Heal Thyself: Health Care Looks to
Heal Its Environmental Ills
Source: GreenBiz.com
The hospital that aims to get you healthy may inadvertently be making
the planet sick. Here's GreenBiz founder Joel Makower's report on how
the health-care industry is starting to green up its act.
The irony is almost too obvious to state: tens of thousands of
hospitals, doctors' offices, medical laboratories, and assorted other
health-care providers spew toxic substances into the environment, or
dispose of trash containing a noxious mix of contaminated or infectious
waste. Some of it will make its way into the air, water, and soil. All
of it potentially endangers the health of people and other living
things.
Talk about a health-care crisis.
For years, the health-care sector -- which employs more than 10 million
people in the U.S. and garners roughly one in seven dollars generated in
the economy -- didn't pay much heed to the environmental impacts of its
operations. And when it did, it tended toward paper recycling and other
modest efforts -- Band-Aid solutions, as it were.
But that's quickly changing, as activists, regulators, and concerned
health professionals come to understand that the industry needs some
environmental CPR. A variety of events, initiatives, and trends have
helped shape the shift: community groups have pressured hospitals and
labs to shut down or not build medical-waste incinerators, which can be
a significant source of carcinogenic dioxin emissions and other
pollutants; activists and public-health officials have raised public
awareness and concern over the use of plastics and mercury, among other
commonly used medical materials; researchers and think tanks have given
the sector's environmental impacts far more scrutiny than ever before,
quantifying its contribution to air and water pollution as well as solid
and hazardous waste; groups of enlightened doctors, nurses, and allied
professionals have convened meetings and developed networks on the
greening of health care, helping to propagate awareness of the problems
and their solutions; and the U.S. EPA and other regulators have pitched
in with partnerships, voluntary programs, and information resources.
Such a convergence is taking place none too soon. The issues surrounding
the greening of health care will require a concerted effort among all
parties to overcome the institutional barriers.
Toxic Buy-Products
Consider procurement. Hospitals don't shop like we do. They rely on
group purchasing organizations, or GPOs, that buy medical and surgical
equipment on their behalf. So they're committed to dealing with the
suppliers that their GPO relies on, sometimes locked into years-long
contracts. If a given GPO uses eco-unfriendly products and a hospital
wants to go a different route, the hospital could face a financial
penalty for breaking its contract, or may have to wait to make changes
until the contract is up for renewal.
Purchasing is just one hurdle health-care facilities must clear to
improve their environmental performance. Like other businesses, they
must grapple with segregating waste for recycling and other disposition.
But hospitals and doctors' offices face a special challenge in this
arena, because potentially infectious medical waste -- every bed pan,
set of gloves, syringe, swab, blood bag, and intravenous tube -- is
regulated and must be "red-bagged" -- that is, placed in red containers
for proper disposal through a third party.
The problem -- and this will sound depressingly familiar to many
managers -- is that keeping health-care workers educated about what
trash to throw where is a never-ending battle. The result: people
red-bag everything, just to be sure. However prudent a move this may be,
it can raise hospitals' disposal costs significantly by requiring tons
of additional trash to be specially handled. (It also turns out that
many red bags themselves are hazardous, because they are dyed using
cadmium, a highly toxic chemical. Cadmium-free red bags are now on the
market.)
As in many businesses, there's the
janitorial issue -- but to an extreme degree, due to the need for
sterility. And then there's the problem of weaning doctors and others
from time-proven products and materials, such as PVC bags used for blood
and other intravenous solutions, and devices containing mercury --
including thermometers and blood-pressure units -- which, when they
break or are discarded, can contaminate air, soil, and water.
The Road to Wellness
Sound like a hopeless case? Fortunately, there are ready alternatives,
and a variety of organizations are actively seeking to educate doctors
and others about their availability and use. And they're making
progress. Some examples:
- As part of a comprehensive waste-reduction program, Albany Medical
Center in Albany, N.Y., built a distillery in 1995 that converts waste
alcohol, formalin, xylene, mineral spirits, and paint into products
the center can use in its labs. In its first 10 years of operation,
the distillery reclaimed 147 tons of chemicals, valued at more than $1
million.
- Kaiser Permanente, the country's largest nonprofit health-care
provider, has its own guidelines for clean and ethical operations and
an executive-level position for resource conservation. Kaiser also has
a "green team" that collaborates with manufacturers on targeted
products.
- Seeking to become mercury-free, Spectrum Health's Butterworth
Campus in Grand Rapids, Mich., instituted a purchasing policy stating
that whenever possible, the hospital must buy mercury-free products.
It also replaced blood-pressure gauges with those containing a
mercury-free alternative, and stopped sending traditional thermometers
home with new mothers.
- Dominican Hospital in Santa Cruz, Calif., takes used, clean
supplies and, rather than throwing them out, distributes them to the
community through its "DominAgain" store. Surgical drapes that would
have been landfilled become painters' tarps, scrub brushes are used by
cooks to clean vegetables, and small jars become paint canisters in
local schools. The hospital either gives materials away or exchanges
them for small donations.
It will take years to get every health-care facility following these
leaders, of course. But the treatments seem to be working, and the
prognosis for recovery is good.
Rx for Information
Needle little more information? Check up on these resources:
Green Guide for Health Care,
Healthcare Without Harm,
Healthcare Environmental
Resource Center,
Hospitals for a Healthy Environment, and the
Sustainable Hospitals Project.
------
Joel Makower, a writer
and consultant on corporate sustainability practices, is the founder of
Green Business Network, producer of GreenBiz.com, ClimateBiz.com, and
GreenerBuildings.com.
This article was first printed on March 28, 2006, as part of Makower's
"Toiling Point" series on
Grist.org. It has been reprinted with kind permission from that
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