Deborah Fleischer, Green Impact, August 2015


Greening of Healthcare:  Five Best Practices You Want to Know About

Kathy picOn July 23rd, over a hundred environmental health specialists, nurses, medical students and sustainability practitioners gathered at University of California San Francisco’s (UCSF) Mission Bay Campus for a workshop that focused on exploring the link between sustainability and healthcare.  The workshop agenda was chocked full of sustainability-related content, including a keynote by Kathy Gerwig, Vice President, Employee Safety, Health and Wellness, and Environmental Stewardship Officer, Kaiser Permanente, on the impact of healthcare on the environment and human health.  Other plenary sessions included a detailed presentation by Linda Rudolph, MD, MPH, Co-director, Climate Change and Public Health Project, the Public Health Institute, on the link between climate change and health; an overview of toxins and the impact on human health by Vicki Leonard, RN, FNP, PhD; and a talk by Tom Newman, MD, MPH, Professor of Epidemiology & Biostatistics and Pediatrics, UCSF, on the environmental consequences of eating meat, aptly named, “Should Hospitals Serve Meat?”

In her keynote, Gerwig kicked things off, exclaiming, “Sustainability is preventative medicine on a grand scale.”  She challenged the audience with a survey question, “What percentage of total greenhouse gas emissions are related to the healthcare industry?”  The answer highlights why the greening of healthcare is a serious business—U.S. hospitals contribute eight percent of our total carbon footprint, creating two million tons of waste annually. While all the presentations stressed the many challenges, each speaker also provided actionable steps healthcare institutions can take.  The plenary sessions’ PowerPoint presentations can be viewed here.

A key message from all the presentations: sustainability is not only good for the planet and the pocketbook, but it also supports total health.

Prioritize Safety and Cost Savings

Kaiser Permanente’s sustainability strategy focuses on five key areas: climate and energy, safer chemicals, water conservation, sustainable food, and waste reduction.  For those just getting started, Gerwig recommended, “As you look across your facilities, prioritize worker and patient safety and cost savings.” Based on this advice and the many topics covered at the workshop, here are five best practices to consider:

Linda1. Start a Reprocessing Program:  Here is a fact that should make hospital administrators across the country pay attention: according to Gerwig, over the past 10 years, Kaiser Permanente has saved over $55 million from its reprocessing program alone.  For fiscal year 14-15, through partnerships with Hygia, Masimo, and Stryker, single-use devices collected in the Surgery Department, Electrophysiology lab, and patient rooms for reprocessing saved UCSF over $1 million dollars.  It makes me wonder why every hospital and medical center has not jumped on this best practice.  Gerwig stressed, “Greening is not more expensive for us—it is a myth that it costs more.”

2. Buy Safer Cleaning Products: Dr. Leonard’s talk on the “Health Effects of Chemical Exposures During Pregnancy and Early Childhood” warned that commonly used products such as cleaners, sanitizers and disinfectants can pose health risks to the fetus and young children.  In the afternoon breakout panel on green teams, Barbara Sattler, RN, DrPH, FAAN, Professor, Public Health & Alliance of Nurses for Healthy Environments, University of San Francisco, also warned about the health impact of chemical exposures in hospitals, which can trigger adult onset asthma in nurses and janitors. Dr. Leonard’s best tip for choosing safer products that pose fewer health risks to these vulnerable populations, as well as to the environment, is to buy Green Seal certified cleaning products. These greener products are better for both staff and patients.  She also urged participants to avoid Triclosan, which is used for hand washing in hospitals. According to Leonard, studies show that Triclosan doesn’t work better than soap and water.  “All risk and no benefit,” she warned.

Tom3. Purchase Meat Without Antibiotics and Serve Less Meat: Dr. Newman kicked his talk off “Should Hospitals Serve Meat?” with a reminder that not that many years ago, it was a big fight to get smoking banned in hospitals.  Today, he considers the fight to improve the quality of food served in hospitals the next movement.  He urged hospitals to consider the environmental, social, and health implications of its food purchasing.  Both UCSF and Kaiser Permanente have programs in place to encourage purchasing local, healthy food.  Dr. Newman spoke of the health and environmental benefits of eating more plants and less meat, as well as provided an overview of the dangers of using antibiotics in livestock.  UCSF has increased sustainable food purchasing from nine percent to 26 percent over the past five years and launched a program to purchase antibiotic-free meat.  You might be surprised to learn that 80 percent of antibiotics aren’t used to treat illnesses in people; but rather are fed to livestock such as cows, pigs, turkeys and chickens for non-therapeutic purposes, creating antibiotic-resistant “superbugs”.

4. Purchase Flame-Retardant Free Furniture: Kaiser Permanente spends big dollars on furniture, $25-30 million per year according to Gerwig.  She explained, “We will no longer buy products with flame retardants.”  Kaiser has promoted this program to others, creating a movement that spends about $50 million/year.  The Center for Environmental Health (CEH) has a new e-guide available listing manufacturers with flame-retardant free furniture.  Go here for a past UCSF website article that presents an overview of how to minimize your exposure to flame retardants.

5. Talk about Climate Change as a Health Issue: Dr. Rudolf spoke passionately about the health impacts associated with climate change.  Smoke from wild fires, increased ozone and dust, a longer pollen season, urban heat islands, vector-borne illnesses, and drought all impact the health of the most vulnerable—the elderly and the young. She urged the audience, “You have credibility.  Talk to others—friends, colleagues, neighbors, and leaders—about climate change as a health issue and call for strong climate solutions. Join the US Climate and Health Alliance.“

Resources for Learning More

Many resources were offered for those interested in learning more, including:

Health Care Without Harm
Practice Greenhealth
Center for Environmental Health
Public Health Institute
Alliance for Climate Education
US Climate and Health Alliance
2015 Lancet Commission on Health and Climate Change: Policy Responses to Protect Public Health
Climate Change, Health, and Equity: Opportunities for Action, Public Health Institute

The workshop was a post-conference session associated with the California Higher Education Sustainability Conference (CHESC), held this year at San Francisco State University. 

Story by Green Impact:  Making Green Happen (Strategy * Communications * Engagement)