- Waste generated by the health care industry has been cited as a major
source of toxic pollution, including mercury and dioxins, which poses a serious
threat to public health. The purpose of this study was to investigate pollution
prevention activities of health care facilities in Oregon related to environmentally preferable
purchasing practices, recycling, mercury reduction efforts, and written
policy. Surveys were sent to 57 hospitals in Oregon, 24 facilities responded
Results indicate that the following environmentally-preferable purchasing
practices are being implemented: purchasing reduced hazardous material (92%);
using recycled packaging (75%); and, using products made from recycled content
material (83%). Other practices, such as the purchasing of cadmium-free red bags
(25%), supplies shipped in reusable shipping containers (34%), and using minimal
packaging (46%) are being implemented in a few hospitals. None of the hospitals
are purchasing chlorine-free office paper.
The majority of participating Oregon hospitals are recycling paper (96%),
cardboard (96%), clear glass (67%), linens (87.5%), batteries (67%) and X-ray film
(83%). Fewer hospitals are recycling plastics: #1 PET and #6 polystyrene
(37.5%), #2 HDPE (42%), #5 polypropylene (33%). Fewer hospitals are also
composting food (46%), computers and equipment (42%), fluorescent lamps (21%)
and solvents/fixers (29%). Major barriers to recycling in hospitals include lack of
established markets for some materials, limited space to collect the materials, and
low employee participation.
The majority of participating hospitals are reducing the purchasing of
mercury containing products, replacing mercury blood pressure units and gauges,
replacing lab and housekeeping chemicals, and pharmaceuticals. Fewer than 50%
of then participating hospitals are replacing switches, recycling batteries and
conducting an inventory of mercury sources. Few hospitals are checking drains
and pipes for mercury contamination (13%), recycling fluorescent lamps (21%) and
requiring vendors to disclose mercury content below 1% (17%). While most
hospitals no longer purchase new mercury-containing devices, the cost associated
with disposal of mercury as a hazardous waste is a major barrier to elimination.
Hospitals located in urban areas in Oregon are more likely to implement
pollution prevention strategies than rural hospitals. Nearly all Oregon hospitals
lack a corporate policy on pollution prevention/source reduction, or written goals
on waste volume reduction or waste toxicity reduction efforts. The few hospitals
(8%) that have put policies in place have done so voluntarily, and with the full
support from upper-level management.
Based on theses findings recommendations include the following:
1) Establish a "Green Team" of hospital staff from diverse departments. This
group can then strategize about courses of action for the facility with input
from all responsible sectors.
2) Conduct a waste audit. This establishes a baseline of existing hospital waste
and will help determine how to shape a waste minimization program and
pollution prevention plan.
3) Pollution prevention education should be a top priority for all departments
within each hospital including purchasing, nursing, housekeeping and top
management. Many health care professionals are not aware of the link
between the products and practices they choose and the environmental consequences of these choices.
4) Rural hospitals can join pollution prevention email list serves such as the
Oregon Health Care Without Harm list (HCWHoregon-health.org) or the
H2E list serve (www.h2e-online.org) to share, learn and identify practical
strategies for pollution prevention and waste minimization.
5) Approach and involve upper level management to work with hospital
"green teams" to develop and implement a hospital policy on pollution