Impact of Healthcare
The health care industry affects the lives of nearly
every person in the United States. Nearly 6,000 hospitals include almost a
million staffed beds, admit almost 37 million patients (not including
outpatient visits), employ nearly 5 million people1, and directly or indirectly support
one in every nine jobs. Today, the sector accounts for 17 percent of the GDP.
Health care is resource intensive with
significant input of materials, water,
and energy that results in output of waste, effluents, and emission pollution.
Health care generates material in almost every category of waste and emissions.
Hospitals consume two-and-a-half times more energy
than other commercial buildings, spending more than $8.7
billion per year according to the EPA Energy Star program. Energy Star for
Healthcare and the U.S. Department of Energy (DOE) Hospital Energy Alliance
(HEA) both have challenged the health care sector to significantly reduce its
energy use. The goal of the DOE initiative is to see commercial buildings
reduce energy consumption by close to 70 percent based on today’s building
codes. What’s clear is that the health care sector can save billions of dollars
by reducing its energy use,
helping to reduce the nation’s dependence on foreign fossil fuels and the
industry’s climate change impacts in the process.
Supply chain expenses alone represent the second
largest expense line on a hospital's balance sheet, following labor: the
average hospital provider spends more than $72 million a
year on supply chain functions, nearly one-third of its annual operating
budget. The majority of the materials consumed in health care facilities
ultimately become waste, costing health care consumers $10 billion annually in
waste disposal costs. The opportunity for cost reduction through smart source
reduction and waste management may be as high 40 to 70 percent, representing $4
to $7 billion for the health care industry.
- Health care realities: Rising costs, lower reimbursements, aging
population, aging facilities, staff retention, diverse operations
- Energy realties: Rising costs, $8 billion annually, growing demand,
carbon emissions, energy security, increasing intensity (DOE)
use 836 trillion Btu of energy annually. (DOE - 1—2. 2003 CBECS)
have more than 2.5 times the energy intensity and CO2 emissions of commercial
office buildings, producing more than 30 lbs. of CO2 emissions per square foot.2 (1—2. 2003 CBECS)
2006 survey published in Health Facilities Management identified the top factors
that stop energy efficiency improvements:
of senior management commitment and support
percent of hospitals reported higher energy costs over the previous year,
and more than half cited an increase of more than 10 percent (ASHE survey,
Facilities Management, June 2006.)
consumption in health care facilities costs health care consumers $10
billion annually in waste disposal costs. The opportunity for cost
reduction through smart source reduction and waste management may be as
high 40 to 70 percent, representing $4 to $7 billion for the health care
in the US generate upwards towards 7,000 tons of waste per day.
small but significant amount of that waste, about 15–20 percent, is highly
regulated by multiple regulatory agencies including EPA, OSHA, DOT, Joint
Commission, DEA and others. Items like regulated medical waste,
pharmaceutical and hazardous chemical waste, radiological waste, sharps
and others are expensive to manage—up to 10–100 times more than solid
waste or recycling.
non-regulated waste, the other 80+ percent, is no different from that
generated by a hotel, up to 60 percent of which is either recyclable or
facts: In the early 1970s, about 20,000 landfills, most of which were
actually unlined dumps, were being used. Today, as a result of the
regulations, the dumps are closed and slightly more than 1,700 MSW
landfills are in use. New landfills are difficult to site and build due to
community pressure (not in my backyard) and the cost of the required
technology. The strategy today is to extend the operating life of a
landfill by recycling and reusing materials that don’t need to be
gas: When waste is landfilled, methane gas is created by organic materials
decomposing in an oxygen poor environment. Methane, a powerful greenhouse
gas (GHG), is 8 times more potent as a GHG than CO2. The strategy for
improvement is an integrated waste management plan that includes reuse and
recycling, and composting programs to remove organic materials. Also
ensuring your landfill has mitigation strategies for capturing the methane
gas as an energy source or at least burning it off to reduce methane
alone makes up almost 15-20 percent of the waste stream of a typical
is used to ship 90 percent of all products in the United States.
cardboard (sometimes called old corrugated containers—OCC) only takes 75
percent of the energy needed to make new cardboard and lessens the
emission of sulfur dioxide that is produced when making pulp from wood
1 ton of cardboard saves 9 cubic yards of landfill space and 46 gallons of
OCC is very recyclable, finding opportunities to reduce it is a
priority—like implementing a reusable tote program.
containers (glass, plastic, aluminum containers) make a combined rate of
about 6&ndash10 percent of healthcare waste. (Practice Greenhealth)
sterilization wrap accounts for up to 19 percent of waste generated in the
Operating Room (www.premierinc.com/quality-safety/tools-services/safety/green-link/green-corner/Harbor_Blue_Wrap_MDH2E.pdf).
standard recycling program in a hospital consists of cardboard,
confidential paper collection (HIPAA), mixed fibers (magazines,
newspapers, non-confidential mixed office paper, boxboard), beverage
containers, metal, recyclable construction/building materials, some
non-traditional mixed plastics. This level of program can reduce waste by
use an average of 139,214 gallons of water per day.
is finite; it cannot be created or manufactured. What is available on the
planet is all there is. Only 3 percent is fresh water, and only a fraction
of that is available for our water consumption needs. Water conservation
has two main categories: (1) using less waste through better technologies
in systems and fixtures and (2) capturing rainwater and other “used” water
for other purposes. (IFMA Water Sustainability
EPA—Profile of the Healthcare Sector—2002 Census of
the Healthcare Industry.
- U.S. Healthcare Costs - www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358 (Back)
Health Care Without Harm
a vision of a health care sector that does no harm, and instead promotes the
health of people and the environment.
that end, we are working to implement ecologically sound and healthy
alternatives to health care practices that pollute the environment and
contribute to disease."
Healthcare Environmental Resource
Center This site provides pollution prevention and compliance
assistance information for the healthcare sector. It is intended to be a
comprehensive resource, covering all the varieties of hospital wastes, and all
the rules that apply to them, including both federal regulations and the
specific rules that apply in your state.
Practice Greenhealth is the
nation’s leading membership and networking organization for institutions in the
healthcare community that have made a commitment to sustainable, eco-friendly
practices. Members include hospitals, healthcare systems, businesses and other
stakeholders engaged in the greening of healthcare to improve the health of
patients, staff and the environment.
MedShareis a nonprofit organization
dedicated to improving the environment and healthcare through the efficient
recovery and redistribution of surplus medical supplies and equipment to
underserved healthcare facilities in developing countries.
Stop Trashing the Climate provides
compelling evidence that preventing waste and expanding reuse, recycling, and
composting programs — that is, aiming for zero waste — is one of the fastest,
cheapest, and most effective strategies available for combating climate change.
Teleosis Institute The Teleosis
Institute is devoted to developing effective, sustainable health care provided
by professionals who serve as environmental health stewards.
Toxic Use Reduction
Institute The Institute is located at the University of
Massachusetts Lowell, and provides services to all Massachusetts companies,
communities and agencies. Our Mission is Clear :
test and promote alternatives to toxic chemicals used
efficiency in energy and water use
training, resources and tools
economic competitiveness through improved efficiency, compliance
stability, reduced risk and new markets.
Healthier Hospitals Initiative (HHI)
is a coalition of major health systems and organizations committed to improving
sustainability and safety across the health care sector. HHI is partnering with
Health Care Without Harm, Practice Greenhealth, and The Center for Health
Design to provide expertise and technical assistance and to develop and
implement training and other programs to help hospitals carry out the HHI