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1 Sustainable Healthcare Wendi Shafir US EPA Region 9 June 2010.

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Presentation on theme: "1 Sustainable Healthcare Wendi Shafir US EPA Region 9 June 2010."— Presentation transcript:

1 1 Sustainable Healthcare Wendi Shafir US EPA Region 9 June 2010

2 2 Outline Why Healthcare? Environmental Concerns Opportunities and Priorities Resources Outline Sustainability – definition

3 3 Sustainability – what does it mean? “Meeting the needs of the present without compromising the ability of future generations to meet their needs”

4 4 Sustainability – 3 Aspects EconomicEquityEnvironmental

5 5 Why Healthcare ? Large environmental footprintLarge environmental footprint Many opportunities – waste, toxics, energy, waterMany opportunities – waste, toxics, energy, water PurposePurpose – First do no harm – First do no harm - Provide healing environment

6 6 Health Care Footprint 1 of every 7 dollars spent Energy ~ $6.5 billion each year Energy ~ $6.5 billion each year Medical Incinerators 3rd largest source of dioxin 3rd largest source of dioxin 4th source of mercury emissions 4th source of mercury emissions 50X more mercury in medical waste 50X more mercury in medical waste Water – often largest users in community Over 2 million pounds of waste per year

7 7 Benefits Reduces costs Improves efficiency Reduces environmental impacts Improves human health Reduces liabilities

8 8 Environmental Concerns Air Pollution Trash Water Pollution Water Shortage Energy Usage Toxic Chemicals

9 9 Waste in Healthcare

10 10 Toxics in Healthcare ?

11 11 Toxics in Healthcare Sterilants and Disinfectants Mercury and other PBTs Pesticides Cleaning Chemicals Laboratory Chemicals RadiologicalsPthalates

12 12 PVC, DEHP, Pthalates In many medical products for flexibility, ex. IV bag, tubing In many medical products for flexibility, ex. IV bag, tubing DEHP: Developmental toxicant DEHP: Developmental toxicant Dioxins– from production and incineration Dioxins– from production and incineration DEHP leaches from the PVC DEHP leaches from the PVC FDA recommends use of alternatives to DEHP when exposures may be excessive (esp. neonates)

13 13 Mercury in Healthcare Medical Devices Thermometers Thermometers Sphygmomanometers Sphygmomanometers Dental Amalgam Dental Amalgam Cantor, Miller Abbot, Dennis tubes Cantor, Miller Abbot, Dennis tubes Building Products Thermostats Thermostats Many switches Many switches Boiler Guage controls Boiler Guage controls Fluorescent Bulbs Fluorescent Bulbs

14 14 Mercury Toxic effects- Long term exposure can permanently damage brain, kidneys and developing fetus Health care industry a major consumer Persistent, Bioaccumulative, Toxic = PBT

15 15 Mercury Toxicity – Fish Connection

16 16 Pharmaceuticals Emerging Issue Water Quality Impacts – Human - Reuse Human - Reuse Aquatic species Aquatic species Many pharmaceuticals in lakes & rivers

17 17 Now we know why - What can we do ?

18 18 Opportunities Waste Reduction Improved Pharmaceuticals Management Mercury / Toxics Reduction Recycling Energy / Water Efficiency Healthy Food

19 19 Waste Reduction Strategies Waste Characterization Waste Segregation Best Practices Minimization of Infectious/Biohazard Waste Paper Management Recycling EPP for Waste Minimization

20 20 Pharmaceuticals Pharmaceutical Waste Management & Minimization Plan EPA, State guidance Swedish model – change prescribing patterns

21 21 Mercury and Toxics Reduction Mercury: Inventory and eliminate Mercury: Inventory and eliminate Less toxic cleaning products Less toxic cleaning products Less toxic sterilants + disinfectants Less toxic sterilants + disinfectants Distill and reuse lab solvents & fixatives Distill and reuse lab solvents & fixatives

22 22 Mercury Elimination a Primary Goal 100s of hospitals virtually eliminated it Many state/local programs Dental opportunities as well Eliminate through: Substitution Substitution Elimination Elimination Environmentally Preferable Purchasing Environmentally Preferable Purchasing

23 23 Mercury Reduction – How to Mercury Reduction 10-step guide Reducing Mercury Use in Health Care Plan cury.html cury.html Mercury Assessment Tool ospitalPollutionPrevention.aspx ospitalPollutionPrevention.aspx

24 24 Alternatives to DEHP There now are effective alternatives PVC-free/ Non-PVC PVC-free/ Non-PVC DEHP-free / Non-DEHP DEHP-free / Non-DEHP Assessment tools and alternatives lists

25 25 Why? Sustainable Food in Healthcare Support patient, staff and visitor health Educate patients, community Provide healthier food (Farmer’s Markets) to community Combat Antibiotic Resistance Reduce food production’s environmental footprint Energy, water, pesticides, soil conservation, fishery depletion Energy, water, pesticides, soil conservation, fishery depletion

26 26 Healthy Food in Healthcare Pledge From Healthcare Without Harm (www.noharm.org) Sample Language provided Over 250 hospitals have signed up Healthcare without Harm – provides resources American Medical Association (AMA) approved a policy resolution in support of sustainable food health care systems

27 27 HOW? Food Policies Locally sourced foods Hormone/antibiotic free animal products, rBGH Free Dairy Sustainably harvested foods, fair trade Sustainably harvested foods, fair trade Organic and other certified food Organic and other certified food

28 28 What else can you do? Healthier vending machines Serve meals lower on the food chain -less meat, vegetarian options Healthy Cooking Classes and demonstrations Sustainable Food service – energy, water, waste Farmers Markets Onsite Gardens

29 29 Paper Reduction Copy & print double-sided Go Paperless - electronic records Fewer Copies Recycle office paper separately Recycling can still be HIPPA compliant!

30 30 More Recycling ! Reduce costs, generate revenue Cardboard, paper, glass, plastic Sterile Blue Wrap – new pilot in N. CA

31 31 Electronics FEC, EPEAT, Energy Star Both purchasing and disposal important UNIVERSAL Waste Reduced disposal costs Reduced energy costs

32 32 Environmentally Preferable Purchasing or EPP Selecting products or services that have a lesser or reduced effect on human health and the environment All Areas – medical, surgical, office supplies, maintenance, etc. Group Purchasing Organizations (GPOs) provide leverage, efficiency for EPP

33 33 Other Opportunities Water Conservation Energy Conservation Renewable Energy Green Building Dental

34 34 A Role for Everyone PurchasingHousekeepingNursing Food Service FacilitiesAdministrativePharmacy

35 35 What Can You Do at Your Hospital? Listen and learn today Identify some things to work on Make a commitment to just one! Get support – co-workers, mgmt. Imagine, if we all do this…

36 36 From sustainablematerials2020.com

37 37 The End Wendi Shafir USEPA Region


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