Environmental Progress - Spring 1999

Thinking "Green" Saving Illinois Hospitals Dollars

No-charge technical assistance finds new ways to reduce, recycle waste.

Faced with the combined impacts of new air pollution control requirements for incinerators and rising waste disposal costs, many hospitals are taking a closer look at their waste-generating practices. To help them address the problems, the Illinois EPA's Office of Pollution Prevention and the Illinois Waste Management and Research Center (WMRC) have created a special technical assistance program that helps hospitals save money and reduce their environmental impacts.

At a hospital's request, the two agencies will send trained specialists to conduct a waste management "walk-through" to assess current practices and identify additional opportunities for segregating, reducing and recycling materials found in hospital waste. The walk-throughs are offered at no cost and do not focus on compliance with environmental regulations. Start-up funding for the project was provided by U.S. EPA's Great Lakes National Program Office in Chicago.

The technical assistance project was initiated in the Chicago area. So far, facility waste management walk-throughs have been conducted at seven facilities. Plans are underway to extend the program to downstate facilities.

Special attention focuses on finding alternatives to mercury-using devices

During the site visits, special emphasis is being placed on promoting alternatives to mercury-containing devices and equipment often used in health care settings since mercury is a major pollutant of concern for the Great Lakes Basin. Mercury is found in many health care products and procedures, including thermometers, blood pressure monitoring devices (sphygmomanometers), dental amalgams, gastrointestinal equipment (Cantor tubes and Miller Abbot tubes), tissues fixatives and staining solutions.

For years, many hospitals have relied on on-site incineration facilities to disinfect waste which has the potential to transmit an infectious disease. According to U.S. EPA, hospital incinerators are the fourth largest source of industrial mercury emissions. Once in the air, mercury can circulate or fall to the ground with rain or snow. Deposited in water bodies, mercury can become concentrated in the food chain and damage the health of humans, birds and animals that eat fish.

Though most people tend to think that hospital waste is laden with needles, body parts, blood and bandages, as much as 85 percent is considered non-infectious solid waste. Hospitals generate a mix of solid waste similar to that found in other institutions, as well as waste generated specifically as a result of patient care activities. Paper, plastics, food waste and disposable items are the largest components of this waste stream, which is amenable to the same waste reduction and recycling methods used in homes and offices.

Infectious waste requires more expensive special handling

Infectious waste (sometimes referred to as biomedical and regulated waste) is generally believed to comprise 10-15 percent of hospital waste. It must be discarded in special containers (labeled red bag or sharps containers) and treated more carefully than non-regulated solid waste because of its infectious potential. The disposal of infectious waste can cost as much as 10 times the amount for solid waste handling, with prices ranging from 20-50 cents per pound. Many hospitals are starting to pay closer attention to their waste streams to determine what truly needs special treatment and what doesn't, and how they can more efficiently separate regulated infectious waste from solid waste.

The average is 15 pounds of waste per patient per day.

Overall, it has been estimated that hospitals and other medical facilities such as nursing homes and doctor's offices generate about 1.9 million tons of waste per year. This translates into an average of 15 pounds per patient per day.

In addition to providing ideas on how hospitals can improve their waste segregation, reduction and recycling programs, Illinois EPA and the Illinois WRMC are identifying ways that hospitals can enhance their overall waste management planning efforts, including

• management support (has the hospital's upper management issued a waste management policy statement and set challenging program goals?)
• purchasing policies (does the hospital prevent waste from "coming through the front door" by using supplies and equipment that are less wasteful, non-toxic or recyclable?)
• waste audits (does the hospital regularly evaluate its waste-generating sources and rates?)
• team planning (has a team been formed from different areas of the hospital to help identify waste reduction opportunities?)
• employee training (are hospital employees made aware of their waste management responsibilities and do they have a role in providing waste reduction ideas?)
• program monitoring (does the hospital regularly review its waste management program and identify ways to improve its efforts?)

Waste management planning has much in common with the planning hospitals already do for other aspects of their operations. It can be incorporated in a total quality management program as a focus on increasing operating efficiency. It also builds nicely on health or environmental safety programs because it can reduce environmental exposures of employees. Hospitals that have developed pro-active waste management programs have found that they can reduce waste generation, lower waste disposal/treatment costs, reduce potential liability and improve community relations.

For more information about the availability of the Illinois EPA and Illinois WMRC technical assistance services for hospitals, contact Doug Neidigh at WMRC, 1010 Jorie Blvd, Suite 12, Oak Brook, IL 60523, phone: (630) 472-5024, or email: dneidigh@wmrc.hazard.uic.edu.