Health Care, Heal Thyself continued from page 51 cycling bins and expect it’s going to work. Who’s going to pick it up and where will we store it until the recycling people come?” Many in the waste management industry see promise in the surging passion for all things green. “Every chance I get, I talk with customers about making it easy to recycle and trying to get them to think—whether it’s composting or cans or bottles—about ways to reduce their carbon footprint,” says Tim Pickering, vice president of Biomedical Waste Services. If there’s good news, it is this: Going green may well make the difference between red and black on the corporate balance sheet. “Waste is not an inevitable result of production, but a measure of inefficiency,” says Laura Brannen, the former executive director of H2E’s national organization who is now director of customer sustainability for the health care solutions division of Houston-based Waste Management Inc., which operates in Baltimore. “If you’re not watching your back door, you’re tossing resources, throwing away tens of thousands, if not millions, of dollars of supplies. If you think you can’t afford to do the right thing, you’re wrong … you can’t afford not to do it.” Rachel DeMunda heads the effort to get a handle on those numbers at Mercy Medical Center, where she is director of environmental health and safety. Until recently, Mercy owned and operated its own incinerator, burning half of all its trash—from medical waste from pathology to pizza boxes discarded in the staff lounge. Then, in 2006 the hospital demolished the incinerator to make way for a high-rise patient facility. Today, a waste reduction and recycling program called “Have Mercy on the Earth” requires an annual training session for every employee. “Have Mercy” has already diverted 20 percent of the hospital’s overall waste stream to recycling centers and shaved $300,000 off the annual garbage bill. Much more work remains. Of the 4 million pounds of garbage generated at Mercy each year, almost 25 percent leaves the site in a red bag. About half of that is just carelessly discarded pizza boxes and the like, but once it’s in the red bag, regulations mandate that it be treated as infectious material—meaning that it is shipped to an incinerator at more than five times the cost. “Right now we pay 4 cents per pound for [regular] trash,” DeMunda says. “For medical waste we pay 21 cents.” DeMunda would like to cut red-bagged waste to just 10 to 12 percent of the final haul. In 2006, the Johns Hopkins Medical Institutions found an alternative to incineration: an enormous rotoclave, a device that heats medical waste to 250 degrees Fahrenheit for at least thirty minutes, then shreds it, transforming it into noninfectious waste that can be trucked to the landfill. Last year, Chris Seale, director of Hopkins’ department of environmental services, launched a waste segregation program that separates regular trash from medical waste; the program start-up cost $60,000, but Seale expects to see more than $100,000 in annual savings as a result. The latest project, he says, is a program that recycles “sharps”—needles and lancets—and replaces disposable collection containers with reusable ones. Cutting down on what leaves in garbage trucks is only the first step of an effort to reduce toxics that reach—literally—into every nook and cranny. This fall, the grassroots Maryland Pesticide Network and the national nonprofit Beyond Pesticides plan to release results of a two-year collaboration with H2E’s Maryland chapter and seven eldercare facilities and hospitals, including Hopkins. Instead of chemical pesticides—many of which are linked to cancer, Parkinson’s, autoimmune disorders, and reproductive dysfunction—the
“Given that our mission is both to keep people healthy and help them heal when they’re unhealthy, it would be a complete contradiction for us to contribute to poor health,” says Barbara Sattler, professor and director of the University of Maryland School of Nursing’s Environmental Health Education Center. program takes a holistic approach to keeping critters such as mice and roaches off the premises in the first place. So far, pest sightings at Hopkins have been cut by 60 percent, Seale says, and spraying has been virtually eliminated. “Pests can carry disease, so pest control is really important. But so is protecting people from unnecessary exposure to pesticide,” says psychotherapist Ruth Berlin, Maryland Pesticide Network’s executive director. Solutions such as this demand a good bit of creative thinking and a passion for questioning the status quo, says Waste Management’s Brannen. “For years, we said, ‘Of course we have to disinfect floors,’” she says. “Then we stopped to think about it.” Today, many hospitals have switched to a general, nontoxic floor cleaner for daily use when patients are present, blasting germs with disinfectant only after a patient is discharged. Sattler compares the mindset to treating a headache: Sure, you could take morphine to knock back the pain, but most of the time Tylenol will do the trick. “The morphine is overkill,” Sattler says. “We began to look for the Tylenol—the most effective, least hazardous approach—throughout the industry.” Not only do such efforts reduce costs associated with dumping hazardous waste, but they also improve employee health and productivity. “The number-one reason people miss work is respiratory illness,” says healthy building materials consultant Jan Stensland, a California-based expert in indoor air quality who helped create green building standards for health care giant Kaiser Permanente. Approximately 16 percent of the U.S. population suffers from asthma, she says. “Any time you can make sure you’ve done your utmost to eliminate [asthma] triggers in the work environment, you help patients and staff, and you help the bottom line.” Stensland has also worked to reduce the use of formaldehyde, a ubiquitous methanol byproduct that features prominently in the manufacture of building materials and cleaning products. “Formaldehyde is a known carcinogen and respiratory irritant,” she says. “In good conscience, how could a health care [organization] assemble a facility with known carcinogens?” Also on her hit list: polyvinyl chloride, or PVC. A component of everything from building materials and water pipes to clothing, upholstery, and IV bags, PVC has been implicated in endocrine disruption, leukemia, and cirrhosis of the liver. Beyond removing health hazards, hospitals should be promoting healthy living, says Louise Mitchell, a physical therapist with a background in nutrition and farming who heads up Maryland H2E’s Healthy Food in Health Care campaign. She serves as a matchmaker, w w w. u r b a n i t e b a l t i m o re . c o m o c t o b e r 0 8
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