Environmentally friendly hospitals

The recently passed health care bill will cover an additional 32 million Americans and begin to dramatically change the way health care is delivered. These are welcome steps that will ultimately save resources, but there are other environmental concerns when it comes to health care””especially care delivered in hospitals. Hospitals should focus on three key areas to address these concerns — waste, cleaning chemicals, and green building — as discussed in this CAP repost.


The health care industry’s ecological impacts are massive. U.S. hospitals generate approximately 6,600 tons of waste daily””no small number””and 85 percent of this is nonhazardous solid waste such as paper, cardboard, food, glass, and plastics that can be recovered or recycled. This recyclable waste could easily be sorted from the hazardous, infectious, and radioactive waste, lowering disposal costs.

Hazardous waste disposal is also a major problem. Dangerous waste from hospitals must undergo at least one of four treatment processes before it arrives at the disposal site: autoclaving, thermal disinfection, microwave sanitation, or incineration. Incineration releases dioxin, mercury, lead, and other carcinogens into the environment, threatening human health.

Luckily, activists and pollution regulations have reduced the number of active medical incinerators in the United States to roughly 100 from more than 5,000 in the mid-1990s. An extended grassroots campaign in Hamtramck, Michigan shut down that state’s last operating incinerator in 2005, which violated state air pollution laws. The campaign was supported by citizens and elected officials and guarantees that residents will no longer be made ill by their own hospital. Continued community pressure could bring that number down to zero and promote the use of alternative, nontoxic disposal treatments.


Many potentially toxic chemicals are used in large amounts not just for patient care, but to clean the hospital itself. These traditional cleaning products, floor strippers, and disinfectants often contain bioaccumulative toxins or PBTs that can contribute to environmental pollution during manufacturing and lead to poor indoor air quality when they’re used. These cleaners also contain chemicals that can cause cancer; immunological, neurological, and reproductive disorders; respiratory problems; skin irritation; and a host of other ailments.

Less toxic, environmentally friendly, and fragrance-free products can be used to ensure patients, health care workers, and the surrounding communities are safe. Many institutions have already gotten on board. For example, Kaiser Permanente, which is the largest nonprofit health system in the United States, instructs hospitals in their purchasing choices to avoid chemicals that can cause cancer and genetic mutation.

Green building

Waste and costs could also be reduced through efficiency. The Environmental Protection Agency, or EPA, estimates that 30 percent of the health sector’s energy use could be reduced by switching toward renewable and more efficient energy sources at no cost to quality of care. The EPA’s ENERGY STAR program has free energy audits for health care facilities as well as energy evaluation tools and information on how to purchase more energy efficient products. And it provides information on making your facility more efficient through simple steps like switching off machines when not in use, calibrating thermostats, and periodically checking the hot water system for leaks.

All these changes can pay off. For-profit hospitals, for example, can boost earnings per share by a penny by reducing energy costs by 5 percent.

Hospitals can also make structural changes to their buildings to save money. Boston’s Brigham and Women’s Hospital’s Shapiro Cardiovascular Center uses only nontoxic cleaners and has banned latex gloves to prevent allergies among workers, and 75 percent of the building’s interior is exposed to natural light. Natural light not only reduces energy costs, but scientific studies conducted in the health care sector support the conclusion that natural daylight shortens patient recovery times, improves their mood, and generally promotes well-being.

The health care bill took a big step toward making sure every American can get the care they need. The health care industry can continue to make great strides and take steps to make sure that care is delivered in a way that causes the least harm to people and the planet.

— Lauren Wyner

8 Responses to Environmentally friendly hospitals

  1. Chris Dudley says:

    We should be looking at the whole supply chain for clean up. One example is medical isotopes which currently use accident prone reactors with proliferation issues as a supply. Nuclear accidents such as at the Chalk River reactor create huge amounts of waste. Shifting to accelerator based methods of production would be wise.

    The article points out that separating waste streams can help. This also requires a supply chain approach since the wrappings, for example, of bandages, would need to use glues that work well in recycling. Medical personnel already separate some waste streams for safety reasons but one needs to make the steps for separation for recycling take less time than not separating since time is very valuable in a medical setting since the supply of doctors is so restricted by the AMA. Doctors don’t really have time to do the right thing. A method to make the waste self-disposing would be a big help. That, again, would be an upstream thing.

  2. crf says:

    Accelerator methods of producing medical isotopes can’t replace a reactor easily, because they cannot easily produce neutrons of the required energy (neutrons can’t be accelerated) or in sufficient volume. To create neutrons, accelerated particles must hit a prepared target, generating neutrons, which hit a sample, and the resulting elements recovered.

    There isn’t really an additional issue of waste with reactors producing isotopes. It’s not substantially different from waste from commercial power plants, whose output dwarfs research and isotope reactors. The reactors might have a different set of risks compared to a commercial power plant from operation, but that can be managed.

  3. Nancy says:

    I’ve spent a lot of time at the Lahey Clinic in Massachusetts with my elderly parents over the past few years and have watched the enormous amount of waste produced at their facility. The food waste issue is one that can be addressed easily. Since it is concentrated in one or two areas (the cafeteria for staff and guests) and the kitchen (in-patient meals) it would take some education and a few specialized containers for them to collect all food waste and have it transported to a composting facility that can turn the waste into energy and high-quality compost for gardens/farms.

    I attended a presentation by Harvest Power, a company that takes food waste from institutions (restaurants, hospitals, schools, supermarkets) and converts it to electricity and a marketable compost. I hope this is the way we’ll be doing things in the future.

  4. Chris Dudley says:


    Accelerator based photon fission is not subject to runaway the way that reactors are: Medical isotope reactors do seem to be beset with more than their share of accidents and reliability problems.

  5. Pete Salazar says:

    The actual first concern is infectious diseases. MRSA is very dangerous. People outside of medicine have apparently limited information. It is the lawyers that demand the liability for hazaarduus waste be transferred to the carrier when any type of waste leaves a hospital. Most carriers are unwilling to sign a contract and carry legal liability. Hospitals have greatly increased the use of disposables in drapes and apparel so there is less handling by humans.
    I don’t have a problem with an incinerator hooked up to a boiler to produce steam for a laundry or heating.

  6. Wes Rolley says:

    Then, there is the idea of doing the simple things first. For example, Kaiser Permanente will be adding solar panels to 15 of it’s facilities in California. The cost (~$96 million) to Kaiser is near zero over 20 years compared to the what they pay for utility provided power.

  7. Peter G. Joseph, M.D. says:

    As an emergency physician for 33 years and department chair for 15, I can say that the best way to coax more eco-consciousness into hospitals is for the organizations that govern their function to raise their own consciousness about these issues. That is, if CMS (Medicare) and JCAHO (Joint Commission) develop and impose standards, they will eventually be met. All hospital administrators understand that. Doing so would create strong incentives. Currently the focus is appropriately on patient safety, quality improvement, reducing hospital-acquired infections, etc. — all worthy goals. But waste and energy consumption just don’t seem to be on the radar yet.

  8. kdk33 says:

    “These are welcome steps that will ultimately save resources”

    As do so many other massive entitlement programs. These programs have proven so successful that I don’t understand why we don’t turn our entire economy over to Washington central planners. That would, no doubt, provide more goods and services to more people for less money – simultaneously combating globabl warming.