“Green” purchasing policies are nothing new, but the health care sector's growing commitment to environmental responsibility is newsworthy. At last year's CleanMed 2001 conference in Boston, delegates from the US, Sweden, Austria, Denmark, Switzerland, Argentina and Canada discussed environmental problems related to hospital products and the actions they've taken. The 130 participants heard:
· how PVC products, which are used to make about 25% of the disposable plastic products used in health care, now account for less than 1% of the waste in Vienna's hospitals, which are moving toward complete elimination;
· how a Stockholm hospital's purchasing policies give priority to “ecotested” products and avoid ones that are toxic or whose use or disposal results in toxic releases.
The conference, sponsored by Health Care Without Harm (www.noharm.org), a US-based international coalition committed to environmentally responsible health care, began with the premise that the products and services we use may have profound implications for both the environment and human health, including the health of hospital workers.
Major concerns addressed at the conference surrounded products containing mercury or latex, cleaning and disinfecting agents, and the use of products containing PVC. The latter are often combined with di-ethylhexyl-phthalate — DEHP, a phthalate that affects the immature male reproductive system — in IV bags and tubing, and become an important source of dioxin when incinerated.
Most impressive was the fact that 4 large group-purchasing organizations (GPOs) that together represent more than 75; of all US hospitals said they are committed to increasing the stringency of their requirements for environmental responsibility in product purchasing. One GPO, Broadlane, switched to PVC-free IV bags in 1996, a move that actually saved money.
This trend may be growing. “We must become troublesome consumers to the producers,” said Dr. Ake Wennmalm, environmental director for the Stockholm County Council.
On another front, the US Environmental Protection Agency has signed a memorandum of understanding with the Maine Hospital Association that calls for the virtual elimination of mercury and the continual reduction in the use and disposal of PVC plastic.
Senior executives from some of the largest US health organizations, including Kaiser Permanente, stressed their commitment to environmentally responsible management. This commitment is incorporated in their mission statements and, in at least 1 case, in the criteria by which executives' compensation and incentive bonuses are assessed.
All the presentations came down to this point: environmentally responsible health care is an ethical duty that must be recognized and incorporated in the system at all levels. In doing so, the system protects its patients, staff, the community that surrounds it and the wider society and environment. And not only are there long-term health, environmental and economic benefits — there can also be costs savings.
This approach must extend from green purchasing policies (see www .sustainablehospitals.org) to operation of green health care facilities and the system as a whole. The final message is that buying and building green is good for our health and the health of our environment, and it needs to become an essential part of health care.
Signature
Trevor Hancock
chair, Canadian Association of Physicians for the Environment