Green Health

The healthcare sector generates millions of tons of waste solid, liquid and gas, including potent pollutants like dioxins (from the incineration of PVC) and mercury. In addition, it uses plastics, paper, lumber and other resources. As a result of these and similar activities, the healthcare sector contributes to the loss of global habitat and biodiversity and the impairment of the health of the world’s ecosystem.

The World Medical Association (WMA) is calling on all its members and on the global health community to adopt an environmentally responsible approach to their activities. Achieving change requires raising awareness and sustained advocacy. This includes making health practice environmentally responsible and greening medical associations.

Making Health Practice Environmentally Responsible

Key facts (Source: WHO, November 2011):

• Of the total amount of waste generated by health-care activities, about 80% is general waste.
• The remaining 20% is considered hazardous material that may be infectious, toxic or radioactive.
• Every year an estimated 16 000 million injections are administered worldwide, but not all of the needles and syringes are properly disposed of afterwards.
• Health-care waste contains potentially harmful microorganisms, which can infect hospital patients, health-care workers and the general public.

There are various ways to make hospitals and clinics environmentally responsible. Some methods include a wiser management of waste, such as limiting waste incineration, recycling non-hazardous wastes responsibly and reducing paper usage with the use of Electronic Medical Records (EMRs). Hospitals and clinics can also be designed and built to make the most efficient use of clean energy and to optimise recycling.

At the micro level in daily medical practice the same principles apply, for example:

• Ensure the most efficient and economic use of hot water heaters
• Use tap water instead of bottled when available
• Ensure recycling bins are available and use recycled paper
• Switch to electric hand dryers in restrooms
• Use only environmentally friendly office cleaning and pest control chemicals
• Reduce the use of mercury-containing equipment such as sphygmomanometers, thermometers, and thermostats
  
• Maintain a consistent pharmaceutical disposal strategy
• Be community leaders and set a good example: carpool or ride bike to work, telecommunicate as much as possible
• Educate patients and staff about the health and environmental benefits of acting green.

Case Studies

Green Nephrology

‘Green Nephrology‘ (Centre for Sustainable Healthcare) in the United Kingdom is a programme to improve the sustainability of kidney care. Set up by the Campaign for Greener Healthcare in response to the call for the NHS to reduce its carbon footprint, the programme funds a Green Nephrology Fellowship, in which a nephrology trainee is seconded to work on climate change mitigation issues within kidney care. The Green Nephrology Programme aims to align the provision of more sustainable health care with higher quality care at lower financial costs.

Korea Society for Green Hospitals

In June of 2013, of the Korea Society for Green Hospitals was launched. It is an organisation devoted to low-carbon growth in medical practice in order to reduce the ecological impact of hospitals within the nation. The Korea Society for Green Hospital also focuses on encouraging Korean hospitals to join international green hospital networks and on preparing efficient launched response plans for the implementation of international green certifications.

Greening Medical Associations

This includes working to reduce the carbon footprint of associations’ supply chain and day-to-day operations. In an effort to move towards green practices, the WMA and its members are committed to developing green working methods and meetings.

For that purpose, the WMA Green Working Group laid down general Green Guidelines:

Travel / Transport

• Explore the use of shared travel / taxi options for WMA members whenever possible.
• Adopt an environmentally sound transport policy, setting targets to reduce staff travel, especially by car and air.
• Encourage the use of public transport and walking for local travel where time constraints allow.
• Encourage the use of cycling where practicable.
• Encourage the use of electronic communications, including video conferencing as alternatives to meetings.

Reducing waste

• Switch to all standard paper from virgin to recycle.
• Switch to electronic communications wherever possible
• Maximise ecological use of computers and other office electronic equipment
• Ensure widespread and systematic use of recycling bins.
• Where offices are renovated, prioritise, green options (movement-sensitive lights, low-flush toilets, heating etc) where possible.
• Maximise energy efficiency, using the best and most cost-effective techniques.
• Explore renewable energy sources.
• Avoid the use of building materials from unsustainable sources, giving preference to timber and wood products from responsibly managed forests.

General issues

‘Staff engagement’ is critical to the success of the policy. Although ultimate responsibility for implementation rests with management, all staff and members have a role in minimising adverse effects on the environment. Offices should ensure compliance with all relevant environmental legislation, and demand the best environmental standards from suppliers.

Monitoring mechanism

Review the office’s carbon footprint by evaluating on a regular basis the cost of paper-usage, electricity, water etc in the office. Appoint one staff member to coordinate the implementation of the proposals.