From the outside, the only clues to what goes on inside the Medical Waste Associates incinerator on Hawkins Point Road in Baltimore are small red signs on the chain-link perimeter fence warning of a "biohazard."
No sign identifies the plant, there is no visible smoke and the trucks that bring in hospital waste are closed, unmarked tractor-trailers.
Inside, the only noticeable smell is that of the plastic bags, in which most of the hospital waste arrives, and in which it remains until it is pushed into the 1,400-degree fire chamber.
The $26 million Hawkins Point incinerator is nevertheless the source of a political and legal stink that threatens five years of work by the city and area hospitals to clean up a troublesome system of medical waste disposal.
And that worries the 21 area hospitals that use the incinerator. "The facility may go out of business," said Frank Monius, director of planning for the Maryland Hospital Association. "The city may say that's tough luck for the facility, but we're the ones holding the bag, literally. We will have no place to take our waste."
The incinerator was supposed to close small hospital incinerators in city neighborhoods and get hospital waste out of municipal landfills.
Instead, neighborhood groups, who always opposed it, and Mayor Kurt L. Schmoke, a former advocate, are suing to close the 17-month-old Hawkins Point incinerator for violating a 1989 city ordinance banning medical wastes originating outside the city, Baltimore, Harford or Anne Arundel counties.
MWA officials say they can neither complete their testing, nor make a profit afterward, without the outside waste. So they're suing the city in federal court, claiming that the ordinance is an unconstitutional restraint on interstate trade.
The constitutionality issue is scheduled to be decided in the U.S. Court of Appeals in April. The city's suits are to be heard in Baltimore Circuit Court in July.
In the City Council, meanwhile, Martin E. "Mike" Curran, D-3rd, and Agnes B. Welch, D-4th, have filed legislation to allow the MWA incinerator to expand its catchment area to all of Maryland and the District of Columbia. "It's a clean facility," Mr. Curran said. "It is an environmentally sound bill."
They are opposed by 6th District council members and others who side with community groups opposed to the plant. Gloria Sipes, president of the Community of Curtis Bay Association, called the Curran bill "ludicrous. . . . How could people in good conscience introduce a bill for a company that so flagrantly violated what they agreed to before?"
The mess began in 1987, a time of heightened worry about illegal medical waste disposal. Syringes were washing up on Atlantic and Chesapeake beaches, and hospitals in the Baltimore region joined to fix what had become a troublesome medical waste disposal system.
By law, hospital waste has to be segregated. Infectious "red-bag" waste -- syringes, body parts and other contaminated material -- has to be burned in specially licensed incinerators. The rest, called "clear-bag" waste, from office paper to cafeteria debris, can be hauled to municipal incinerators and landfills.
Hospitals dislike the sorting because it requires more handling and exposes hospitals to lawsuits for injuries or infections. Many hospitals with their own incinerators can combine the waste, but they face tightening air pollution standards.
And in the Baltimore area, waste segregation simply wasn't working.
"As much as the hospitals tried, there was always something infectious or bloody that ended up in the general waste stream," Mr. Monius said. It became a hazard to municipal incinerator workers and a potential legal liability.
So in 1987, the city "threw the hospitals out," Mr. Monius said. The city let the hospitals' general waste into the city landfill temporarily, but hired a contractor to find and remove stray infectious material before the rest could be buried.
Medical Waste Associates offered a way out and an end to the costs and hazards of segregating waste. It promised to collect everything in lidded plastic carts wheeled right onto the hospital floors.
The carts would be hauled away daily by MWA trucks. At the incinerator, they would be dumped and cleaned automatically, the contents unopened and untouched by humans. The waste would burn for six hours at 1,400 degrees in a furnace with modern emissions controls.
City officials accepted MWA's proposal, but to calm opponents who feared Hawkins Point would become an interstate magnet for medical waste, passed the ordinance restricting the company to customers in the city and three neighboring counties.
The compromise worked, almost. The plant was built and began accepting waste in November 1990. It won a state operating permit in May 1991 and state environmental officials say it has operated well within all state and federal air pollution standards.