Detoxing healthcare: hospitals get healthier

Marc Gunther

October 1, 2014

The Guardian

syringes in bio waste container

Hazardous medical waste once made hospitals the biggest US emitter of dioxin. Now, waste is more likely to be sterilized. Photo: Robert Giroux/Getty Images


Are hospitals making tiny babies sick?

That question troubled Kathy Gerwig, an executive at Kaiser Permanente, the big US healthcare provider, when she visited a Kaiser neonatal intensive care unit in San Francisco back in 2001, to take an inventory of medical equipment including IV tubing, blood bags and feeding tubes. She and her colleagues wanted to find out if they contained a chemical substance known as DEHP, a phthalate used in polyvinyl chloride (PVC) plastics to make them soft and flexible. Studies of animals had suggested that DEHP could be harmful to a fetus, especially to the reproductive systems in males.

The science around the health effects of DEHP was far from clear-cut, but Gerwig and her colleagues at Kaiser plowed ahead. They asked equipment suppliers to provide DEHP-free products where possible, and subsequently sought to remove other so-called chemicals of concern from Kaiser’s facilities, even amidst scientific uncertainty.

“The fact that so many (chemicals) are not well understood, to me, is a red flag,” Gerwig told me in an interview at Kaiser’s Washington office. “Our bar has never been proof of harm. Our bar has been when there is ‘credible evidence.’ And credible means credible.”

A pioneer in the healthcare industry’s sustainability movement, Gerwig devotes a chapter of her new book, Greening Health Care: How Hospitals Can Heal the Planetto the challenge of “detoxing healthcare.”

It’s just one example of a troubling paradox: an industry devoted to health produces more than its share of waste, greenhouse gases and toxic air emissions – all of which make people sick. What’s more, some hospitals still feed sugary soft drinks and Jell-O to patients and employees alike.

That makes no sense, argues Gerwig, who has worked on sustainability issues at Kaiser for more than 20 years. Fortunately, she reports, the healthcare industry is getting serious about going green.

Remember mercury thermometers? They’re all but gone from hospitals, after the industry was shown that the incineration of medical wastes contributed about 10% of the nations’s mercury air emissions. (Burning coal produces most of the rest). Most of America’s 5,000 hospitals used to have their own incinerators to burn hazardous waste, which made hospitals the biggest emitter of dioxin; now medical waste is more likely to be sterilized, then sent to landfill, which is better. Hospitals are also turning to greener chemicals, building LEED-certified buildings and hosting farmers’ markets on their grounds.

“A truly green healthcare system may be a distant goal, but at least today it really is a goal,” Gerwig says.

Much of the credit goes to Gerwig, Kaiser and other industry leaders, including Gary Cohen, an activist who co-founded Health Care Without Harm in 1996 and still leads the group. Dignity Health, a California-based healthcare system, published the industry’s first environmental report, and switched to PVC-free tubing ahead of Kaiser. Wisconsin-basedGunderson Health System formed a for-profit subsidiary that has invested in wind turbines, a biomass boiler and a manure digester in an effort to go carbon-neutral. Fletcher Allen Health Care, the academic medical center for the University of Vermont, pledged to stop buying beef, poultry, pork, fish and cheese that contain antibiotics, in part because of worries about the growth of antibiotic-resistant infections.

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