Correction to This Article
This article incorrectly associated Stacy Malkan with H2E. She is a steering committee member of Health Care Without Harm.

Medicine Gears Up for a Code Green

By Lindsay Minnema
Washington Post Staff Writer
Tuesday, July 22, 2008

Tossing out everything from plastic bandages and cotton swabs to hospital robes after a single use, the U.S. medical industry generates more than 2 million tons of waste per year, environmental advocates say. Some of that waste makes its way to incinerators and, when burned, releases dioxin, mercury and other toxins.

Is it ironic that the industry we trust to protect our health is releasing substances that may be tied to cancer, diabetes and other illnesses? Many health-care professionals think so.

In recent years, some have begun to think greener. Most efforts focus on reducing toxic waste from hospitals and medical offices as well as cutting back on water and energy use. But some doctors and health workers are also considering changes in their practices that could enhance environmental and patient health.

"There is an understanding between and among health professionals that the environment is playing a really important part in our health status," said Barbara Sattler, director of the Environmental Health Education Center at the University of Maryland School of Nursing. In fact, she added, many of the industry's most wasteful habits, including those made in the name of hygiene and sterility, "may be creating avenues for disease."

Many U.S. hospitals are seeking ways to make their daily operations more environmentally friendly. More than a fourth have joined Hospitals for a Healthy Environment (or H2E, as it styles itself), a government-supported movement to minimize medicine's environmental footprint.

But getting hospitals to curb resource consumption on a large scale can be tough, given their need to operate 24 hours a day.

"There are major parts of the building that never shut down," said Cindy Kilgore, assistant vice president of materials management at Inova Fairfax Hospital. "We have to have a certain airflow, have to stay at a certain temperature, so there are unique things that make [cutting energy use] more complicated."

Still, Inova has come up with some cost-saving answers. After its five hospitals completed energy audits last month, they turned off the lights in their vending machines. Kilgore said that simple change will save about $15,000 a year. More changes will come once Inova has had a chance to analyze the audit's findings, she said.

Inova is also exploring the feasibility of a system that would shut down nonessential computers each night. And before the summer landscaping season ends, Kilgore said, Inova Fairfax hopes to use leftover oil from its cafeteria fryers to make biodiesel for its lawn mowers.

Reducing the environmental impact of medical waste is a tougher challenge. The biggest problem: limiting toxins, such as mercury, that are released into the environment during disposal.

Mercury "is leaching into the environment, and we're ingesting some of that through fish and seafood," said Ravindra Gupta, an internist at Inova Fairfax and co-chairman of the Going Green Committee for the Inova Health System.

Hospitals throughout the country have responded in the past decade by eliminating mercury from many of their supplies, including thermometers and blood pressure cuffs.

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