By: Jean Johnson for Medtech1
No hospital administrator wants to be part of the problem. No one in the healthcare profession wants the technology they use or the building in which they work to be a source of pollutants that cause disease. Indeed, the Hippocratic Oath to do no harm is what moves physicians and those with whom they work. Restoring health, not making people sick, is the goal.
In 1996 the Environmental Protection Agency identified medical waste incinerators as significant sources of dioxin, a carcinogen given off during the manufacturing and destruction of polyvinyl chloride (PVC). Soon after, the international coalition Health Care Without Harm (HCWH) was born. Over the past 10 years HCWH has worked to raise awareness and reduce the environmental impact of the healthcare industry. If decreased reliance on PVC plastics and mercury – as well as green building practices – are any indication, HCWH is succeeding.
|Questions to consider when choosing a hospital for your medical needs:|
Has there been recent reconstruction or remodeling? If so, have designers thought in terms of environmentally-sound plans and materials?
Is there an office devoted to environmental stewardship like at Kaiser Permanente or ecology as with Catholic Healthcare West?
Is there information available on hospital equipment and supplies that are free of PVCs, phthalate, and mercury?
Is the hospital making an effort to rethink its food production in terms of local and sustainable products? Are they cooking from scratch or still using processed foods?
PVC-Free IV Bags
Hospira – a top manufacturer of hospital products – agrees that PVC products belong to another era and do little to contribute to a sustainable environment. They were the first leading supplier to offer IV containers free of polyvinyl chloride (PVC) and phthalates made from propylene. While PVC produces dioxin, phthalates DEHP can leach out of the plastic bags and has been shown to cause birth defects in laboratory animals.
According to a HWH, the Food and Drug Administration (FDA) “warned healthcare providers in 2002 that some patients may be at risk from DEHP leaching from PVC medical devices and recommended switching to alternatives.” Along with Hospira, the other top manufacturer of medical products, Baxter International, announced its intent to explore PVC-free IV systems at a spring 2006 CleanMed conference held in Seattle, Washington.
Additionally, the new green IV containers weigh 40 to 60 percent less than their counterparts and will thus make for less waste in medical incinerators across the country. Hospitals burn an average of more than 6,500 tons of waste every day, including 800 tons of plastic.
“These developments indicate a significant market shift away from PVC plastic,” said Gary Cohen, co-executive director of HCWH. “Health Care Without Harm has been partnering with major health care systems and their buyers to create demand for safer alternatives. We’re pleased that these manufacturers have recognized the critical importance of providing PVC-free products that will better protect patient health and the health of our communities.”
PVC plastic has become a mainstay in many products over the past several decades, including the backing for wall-to-wall carpeting. Kaiser Permanente, for one, wants to distance itself from this type of manufacturing. As construction supervisor at a new Kaiser hospital site in Modesto, California, Mike Hrast, told American Public Media’s (APM) Marketplace, “Kaiser has a $20 billion appetite over the next 10 years in construction. We’re telling vendors, here’s what we want from you, don’t tell us what you’re going to give us. If you can provide what we want, then you get the contract with Kaiser.”
Aside from the cancer-producing dioxin, Hrast told APM that when PVC is on the backs of carpeting, it can leak into the hospital air and trigger asthma. In short, it was not a technology Kaiser wants to support, so the huge hospital system’s contract went exclusively to a company that developed a PVC-free option. In addition to environmental and health benefits, the move made smart business sense.
“We saved, at a minimum, $238,000 in this project, just by implementing green,” said Hrast to APM. “Green has that stigma to a lot of contractors and architects out there that it costs more money. We like to be the example out here that it doesn’t. It saves you money if it’s done right, and it’s well thought out and integrated into your design process.”
Mercury-Free Thermometers and Blood Pressure Cuffs
Mercury is another substance that society has come to recognize as potentially dangerous. The element moves easily from medical waste incinerators into the water, is eaten by fish, and ultimately can affect brain development in growing fetuses. As Ted Schettler, M.D. at Boston Medical Center and HCWH science advisor told APM, “If a pregnant woman eats fish that are contaminated with mercury, the mercury will get into the developing brain of her fetus and will cause damage. So choices made with regard to materials in hospitals can have public health impacts that may then come back to the hospital as a sick patient.”
It is easy to see why producers have moved away from thermometers and blood pressure cuffs that use mercury, and why hospitals are switching to mercury-free devices. Indeed, Catholic Healthcare West (CWH) – a 40-hospital system so dedicated to going green that it has an ecology program director, Sister Mary Ellen Leciejewski – has freed itself from dependence on mercury. The process took five years but was worth it, Leciejewski told the Sustainable Industries Journal in March 2006. Now Leciejewski says CHW has its eye on reducing greenhouse gas emissions and getting healthier food onto its trays.
Oregon Hospital is Greenest in the Nation
The Pacific Northwest state of Oregon has captured the nation’s greenest hospital award from the U.S. Green Building Council. Providence Newburg Medical Center in the 20,000-strong Portland suburb is the place. Gold LEED, Leadership in Energy and Environmental Design, is the award.
“All the evidence shows that green hospitals help people heal faster,” said Rick Fedrizzi, president, chief executive officer and founding chair of the U.S. Green Building Council. “As the first LEED Gold hospital, Providence Newburg Medical Center is proving their commitment not only to the health of their patients, but also the well-being of their staff, their community, and the environment. Providence’s leadership is an inspiration to healthcare providers everywhere.”
So how did the folks in Oregon go green? First, they put in a ventilation system that filters air from outside through the 40-bed hospital building. Then they installed low-flow toilets, sensors to turn off lights when not in use, and natural lighting throughout the building. Providence Newburg also participates in what is called the Dispatchable Standby Generation program through a major utility, Portland General Electric. This allows the hospital to sell power produced by the medical facility’s two 750 kilowatt emergency generators to Portland General Electric in times of peak demand.
“We have a wonderful guy named Richard Beam who directs our energy management for the entire Providence Health System,” said Mike Antrim, Senior Public Affairs and Marketing Coordinator. “We’d always thought in terms of preserving resources, but when Richard found we could do this and save money, he brought it to the table four years ago and made it happen.”
For Beam’s part, he said, “It’s just the smart way to build. We use our natural resources responsibly, we reduce our energy costs, and as a result we put more money back into patient care and the community. Most importantly, we create a healthy building for patients and staff.”
Hospitals are going green just in time for the aging baby boomer population, which has staked its claim on environmental ethics. Indeed, if trends continue, this highly-educated generation that has amassed considerable affluence will age with the satisfaction that, at least in the area of health care, meaningful, environmentally responsible changes are under way.