by this final rule may not be challenged separately in any
civil or criminal proceedings brought by EPA to enforce these
requirements.
II. Background Information for Final Area Source Standard
Sections 112(c)(3) and 112(k)(3)(B) of the CAA instruct EPA to
identify not less than 30 hazardous air pollutants (HAP) which, as a
result of emissions from area sources,\1\ present the greatest threat
to public health in the largest number of urban areas, and to list
sufficient area source categories to ensure that sources representing
90 percent of the 30 listed HAP (the ``urban HAP'') are subject to
regulation. Consistent with these provisions, in 1999, in the
Integrated Urban Air Toxics Strategy (64 FR 38706, 64 FR 38715-716,
July 19, 1999), EPA identified the 30 urban HAP and listed the source
categories that account for 90 percent of the urban HAP emissions.\2\
---------------------------------------------------------------------------
\1\ An area source is a stationary source of HAP emissions that
is not a major source. A major source is a stationary source that
emits or has the potential to emit 10 tons per year (tpy) or more of
any HAP or 25 tpy or more of any combination of HAP.
\2\ Since its publication in the Integrated Urban Air Toxics
Strategy in 1999, the area source category list has undergone
several amendments.
---------------------------------------------------------------------------
Under CAA section 112(d)(5), the Administrator may, in lieu of
standards requiring maximum achievable control technology (MACT) under
section 112(d)(2), elect to promulgate standards or requirements for
area sources ``which provide for the use of generally available control
technologies or management practices by such sources to reduce
emissions of hazardous air pollutants.'' As explained in the proposed
national emission standards for hazardous air pollutants (NESHAP), we
are setting standards for the Hospital Sterilizers Area Source category
pursuant to section 112(d)(5) of the CAA. See 71 FR 64907, November 6,
2006.
III. Summary of the Final Rule and Significant Changes Since Proposal
This section summarizes the final rule and identifies and discusses
the significant changes since proposal. For changes that were made as a
result of public comments, we have provided detailed explanations of
the changes and the rationale in the responses to comments in section V
of this preamble.
A. What is the affected source and the compliance date?
This final rule applies to any existing or new hospital ethylene
oxide sterilization facility that is an area source of HAP. The owner
or operator of an existing area source must comply with this area
source NESHAP by December 29, 2008. The owner or operator of a new area
source must comply with this area source NESHAP by December 28, 2007 or
upon initial startup, whichever is later.
B. What is required by the management practice?
In our November 6, 2006 proposal, we proposed two alternative
emission standards for this area source category. As Alternative 1, we
proposed to require that the affected source, as defined above,
sterilize full loads of medical items having common aeration times
except during emergency circumstances that dictate the use of less than
full loads to protect human health. As Alternative 2, we proposed a
finding that there are no generally available control technologies or
management practices (GACT) within the meaning of CAA section 112(d)(5)
for the Hospital Sterilizers Area Source category. As explained in more
detail in section V of this preamble, based on the comments and
information we received during the public comment period, we conclude
that the management practice described in Alternative 1 reflects GACT
for this area source category, and we, therefore, adopt Alternative 1
as the standard for area source hospital ethylene oxide sterilization
facilities.
Specifically, the final rule requires that a hospital ethylene
oxide sterilization facility sterilize full loads of items having a
common aeration time except where medical necessity dictates the use of
less than a full load to protect human health. As explained in more
detail in section V.A.3 of this preamble, the determination that a
medical necessity exists must be made by a hospital central services
staff,\3\ a hospital administrator, or a physician on duty. This
management practice applies to all affected sources. As explained in
more detail in section V.A.2 of this preamble, sources may demonstrate
compliance with this requirement by operating their sterilizers with an
air pollution control device and providing the certification required
in this final rule.
---------------------------------------------------------------------------
\3\ Hospital central services staffs are healthcare
professionals, including managers and technicians, who are either
directly involved in or responsible for sterile processing at a
hospital.
---------------------------------------------------------------------------
C. What are the testing and initial compliance requirements?
There are no performance test requirements for the management
practice standard. Affected sources are required to submit an Initial
Notification of Compliance Status that notifies EPA that they operate a
sterilizer covered by the rule and certify that they are operating
their sterilizers in accordance with the requirement of the rule.
In the preamble to the proposed rule, we acknowledged that some
hospitals operate their sterilizers with add-on controls and that such
controls achieve reductions in ethylene oxide emissions that are at
least equivalent to the ethylene oxide reductions resulting from the
management practice. Therefore, the final rule includes the use of a
control device as an alternative compliance option for the management
practice requirement. Specifically, a source may demonstrate compliance
by certifying that it is operating its sterilizer(s) with an air
pollution control device. The source must certify that it is running
the sterilizer(s) in accordance with any applicable State and/or local
regulations, or, if there are no such regulations, with manufacturers'
specifications.
D. What are the notification, recordkeeping, and reporting
requirements?
As mentioned above, affected sources must submit an Initial
Notification of Compliance Status that includes the
[[Page 73613]]
required compliance certification described above. The final rule does
not require ongoing reporting.
Except for hospital ethylene oxide sterilization facilities that
demonstrate compliance by using add-on controls, affected sources must
maintain on site records of the date and time of each sterilization
operation. If less than a full load is sterilized due to medical
necessity, the operator must record this as well. These sterilization
records must be kept in a form suitable and readily available for
expeditious review. They must be kept for 5 years and at least the most
recent 2 years on site.
IV. Exemption of Certain Area Source Categories From Title V Permitting
Requirements
Section 502(a) of the CAA provides that the Administrator may
exempt an area source category from title V if he determines that
compliance with title V requirements is ``impracticable, infeasible, or
unnecessarily burdensome'' on an area source category. See CAA section
502(a). In December 2005, in a national rulemaking, EPA interpreted the
term ``unnecessarily burdensome'' in CAA section 502 and developed a
four-factor balancing test for determining whether title V is
unnecessarily burdensome for a particular area source category, such
that an exemption from title V is appropriate. See 70 FR 75320,
December 19, 2005 (Exemption Rule).
The four factors that EPA identified in the Exemption Rule for
determining whether title V is ``unnecessarily burdensome'' on a
particular area source category include: (1) whether title V would
result in significant improvements to the compliance requirements,
including monitoring, recordkeeping, and reporting, that are proposed
for an area source category (70 FR 75323); (2) whether title V
permitting would impose significant burdens on the area source category
and whether the burdens would be aggravated by any difficulty the
sources may have in obtaining assistance from permitting agencies (70
FR 75324); (3) whether the costs of title V permitting for the area
source category would be justified, taking into consideration any
potential gains in compliance likely to occur for such sources (70 FR
75325); and (4) whether there are implementation and enforcement
programs in place that are sufficient to assure compliance with the
NESHAP for the area source category, without relying on title V permits
(70 FR 75326).
In discussing the above factors in the Exemption Rule, we explained
that we considered on ``a case-by-case basis the extent to which one or
more of the four factors supported title V exemptions for a given
source category, and then we assessed whether considered together those
factors demonstrated that compliance with title V requirements would be
`unnecessarily burdensome' on the category, consistent with section
502(a) of the Act.'' See 70 FR 75323. Thus, in the Exemption Rule, we
explained that not all of the four factors must weigh in favor of
exemption for EPA to determine that title V is unnecessarily burdensome
for a particular area source category. Instead, the factors are to be
considered in combination, and EPA determines whether the factors,
taken together, support an exemption from title V for a particular
source category.
In the Exemption Rule, in addition to determining whether
compliance with title V requirements would be unnecessarily burdensome
on the hospital sterilizer area source category, we considered,
consistent with the guidance provided by the legislative history of CAA
section 502(a), whether exempting the Hospital Sterilizer Area Source
category would adversely affect public health, welfare, or the
environment. See 70 FR 15254-15255, March 25, 2005.
In the proposed rule, we evaluated the four factors described above
in relation to the Hospital Sterilizer Area Source category and
explained our proposed conclusion that the factors collectively
demonstrated that compliance with title V requirements would be
unnecessarily burdensome for the source category. Among other things,
we explained in the preamble to the proposed rule, that title V
permitting would not result in significant improvements to the
compliance requirements for the Hospital Sterilizer Area Source
category. In the proposal, we further explained that title V permitting
may impose a significant burden on facilities within this source
category, some of which are small businesses. We explained that, for
many facilities, the cost of obtaining a title V permit may far exceed
the cost of complying with the final rule without significant gains in
compliance. Based on the above analysis, we proposed that title V
permitting would be ``unnecessarily burdensome'' for hospital
sterilizer area sources. We also proposed that the exemptions from
title V would not adversely affect public health, welfare, and the
environment.
In response to the proposed rule, we received two comments
concerning the proposed title V exemption. However, as discussed in
more detail in section V.A.7 of this preamble, neither comment
addressed the above-mentioned factors that we considered in proposing
the title V exemption. Accordingly, our assessment of these factors
remains unchanged in light of these comments. We, therefore, finalize
the proposed exemption for the Hospital Sterilizer Area Source category
in this rule. Hospital sterilizer area sources are not required to
obtain title V permits solely for purposes of being the subject of this
final NESHAP; however, if they are otherwise required to obtain title V
permits, such requirements are not affected by this exemption.
V. Summary of Comments and Responses
The hospital sterilizer area source rule was proposed on November
6, 2006 (71 FR 64907). The 60-day comment period ended on January 5,
2007, and we received a total of 10 comment letters on the proposed
NESHAP. Comments were received from one industry trade association, a
representative of one affected facility, representatives from two
affected Federal agencies, one sterilant manufacturer, three State and
local air pollution control agencies, one State agency association, and
one private citizen. This final rule reflects our consideration of all
of the comments received on the proposed action. This section
summarizes the significant comments received on the proposed NESHAP and
our response thereto. A summary of all of the minor comments and EPA's
response thereto are presented here in this preamble and in the
Response to Comments Document (RTC Document), which is available in
Docket No. EPA-HQ-OAR-2005-0171.
A. Proposed Alternative 1: Management Practice
1. Management Practice Approach
Comment: Two commenters supported promulgation of the management
practice approach, i.e., Regulatory Alternative 1. One of the
commenters noted that EPA recognizes that, by minimizing ethylene oxide
use with the management practice, hospital ethylene oxide sterilization
facilities also minimize ethylene oxide emissions. Both commenters
expressed that the proposed management practice alternative ensures
that hospitals sterilize the most number of medical devices per pounds
of ethylene oxide emitted, and it is consistent with hospital
practices.
Two commenters stated that the management practice is common sense.
One commenter argued that EPA's proposed GACT were neither acceptable
nor consistent with legal requirements. Another commenter stated that
EPA's
[[Page 73614]]
alternatives do not reflect what many sterilizers have achieved (using
control technology) and are capable of achieving cost effectively.
Response: As previously mentioned, we are setting standards for
hospital sterilizer area sources based on GACT (i.e., generally
available control technologies or management practices) pursuant to
section 112(d)(5) of the CAA. As several commenters noted, the
management practice for running sterilizers with full loads will ensure
that hospitals sterilize the most number of medical devices per pounds
of ethylene oxide emitted. We believe that the comments indicating that
the management practice is common sense, consistent with current
operating practices at many hospitals, and cost-effective, all support
our determination that this management practice represents a generally
available management practice that is used to control ethylene oxide
emissions from area source hospital sterilizers. We, therefore,
disagree with the comment that the management practice requirement in
this final rule is not consistent with legal requirements. In addition,
for a detailed discussion on EPA's consideration of the existing
control technologies, please see section V.C of this preamble.
2. Exemption of Certain Sources From the Rule
Comment: One commenter recommended that EPA exclude controlled
sources (i.e., sources with add-on control) and sources that use an
ethylene oxide concentration of less than 10 percent from all
requirements associated with Alternative 1 should EPA adopt that
alternative. The commenter expressed that Alternative 1 imposes no
additional substantive requirements on controlled sterilizers and would
only add administrative burdens with no additional environmental
benefits. The commenter also asserted that sources that use an ethylene
oxide concentration of less than 10 percent can be excluded with no
detrimental effect.
Response: EPA disagrees that this rule contains no substantive
requirements on controlled sterilizers. As we clarify in the final rule
and in section III.B of this preamble, all area source hospital
sterilizers, including sources with add-on controls, are subject to the
requirements in this final rule. However, the final rule provides
certain compliance options. Specifically, the final rule provides
sources with add-on controls the option of demonstrating compliance
with the management practice requirement by certifying that they will
continue to operate their sterilizers with such control.
EPA also rejects the recommendation of excluding from this rule
sources that use an ethylene oxide concentration of less than 10
percent. We recognize that there are hospital sterilization facilities
that use sterilant gas blends with low ethylene oxide concentrations.
However, we have no information suggesting that facilities using low
ethylene oxide sterilant gas blends emit negligible amounts of ethylene
oxide. On the contrary, it is our understanding that there is little
difference in the amount of ethylene oxide usage (and, therefore,
ethylene oxide emissions) between operating a sterilization cycle with
pure ethylene oxide as opposed to using sterilant gas blend with less
than 10 percent ethylene oxide. When we listed the Hospital Sterilizer
Area Source category, we included hospital ethylene oxide sterilization
facilities using sterilant gas blends and the commenter did not provide
any information that suggests these facilities should not be part of
the source category. Further, we have analyzed the costs and impacts
associated with the management practice that we are finalizing and we
believe the costs are reasonable. See section V.C.1 of this preamble.
For the reasons stated above, we reject the commenter's recommendation
to exclude from this regulation sources using sterilant gas blends with
less than 10 percent ethylene oxide concentration.
3. Exception to the Management Practice Requirement
Comment: One commenter stated that EPA would need to establish,
based on comments received and then propose again for comment, examples
of definitions of circumstances that would be acceptable for an
exemption to the full load requirement. Another commenter observed that
hospitals try to minimize their use of ethylene oxide and avoid
exceptions to full load runs. Although the commenter stated that
generating and managing an inclusive list of all the exceptions to
running a full load may be difficult, it provided examples for such
exceptions. Specifically, the commenter stated that, on some days, a
hospital may receive back from surgery just a few devices that must be
ethylene oxide-sterilized and returned as soon as possible to surgery
for cases scheduled for the next morning. The commenter stated that, in
these instances, the hospital can be forced to run a sterilizer with
less than a full load. The commenter also stressed that hospital
surgical needs can be unpredictable.
The commenter stated that hospitals have reduced their use of
ethylene oxide to sterilize medical devices (and its ethylene oxide
emissions) by switching to single-use devices or alternative
sterilizing and disinfection technologies, or by consolidating ethylene
oxide sterilization. The commenter noted that, ironically, a hospital
may increase the frequency with which it needs to run a partially
loaded ethylene oxide sterilizer as a result. The commenter, however,
emphasized that even with occasional running of less than full loads,
there has been a continuing decline in hospital ethylene oxide use and
emissions.
Another commenter similarly noted that hospitals currently strive
to run full loads unless it is medically necessary to run less than a
full load. According to the commenter, often the medical devices
processed by the hospital ethylene oxide sterilizer are expensive and
hospitals can only afford to retain a minimal number of such devices.
The commenter further noted that some of the devices are older devices
and cannot be replaced. The commenter stated that these devices are
typically utilized in surgical areas and, at times, these devices may
need to be used on consecutive days. The commenter stated that the
ethylene oxide sterilizer load is processed at the end of the day so
the devices will be ready for surgery the following day. According to
the commenter, by waiting to run a sterilization cycle until the end of
the day, the sterilizer load has a chance to fill up. The commenter
noted, however, that if a medical device is needed the following day,
the load will be processed even though the load is not full. The
commenter stated that the determination to process a load is based on
the needs of the patient.
Response: According to the comments, hospitals deviate from the
full-load management practice only when patient safety may be at risk.
EPA agrees that medical necessity warrants operating a partially loaded
ethylene oxide sterilizer. To accommodate patient needs, we have
incorporated in the final rule an exception based on medical necessity.
EPA also agrees with the comment that developing a comprehensive
list of medically necessary circumstances warranting sterilization of a
partial load is difficult. EPA is concerned that such a list may
inadvertently exclude some justified circumstances. Further, as
reflected in our final rule, we believe that the decision to run a
partially loaded sterilizer due to medical necessity should be made by
authorized hospital personnel who have knowledge
[[Page 73615]]
of patients' medical needs instead of by EPA. However, to assure that
hospitals run sterilizers in full loads except during medically
necessary circumstances, the final rule requires that facilities
document and maintain records of every sterilization cycle, including
each partially loaded sterilization, and confirm that it was medically
necessary.
Comment: One commenter noted that many university hospitals develop
new and unique surgical procedures and devices that may need to be
sterilized in partial loads to comply with the more stringent
requirements for sterilizing a new instrument.
Response: We believe that it is medically necessary to allow
hospitals to sterilize medical devices that are under research and
development without a full load. The novelty or uniqueness of the
design in some instances require different sterilizing parameters than
those used for regular medical devices. In addition, unlike medical
devices that are regularly used for patient care, new and experimental
medical devices that are under research and development do not have
established or known sterilization cycles. Therefore, they may
compromise the effectiveness of sterilizing other devices in the same
loads. However, hospitals generally do not possess enough medical
devices that are under research and development to fully load a
sterilizer. To avoid compromising the sterilization process of medical
devices regularly used for patient care, we believe that it is
medically necessary to allow hospitals to sterilize medical devices
that are under research and development in separate and partial loads.
Hospitals may invoke the medical necessity exception in the final rule
when sterilizing devices that are under research and development.
4. National or Urban
Comment: Three commenters recommended that EPA apply this rule
nationwide. Two of the commenters noted that hospital parking areas are
typically close to the hospital and that visitors and employees are,
therefore, exposed to emissions from hospital ethylene oxide
sterilizers regardless of the hospital's location (i.e., urban or
rural). One commenter stated that the impacts of ethylene oxide
emissions are localized and would be similar for most urban and rural
areas. According to the commenter, hospitals are typically located in
residential areas, whether or not they are in urban areas, and that
populations residing nearby would likely be exposed to the ethylene
oxide emissions from a hospital ethylene oxide sterilization facility.
Another commenter further stated that hospitals clearly serve more
sensitive populations who could be more susceptible to impacts from
exposure to ethylene oxide. The commenter similarly noted that the
impacts of ethylene oxide emissions are very local and would be roughly
the same for both urban and rural areas, except perhaps for hospitals
located in areas with a high population density.
Two commenters noted that the cost (of controlling a sterilizer) to
a facility is the same for a rural hospital and an urban hospital. The
commenters stated that, because the cost and impact are the same, there
does not appear to be any rationale for treating rural hospitals
differently from urban hospitals.
Response: We agree that a nationwide approach is appropriate given
the facts and circumstances of this particular area source category. A
rule of nationwide applicability is particularly appropriate here
because requiring controls nationwide provides for equitable emission
reductions. Control costs are not expected to differ in rural versus
urban settings, therefore, the control's cost-effectiveness is the
same, and economic impacts are equally distributed. Furthermore,
because hospitals are generally located in densely populated areas, we
expect negligible difference in the scope of this rule's coverage
between a national and an urban (i.e., Urban-1 and Urban-2 areas)
rule.\4\ We have received no comments recommending that we limit this
rule's applicability only to hospitals in Urban-1 and Urban-2 areas.
---------------------------------------------------------------------------
\4\ In the Integrated Urban Strategy, EPA defined ``urban
areas'' to include Urban-1 and Urban-2 areas. (64 FR 38724). The
Urban-1 and Urban-2 definitions are based on the United States
Census Bureau's most current decennial census data. Urban-1 areas
are counties with metropolitan statistical areas with a population
greater than 250,000. Urban-2 counties are all other counties where
more than 50 percent of the population is designated urban by the
United States Census Bureau.
---------------------------------------------------------------------------
5. Compliance Date
Comment: One commenter stated that EPA's proposal that a source
comply with the management practices within 1 year after the effective
date of the final rule may not be a sufficient period of time. The
commenter stated that two scenarios could result for medical facilities
under the management practice alternative. According to the commenter,
one scenario could be that medical facilities may need to purchase
smaller ethylene oxide sterilizers to turn around medical
instrumentation and equipment without having to purchase more of these
medical items, and this could involve construction projects/costs to
make ready additional space to accommodate the new sterilizers. The
commenter stated that the other scenario could be that medical
facilities may need to purchase additional medical instrumentation and
equipment to allow for sufficient availability while waiting for enough
items to accumulate to run a full load in an ethylene oxide sterilizer.
The commenter suggested that EPA consider the costs of additional
ethylene oxide sterilizer equipment and related construction, as well
as the additional medical instrumentation and equipment costs in any
proposed rule by EPA.
Response: EPA does not believe that the management practice
requirement in Alternative 1 will result in either of the scenarios
described above. The management practice requires sterilizing full
loads except during medically necessary circumstances, i.e., necessary
to protect human health. As discussed above, this exception to running
sterilizers in full loads is based on patient needs. Under the final
rule, whether a medically necessary circumstance exists must be
determined by an authorized hospital personnel. The final rule,
however, requires only that the hospital personnel consider whether
sterilizing a partial load is necessary to protect human health; the
personnel are not required to consider whether there are viable
alternatives to running a partial load, such as purchasing additional
sterilizer equipment or medical devices, before invoking the exception
to the management practice requirement. Therefore, we do not expect any
need for construction and/or capital expenditures associated with such
new purchases, as the commenter suggested. We have received no other
comments suggesting that hospitals may have difficulty achieving
compliance with the management practice alternative within 1 year, as
we proposed. We, therefore, retain the 1-year compliance deadline in
the final rule.
6. Recordkeeping
Comment: In the proposed rule, EPA solicited comments on whether to
require recordkeeping under Alternative 1. We received six comments on
recordkeeping. One commenter asked that EPA specify what recordkeeping
would entail if less than full loads were run and what EPA would
propose to be done with these records. Another commenter stated that,
regardless of the size of the load, all items sterilized are recorded
following the Association for the Advancement of Medical
Instrumentation standard, Ethylene
[[Page 73616]]
Oxide Sterilization in Health Care Facilities: Safety and
Effectiveness, ANSI/AAMI ST 41:1999. According to the commenter, the
sterilizer records under this standard include the following: Load or
lot number; item description and quantity; the department; the name of
the sterilizer operator; aeration time and temperature; results of the
biological monitoring (which is processed with each load to ensure that
sterilization has occurred); chemical indicator results; and reports of
nonresponsive chemical indicators.
Two commenters stated that hospitals keep a record of each load
they run for traceability. Two commenters stated that hospitals could
probably add a few more items of information to their records to comply
with EPA's requirements. These commenters recommended that EPA's
recordkeeping requirements be consistent with hospitals' current
practice in maintaining records of sterilized loads.
Two commenters indicated that some State programs require keeping
sterilization records, and one commenter stated that some States have
required such recordkeeping for many years. The commenters indicated
that some hospitals keep such records through computerized
recordkeeping systems while others use handwritten records. The
commenters believed that these requirements are not likely to be overly
burdensome or costly to the facilities.
Response: In light of the comments indicating that hospitals are
already keeping records of each sterilization cycle and that such
recordkeeping provisions are not overly costly or burdensome, we are
requiring affected facilities to keep sterilization records in the
final rule. Specifically, the final rule requires that a facility
record the date and time of each sterilization cycle, whether each
sterilization cycle contains a full load of items, and, for each
partial load, state that it was medically necessary. Based on
information provided during the comment period, we believe that this
recordkeeping requirement is consistent with hospitals' current
practice. We also believe the time required to keep these records would
be offset by the time saved by the reduced cycles run.
7. Title V Permitting
Comment: One commenter favored title V permitting. The commenter
stated that, by requiring title V permits, title V funds could be used
to assure compliance. The commenter noted that, according to an EPA
Regional office, title V funds cannot be used for non-title V programs.
The commenter stated that if, from a national perspective, EPA prefers
to exempt area sources such as these from title V permitting, EPA
should explain the level of effort they expect from State and local
agencies, and develop a funding mechanism for that effort. The
commenter further noted that, in this case, the commenter's State
already has operating permits for affected facilities and that there
would be little cost involved in updating these permits to reflect the
Federal rule during the normal permit renewal process.
Response: As discussed in the preamble to the proposed rule, EPA
considered four factors in determining whether title V is
``unnecessarily burdensome'' for a particular area source category.
Based on its consideration of these factors, EPA concluded that the
requirements of title V would be unnecessarily burdensome for area
source hospital ethylene oxide sterilization facilities. Among other
things, EPA concluded that title V permitting would not result in
significant improvements to the compliance requirements for the
hospital ethylene oxide sterilization area source category and that
title V permitting would likely impose a significant burden on
facilities within the source category, some of which are small
businesses. The Agency also found that, for many facilities, the cost
of obtaining a title V permit may far exceed the cost of complying with
the final rule without significant gains in compliance. EPA further
determined that the proposed exemptions from title V would not
adversely affect public health, welfare, and the environment.
Although the commenter advocates title V permitting, the commenter
failed to address EPA's application of the four factors described
above, and its conclusion that the proposed exemptions would not
adversely affect public health, welfare, and the environment. Indeed,
none of the commenters disagreed with any of EPA's proposed findings
described above and in the proposed rule that served as the basis for
the proposed title V exemption.
Instead of challenging EPA's application of the four factors
relevant to determining whether title V requirements would be
unnecessarily burdensome on a particular area source category, the
commenter focuses on the fact that, in its State, area source hospital
sterilizers have State operating permits and that adding the
requirements of this rule to those permits would involve little costs.
The fact that title V permitting may not be burdensome or costly in one
State does not reflect the burden or costs associated with title V
permitting nationwide. Once again, the commenter has not identified any
flaws in EPA's application of the four factor test described above,
which involve an assessment of the costs of title V reporting for the
entire source category. Therefore, for the reasons discussed above and
in the proposed rule, we are exempting area source hospital ethylene
oxide sterilization facilities from the requirements of title V in this
final rule.
The commenter apparently favored title V permitting based on its
belief that ``by requiring title V permits, EPA would allow title V
funds to be used to assure compliance.'' The commenter requested that
EPA explain the level of State and local efforts that may be involved
in implementing and enforcing the requirements of the final rule and
develop a funding mechanism for that effort. We expect such effort to
be minimal. We believe that the management practice and the associated
recordkeeping requirements in this final rule are straightforward and
can, therefore, be easily implemented and enforced. Further, according
to the comments received, the management practice requirement is
consistent with hospital practices and hospitals are already keeping
records of sterilization cycles. In light of the above, we do not
anticipate that State and local agencies would need to spend a
significant level of effort to implement and enforce this rule. EPA,
however, remains committed to working with State and local agencies to
implement this rule. State and local agencies that receive grants for
continuing air programs under CAA section 105 should work with their
project officers to determine what resources are necessary to implement
and enforce this area source standard. EPA will continue to provide the
resources appropriated for CAA section 105 grants consistent with the
statute and the allotment formula developed pursuant to the statute.
Comment: One commenter agreed with EPA's proposal that title V
permits are not necessary for area sources. The commenter noted that
some hospitals, however, already have or are covered by title V
permits, and that any rulemaking has the potential to impose additional
permit modification costs. The commenter asserted that EPA should
minimize title V permitting cost impacts by adding a provision in this
rule stating that an existing title V permit does not have to be
reopened or revised to address the requirements of this rule until the
next time the permit is renewed, reopened, or revised for another
reason. The commenter
[[Page 73617]]
alternatively proposed that EPA consider an exemption similar to that
which was included in 40 CFR 63.7881(c)(3) of the recently finalized
amendments to the Site Remediation NESHAP.
Response: The commenter requested that EPA prescribe in this rule
the time for reopening and revising existing title V permits for area
source hospital sterilizers. CAA section 502(a) authorizes EPA to
exempt an area source category from title V permitting if the
Administrator finds that compliance with title V is impracticable,
infeasible, or unnecessarily burdensome on such category; however, to
the extent that some sources within this area source category are
already otherwise required to obtain title V permits, CAA section
502(a) does not authorize EPA to affect in any way these sources'
existing obligations under title V, including when the permits must be
renewed. As discussed above, pursuant to CAA section 502(a), EPA has
determined that the requirements of title V would be unnecessarily
burdensome for area source hospital ethylene oxide sterilization
facilities. Accordingly, this final rule exempts area source
sterilization facilities from the obligation to obtain title V permits
for purposes of being subject to the requirements of this rule. The
commenter, however, is requesting that EPA prescribe in this rule the
time for reopening and revising existing title V permits for area
source hospital sterilizers. The commenter's request is unrelated to
and beyond the scope of EPA's authority to issue this area source rule
pursuant to CAA sections 112(c)(3) and 112(d)(5). The request is also
beyond the scope of EPA's authority under CAA section 502(a) to exempt
area sources from title V permitting. We, therefore, reject the
commenter's request to include its recommended language in this final
rule.
B. Proposed Alternative 2: No Control
Comment: One commenter recommended that EPA select Regulatory
Alternative 2 (the no additional control alternative). The commenter
stated that hospitals have strong economic incentives to operate
sterilizers with a full load because doing so reduces both material and
labor costs. According to the commenter, because economics already
drive hospital ethylene oxide sterilization facilities to implement the
management practice, Alternative 1 is unlikely to result in significant
emission reduction. The commenter states that it has encouraged its
facilities to switch to alternative sterilization methods and,
therefore, there are not many ethylene oxide sterilizers at its
facility.
Response: As previously mentioned, we included two regulatory
alternatives in the proposed rule. As Alternative 1, we proposed to
require that hospitals sterilize full loads of medical items having
common aeration times except during emergency circumstances that
dictate the use of less than full loads to protect human health.
However, at the time of the proposal, we had limited information to
conclude that the proposed management practice in Alternative 1 reduced
ethylene oxide emissions or was cost-effective. Therefore, we included
an alternative proposal (Alternative 2) that there are no GACT within
the meaning of CAA section 112(d)(5) for the Hospital Sterilizers Area
Source category. We also solicited comments on the costs and emission
reduction estimates for the management practice.
As explained in more detail in section V.A.1 of this preamble, we
have since received comments indicating that the management practice
minimizes ethylene oxide emissions by minimizing ethylene oxide use and
that the practice is cost-effective. We, therefore, conclude that the
management practice requirement we proposed as Alternative 1 reflects a
generally available management practice within the meaning of CAA
section 112(d)(5) for this area source category.
The commenter apparently agreed that the management practice is
cost-effective. It stated that hospitals have economic incentives to
run the sterilizers full because it reduces both labor and material
costs. The commenter, nevertheless, recommended Alternative 2, claiming
that Alternative 1 may not achieve significant reduction since it is
already being implemented. However, the CAA does not require a GACT
standard to achieve any specific level of emission reduction.
As explained above, we have determined that the management practice
that we proposed as Alternative 1 represents GACT for this area source
category. The commenter offered no information suggesting otherwise.
Having determined that our proposed Alternative 1 represents GACT, we
can no longer conclude that there are no GACT within the meaning of CAA
section 112(d)(5). We, therefore, reject the commenter's recommendation
that we adopt the no control option (Alternative 2) in this final rule.
C. Add-on Controls
1. Cost Considerations
Comment: Four commenters recommended that EPA require add-on
controls for the area source hospital ethylene oxide sterilizers. Two
commenters noted that, in the preamble to the proposed rule, EPA stated
that the two predominant types of control devices (i.e., acid-water
scrubbers and catalytic oxidation units) reduce emissions by
approximately 99 percent. One of these two commenters also noted that,
according to the National Toxicology Program, researchers have
demonstrated that the application of these control technologies to
hospital sterilizers effectively reduce ethylene oxide concentrations.
This commenter, therefore, concluded that proven control technology is
readily available to control ethylene oxide emissions from hospital
sterilizers and that application of this technology is practicable,
feasible, prudent, and not unnecessarily burdensome. Two commenters
drew the same conclusion, noting that the control technologies have
been required by some State programs for many years. One commenter
similarly stated that if more than half of the sources already have
add-on controls, it suggests that these controls are practical and
feasible.
One commenter expressed that, with nearly half of the hospitals
using add-on controls, it is hard to understand EPA's rationale in the
proposed rule that add-on controls are too costly. One commenter
suggested that, if cost is to be considered, EPA should consider a full
array of alternatives, including the cost of alternatives to
sterilization and alternative means of sterilization, and compare them
to the cost of controlling ethylene oxide sterilization. The commenter
stated that the proposed rule presumes ethylene oxide sterilization
must be preserved. The commenter noted that in the Hospital, Medical,
Infectious Waste Incinerator (HMIWI) standard, however, EPA recognized
that there were alternatives to incineration of the wastes and,
therefore, required emission controls that were not necessarily cost-
effective. The commenter recommended that the same approach should be
applied here.
One commenter stated that installing control would be an
unnecessary cost to hospitals providing no benefits. The commenter
observed that hospital ethylene oxide sterilization has declined due to
Occupational Safety and Health Administration regulations, new
sterilization methods, and new designs and materials used in medical
devices. The commenter, however, emphasized that ethylene oxide
sterilization is a
[[Page 73618]]
necessity in hospitals. The commenter explained that the medical
devices processed by ethylene oxide are expensive and that hospitals
can only afford minimal amounts on hand. The commenter further
explained that some of the medical devices are old and cannot be
replaced. The commenter noted that these devices are typically utilized
in surgical areas. The commenter stated that EPA's rationale makes
clear that existing ethylene oxide emission control technology will not
provide the type of cost-benefit needed to justify new hospital
investment in the control devices. The commenter noted that the cost of
add-on control would include not just the cost of the device, but also
the cost of installation, facility modification, annual testing of
control devices, and utility and maintenance.
Response: CAA section 112(d)(5) provides that, with respect to area
source categories listed pursuant to CAA section 112(c), the
Administrator may, in lieu of MACT, promulgate standards or
requirements which provide for the use of GACT. As explained in the
preamble to the proposed rule, EPA is issuing the standards for the
hospital sterilizers area source category under CAA section 112(d)(5).
In determining what constitutes GACT for a particular area source
category, EPA evaluates the control technologies and management
practices that reduce HAP emissions and are generally available for the
area source category. The legislative history supporting CAA section
112(d)(5) provides that EPA may consider costs in determining what
constitutes GACT for the area source category.\5\
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\5\ Additional information on the definition of ``generally
available control technologies or management practices'' (GACT) is
found in the Senate report on the 1990 amendments to the CAA (S.
Rep. No. 101-228, 101st Cong. 1st session. 171-172). That report
states that GACT is to encompass: * * * methods, practices and
techniques which are commercially available and appropriate for
application by the sources in the category considering economic
impacts and the technical capabilities of the firms to operate and
maintain the emissions control systems.
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In considering costs, the commenters who recommended add-on control
focused mainly on the actual costs to hospitals and asserted that such
control is likely not too costly if many hospitals are using it under
existing State or local requirements. As we stated in the preamble to
the proposed rule, EPA recognizes that over half of the hospitals use
add-on controls. However, the actual cost to individual hospitals is
but one cost factor that we considered in this rulemaking. We also
noted that the total annualized cost for add-on controls, which we
estimated to be $8.5 million, exceeds the total annualized cost for the
management practice, which we estimated to range from $32,000 to
$61,000, by more than 100 fold. In addition, we considered the cost-
effectiveness of the add-on controls. See, e.g., Husquavarna AB v. EPA,
439 U.S. App. DC 118, 254 F.3d 195, 201 (DC Cir. 2001) (finding EPA's
decision to consider costs on a per ton of emissions removed basis
reasonable because CAA section 213 did not mandate a specific method of
cost analysis). EPA's cost analysis for the add-on controls showed poor
cost-effectiveness. Specifically, EPA's cost-effectiveness estimate for
add-on controls was $200,000 per ton of ethylene oxide reduced. This
cost-effectiveness excludes monitoring, recordkeeping, and reporting
costs.
We also considered alternatives to ethylene oxide sterilization, as
one commenter suggested. We learned from several commenters that,
although ethylene oxide sterilization in hospitals has declined, it
remains a necessity for certain medical devices that cannot be easily
replaced or sterilized by other means. We agree with these commenters
that, in light of the declined level of ethylene oxide sterilization
and the lack of alternatives for sterilizing certain unique and
expensive medical devices, the benefit of requiring add-on control is
outweighed by the various costs associated with such control. Based on
the foregoing, we determined that add-on controls do not represent GACT
for this area source category.
One commenter argued that EPA required add-on control in the HMIWI
standard that were not necessarily cost-effective and that EPA should
take the same approach in this final rule.\6\ The HMIWI standard,
however, was promulgated pursuant to section 129 of the CAA, which
requires that EPA establish standards that reflect the MACT. Consistent
with the requirements of CAA section 129, EPA issued the original HMIWI
standards based on MACT. CAA section 129(a)(2) does not allow EPA to
consider costs in setting the floor for control. By contrast, EPA is
issuing this final rule pursuant to CAA section 112(d)(5), which allows
EPA to consider costs, including cost-effectiveness, in establishing
GACT. Thus, the HMIWI rule is not relevant, because in that rule, EPA,
by statute, could not consider costs.
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\6\ 40 CFR part 60, subpart Ce--Emission Guidelines and
Compliance Times for Hospital/Medical/Infectious Waste Incinerators
(constructed on or before June 20, 1996).
40 CFR part 60, subpart Ec--Standards of Performance for
Hospital/Medical/Infectious Waste Incinerators for Which
Construction is Commenced After June 20, 1996.
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2. Best Available Control Technology (BACT) or MACT
Comment: One commenter stated that, because ethylene oxide is a
known human carcinogen, its emissions should be controlled using the
BACT. The commenter stated alternatively that, due to the widespread
use of control on hospital sterilizers, the MACT floor level of control
would be add-on controls under CAA section 112(d)(2). The commenter
stated that, based on the experience in its State, the MACT floor and
associated recordkeeping are feasible and prudent and, therefore, none
of EPA's proposals are in accordance with legal requirements. The
commenter claimed that the proposed NESHAP must be revised to represent
MACT floor of add-on emission control and recordkeeping as required by
law.
Response: CAA section 112(c)(2) requires that EPA establish
emission standards under CAA section 112(d) for the categories listed
under CAA section 112(c), including area source categories listed
pursuant to CAA section 112(c)(3). As mentioned above, EPA may issue
standards for listed area source categories based on MACT (CAA section
112(d)(2)) or GACT (CAA section 112(d)(5)). CAA Section 112(d) does not
contain a standard based on BACT. Therefore, EPA rejects the
commenter's request to require the use of BACT because such standard is
not authorized by the CAA.
The commenter also argued alternatively that neither of EPA's
proposed alternatives was in accordance with legal requirements and
that EPA must issue a MACT standard as required by law. The commenter,
however, did not identify any legal requirement that allegedly is not
satisfied by EPA's proposed alternatives or requires EPA to issue a
MACT standard for the Hospital Sterilizer Area Source category. On the
contrary, the commenter noted that ``EPA is 'exercising discretion' in
promulgating standards or requirements under section 112(d)(5) of the
CAA.'' Although the commenter acknowledged that EPA has discretion
under CAA section 112(d)(5) to issue a GACT standard in lieu of a MACT
standard for listed area source categories, it claimed that, based on
its State's experience with regulating and controlling ethylene oxide
emissions from hospital sterilizers, the MACT floor and associated
recordkeeping are feasible and prudent. The commenter argued that,
therefore, neither of EPA's proposals is acceptable in accordance with
legal requirements and that EPA
[[Page 73619]]
must issue a MACT standard as required by law.
The commenter's argument seems to imply that EPA must first find
that a MACT standard is infeasible, imprudent, or otherwise
inappropriate before the Agency can legally issue a GACT standard for
an area source category pursuant to section 112(d)(5) of the CAA.
However, there is no such requirement under the CAA. In fact, the CAA
does not contain any condition precedent for issuing a GACT standard
under CAA section 112(d)(5). CAA section 112(d)(5), which is entitled
``Alternative standard for area sources,'' provides:
With respect only to categories and subcategories of area
sources listed pursuant to subsection (c) of this section, the
Administrator may, in lieu of the authorities provided in paragraph
(2) and subsection (f) of this section, elect to promulgate
standards or requirements applicable to sources in such categories
or subcategories which provide for the use of generally available
control technologies or management practices by such sources to
reduce emissions of hazardous air pollutants. (Emphasis added).
There are two critical aspects to CAA section 112(d)(5). First, CAA
section 112(d)(5) applies only to those categories and subcategories of
area sources listed pursuant to CAA section 112(c). The commenter does
not dispute that EPA listed the Hospital Sterilizer Area Source
category pursuant to CAA section 112(c)(3). Second, CAA section
112(d)(5) provides that, for area sources listed pursuant to CAA
section 112(c), EPA ``may, in lieu of '' the authorities provided in
CAA section 112(d)(2) and 112(f), elect to promulgate standards that
provide for the use of generally available control technologies or
management practices (GACT). Section 112(d)(2) provides that emission
standards established under that provision ``require the maximum degree
of reduction in emissions'' of HAP (also known as MACT).\7\ Webster's
dictionary defines the phrase ``in lieu of'' to mean ``in the place
of'' or ``instead of.'' See Webster's II New Riverside University
(1994). Thus, CAA section 112(d)(5) authorizes EPA to promulgate
standards that provide for the use of GACT instead of issuing MACT
standards. The statute does not set any condition precedent for issuing
standards under CAA section 112(d)(5) other than that the area source
category or subcategory at issue must be one that EPA listed pursuant
to CAA section 112(c), which is the case here. Had Congress intended
that EPA first conduct a MACT analysis for each area source category
and only if cost or some other reason made applying the MACT standard
inappropriate for the category would EPA be able to issue a standard
under CAA section 112(d)(5), Congress would have stated so expressly in
CAA section 112(d)(5). Congress did not require EPA to conduct any MACT
analysis, floor analysis, or beyond-the-floor analysis before the
Agency could issue a CAA section 112(d)(5) standard. Rather, Congress
authorized EPA to issue GACT standards for area source categories
listed under CAA section 112(c)(3), and that is precisely what EPA has
done in this rulemaking.
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\7\ CAA section 112(d)(5) also references CAA section 112(f).
See CAA section 112(f)(5) (entitled ``Area Sources'' and providing
that EPA is not required to conduct a review or promulgate standards
under CAA section 112(f) for any area source category or subcategory
listed pursuant to CAA section 112(c)(3) and for which an emission
standard is issued pursuant to CAA section 112(d)(5)).
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Although EPA has no obligation to justify why it is issuing a GACT
standard for an area source category as opposed to a MACT standard, we
did so in the proposed rule. See 71 FR 64910, November 6, 2006. As
explained in the proposed rule, we determined that the MACT floor level
of control would be add-on controls if we were to develop this area
source rule based on CAA section 112(d)(2). As explained in more detail
in section V.C.1 of this preamble, we took costs into consideration and
determined that the benefit of requiring add-on controls is outweighed
by the costs associated with such control. We belie