Our bodies and the planet need a healthier medical system—stat. And they’re getting one
Bad food. Toxic fumes. Not a blade of grass in sight. Welcome to the hospital, the place where you’re
supposed to get well. It’s an odd truth that while grocery chains sell organic products and businesses boast energy-e≈cient skyscrapers, the places where Americans go to heal have traditionally been among the worst offenders when it comes to disposing chemicals, using resources e≈ciently, and providing a healthy environment and diet.
But recent years have seen a quiet yet radical change. A movement to turn hospitals “green”—healthier, more e≈cient, less toxic—is gathering force, and can already boast a host of successes. From the use of nontoxic cleaners to the shuttering of many medical incinerators that once polluted the planet with dangerous chemicals, “we have achieved the tipping point,” says Barbara Sattler, director of the Environmental Healthy Education Center at the University of Maryland.
As community centers open 24/7, hospitals aren’t the easiest places to turn into eco-utopias. Air and surfaces must be kept clean to prevent infections, patients and staΩ need food around the clock, and tons of waste must be disposed of. But as Sattler and other passionate advocates explain it, the greening of our medical system, both within hospital walls and outside them, holds promise for human health and the health of the planet—while illuminating the ways they’re
inextricably linked.
Cleaning Up Hospitals
The irony of unhealthy health care is on full display in hospital eateries. Think of oncology wards full of chemotherapy patients eating processed food, obesity wards with vending machines stocked with candy, and cafeterias serving meat from animals given antibiotics at a time when antibiotic resistance poses a serious threat. No doubt about it, says Laura Brannen, director of Hospitals for a Healthy Environment, an advocacy organization based in Lyme, New Hampshire: “We serve really crappy food.”
There’s a long way to go, but changes have begun to take hold at hospitals large and small. The health-care giant Kaiser Permanente, for instance, serves milk free of the hormone rGBH and has farmers’ markets on its premises and healthier choices in vending machines. Good Shepherd Health Care System, a small hospital in Oregon, serves meat from grass-fed, antibiotic-free animals and only whole-grain breads and pastas. And if you’re a patient at St. Luke’s in Duluth, Minnesota, you can request organic vegetables in your meals. “And you have to go beyond food,” says Brannen. “If you are serving organic coΩee in a polystyrene cup, it doesn’t cut it.” That may mean hospitals rethinking their kitchens. “We are telling them, ‘Sorry, you have to put your dishwashers back,’ ” she adds.
Just as important as healthy food, of course, is clean air—and in hospitals it’s often hard to come by. The bacteria-fighting cleaners so ubiquitous in hospitals, for instance, have a downside, releasing chemicals shown to cause everything from headaches to breathing di≈culties. And patients are not the only ones at risk: A recent study showed that nurses have one of the highest rates of adult asthma.
As it turns out, safer options can be just as eΩective. In 2001, New Jersey’s Hackensack University Medical Center (the nation’s fourth-largest hospital) replaced the usual cleaners with greener alternatives without any rise in infections. What’s more, the staΩ who had sprayed the chemicals stopped reporting headaches and other symptoms once they made the switch. “This is common sense,” says Deirdre Imus, who founded the hospital’s Environmental Center for Oncology. “We need to eliminate exposure to the things that make people sick.”
A less obvious, more insidious threat comes from the widespread use of PVC plastic or vinyl, common in IV bags and tubing. To make such plastic flexible, manufacturers often use a softener made from DEHP, a chemical shown to harm the reproductive systems, livers, kidneys, and lungs in animals. That worried Valerie Briscoe, a neonatal nurse at John Muir Medical Center in Walnut Creek, California, and she spent six months transitioning the facility to alternative materials.
Briscoe’s concerns were confirmed in a 2005 study by the Harvard School of Public Health. Babies in two Boston-area intensive-care units had up to 25 times the amount of DEHP in their systems as the general population. Though the study didn’t detail health eΩects on the babies (and there’s no evidence the chemical harms humans), the FDA now recommends against its use in some medical procedures—another green-hospital victory.
The Planet’s Health
The movement extends far beyond the patient wards and cafeterias, as medical facilities work to minimize their negative impact on the planet. As late as the 1990s, more than 5,000 medical incinerators in the United States burned through millions of tons of waste every year—a practice considered environmentally sound at the time because it reduced the need for landfills. But researchers then discovered that those incinerators burned medical devices made with PVC plastic, creating dioxin, a dangerous toxin used in the infamous herbicide Agent Orange.
“It was so ironic. Hospitals full of cancer patients were pumping out one of the worst carcinogens,” says Stacy Malkan at Health Care Without Harm, an international consortium of hospitals, community groups, and health organizations. Stricter pollution-control regulations along with a public outcry for cleaner air has led to the closure of the majority of medical incinerators over the past decade; only about 100 remain active in the United States. (So worrisome is PVC that Kaiser Permanente is investing billions to replace PVC-laden floors and carpets at its facilities with safer alternatives.)
Of course, when you take incinerators out of commission, landfill contents soar—and they have. Recycling eΩorts are under way, however. StaΩat Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, for example, upped recycling to 38 percent of its waste stream in the past decade, winning kudos from eco-advocates.
Unlike recycling at home, hospitals must sort out dangerous wastes such as mercury, used in thermometers and other equipment. A single splash can contaminate a 20-acre pond, and up to 1 in 10 women in the United States has enough of the potent neurotoxin in her blood to threaten the health of a fetus. Hospitals produced 17 tons of mercury waste from thermometers in 2000 alone—a tenth of the amount generated in the entire country.
Alarmed at the mercury threat, a group of activists, including Hospitals for a Healthy Environment, started a campaign, and today more than 4,000 medical centers have pledged to become mercury-free. For thermometers, there’s even a relatively simple fix: Digital or alcohol-based versions are widely available and are generally as accurate as their toxic counterparts.
A Green Frontier
As with the rest of the green movement, there’s no more ignoring the cause-and-eΩect nature of unhealthy hospitals or putting changes oΩ for the future. “This is the future,” says Imus.
On the green-building front, the Green Guide for Healthcare was launched in 2004 as an educational tool for hospitals wanting to integrate environmental design, construction, and operations principles. “In the past year, I’ve seen an upsurge in the number of hospitals going green,” says Kim Shinn, a consulting engineer in Nashville who works with architectural firms to create healthier medical centers. That means more natural light, more open spaces, and more comfort for patients, visitors, and staff. Behind the scenes, new hospitals have more-e≈cient systems that capture rainwater and automated controls that switch oΩ lighting and electronics when not in use. As it turns out, right action and good business sense can go hand in hand; investing more up front leads to reduced operating costs over time.
What’s next? The pioneers in the green-hospital movement want to transform medical centers into carbon-neutral places that, at the very least, don’t harm the environment. It’s a bold idea—but then, “do no harm” is the first tenet of medicine.