Medicine Gears Up for a Code Green

"Now it would be hard to find a hospital anywhere using mercury thermometers," Sattler said. "We were also able to get them out of retail drugstores."

Sattler said environmental health groups have also been working with medical manufacturers to limit polyvinyl chloride, a flexible plastic commonly used in IV and surgical tubing. Burning PVC releases toxic dioxins into the air.

In the mid-1990s, there were more than 5,000 medical waste incinerators in the United States, said Stacy Malkan, a steering committee member of H2E. Today, there are fewer than 100.

"But we'd like to see the end of all medical waste incineration," Malkan said.

For many hospitals, autoclaving, or steam sterilization, has proved to be a good alternative: The waste is steam-sterilized, compressed, then sent to landfills.

But to be really effective, the effort to minimize the environmental impact of medical waste has to start with smart purchasing practices, Kilgore said.

"We are looking at what we're buying and changing over [to greener products] because that sends a message to manufacturers that this is what is important to us," Kilgore said. "We make sure we're dealing only with manufacturers that are as concerned about the environment as we are."

Thanks to advances in product development and manufacturing, "there are many kinds of cleaners, pesticides, nontoxic chemicals on the market today that meet medical standards," said Anna Gilmore Hall, executive director of Health Care Without Harm, an international coalition working to reduce medical industry pollution. "Infection control, for example, is just as effective with green cleaners as it is when you use Clorox."

On the construction side, there has been progress in establishing medically appropriate green standards. The Green Guide for Healthcare, released in 2004 by a coalition of environmental and medical advocacy groups, was the first to offer hospitals guidelines for building green facilities. And sometime next year the U.S. Green Building Council, which sets green construction standards for a range of industries, plans to issue some specific to the medical profession, known as the LEED for Healthcare rating system.

Of all medical green efforts, "the greening of the built environment is what has really taken off," said Niyati Desai, associate director of the Teleosis Institute, a Berkley, Calif.-based environmental outreach group that offers classes on green practices to medical professionals. "It's a strategy that doesn't involve changing care. It involves changing light bulbs and changing paint and changing material."

But for Teleosis and a still small group of medical professionals, green medicine can be even more.

"It goes beyond what light bulb you're using to how do we make our care more sustainable?" Desai said. "Sustainable medicine is about prevention, precaution and using the most invasive procedures only when necessary."