Ten-Plus Years (And as Many Analogies) in Healthcare Sustainability

A journey, a path, a garden, a book—these are all words commonly used to analogize the progression toward environmental excellence. Whatever the vehicle used to get there, the path taken is composed of increments (rungs, steps, chapters, ingredients). This column will highlight some of the signposts our sector has planted along the way (hard to avoid that road theme) as well as two health systems—Kaiser Permanente (see a PDF of Kaiser Permanente's Road to Sustainability at the bottom of this page) and Catholic Healthcare West—and the respective steps they took on their sustainability journey (Oh, I keep stepping on analogies!). In honor of these visual cues, let’s get off our bike, ladder, road, boat, or garden for a minute to reflect on how far we’ve come. 

1980s

1987—Medical waste washes up on eastern shores, prompting negative media attention and fear.

1988—The Environmental Protection Agency (EPA) Medical Waste Tracking Act requires eastern states to red bag certain waste based on perceived, not actual, risk.

1988—The Intergovernmental Panel on Climate Change is established to, among other things, prepare comprehensive assessment reports about the state of scientific, technical, and socioeconomic knowledge on climate change, its causes, potential impacts, and response strategies. 

1990s

1990—The Association for Operating Room Nurses publishes its “Statement on the Protection of the Environment.”

1992—Physicians for Social Responsibility expands its mission to apply its medical expertise to environmental health issues, in recognition that global climate change and toxic pollution also pose grave risks to human health.

1993—The Center for Health Design (CHD) forms.

1993—The American Hospital Association’s (AHA) “An Ounce of Prevention: Waste Reduction Strategies for Health Care Facilities” is published.

1994—An EPA Dioxin Assessment identifies incinerators as a dioxin source, due to burning of chlorinated plastics.

1996—The American Public Health Association passes a resolution on the prevention of dioxin generation from PVC plastic in healthcare.

1996—“Our Stolen Future” by Theo Colborn, Dianne Dumanoski, and John Peterson Myers examines certain synthetic chemicals and how they interfere with hormonal messages involved in the control of growth and development, especially in the fetus.

1996—Health Care Without Harm (HCWH) forms.

1997—EPA Mercury Study Report to Congress documents medical waste incinerators as a major source of mercury in the environment.

1997—“Living Downstream: An Ecologist’s Personal Investigation of Cancer and the Environment” by Sandra Steingraber is published.

1998—The Sustainable Hospitals Program at the University of Massachusetts Lowell pro­vides science-based technical guidance to the healthcare industry for selecting products and practices that promote occupational and environmental health and safety.

1998—EPA and AHA’s Hospitals for a Healthy Environment Program is kicked off.

1998—The Wingspread Consensus Statement on the Precautionary Principle is created.

1998—The U.S. Green Building Council (USGBC) and LEED rating system starts.

1998—The AHA and the EPA sign a Memorandum of Understanding asking hospitals to voluntarily eliminate mercury and other persistent chemicals, and to reduce waste volume.

1999—HCWH petitions the U.S. Food and Drug Administration to label medical devices that leach phthalate plasticizers and to establish a program to promote alternatives. 

2000s

2000—CHD launches its Pebble Project.