How healthy is your hospital?

Why Materials Management Needs to Change

Prevailing practices in health care have become an important source of environmental pollution and potential harm to health. Mercury, other heavy metals, and endocrine disrupters are present in many health care products and threaten the health of patients, workers, and communities. Incineration of medical wastes can produce dioxin1 and disperse this toxin as well as heavy metals into the atmosphere.

Both dioxin and mercury are persistent, bioaccumulative toxins that pose threats to humans and the environment. According to the EPA's 1994 Dioxin Reassessment, the average dioxin level in Americans is now "at or approaching" levels that cause health effects - effects that may include cancer, birth defects, and damage to the immune, neurological, and hormonal systems. Dioxin is formed as a by-product of several processes, including the incineration of wastes containing chlorinated materials such as PVC (polyvinyl chloride, a type of plastic). PVC is used extensively in medical care, especially in disposable products such as intravenous tubing, ID bracelets, and blood bags. Many hospitals incinerate PVC-containing materials and heavy metals, including mercury. Medical waste incinerators thus burn particularly high amounts of PVC and contribute to the presence of dioxin, mercury, and other heavy metals in the environment.

Sustainable Hospitals

Plasticizers, such as phthalates, are used in PVC plastics and are thought to mimic the effects of hormones such as estrogen. These substances have unproven but potentially harmful effects to reproductive systems.

Other materials previously thought to be safe, such as latex, are a growing problem in health care. It has been estimated that 8% to 12% of regularly-exposed health care workers are sensitive to latex. (NIOSH, 1997) [NIOSH Alert: Preventing Allergic Reactions to Natural Rubber Latex in the Workplace. National Institute for Occupational Safety and Health (NIOSH). Cincinnati, Ohio. Publication Number 97-135, June 1997.] Severe reactions to latex, such as shock, are an increasing concern.


1 The term dioxin is used here as a generic term that includes two classes of chemicals: 75 compounds known as chloro dibenzo dioxins, seven of which are highly toxic (including 2,3,7,8 TCDD, possibly the most carcinogenic chemical known) and 135 compounds known as furans, ten of which are highly toxic.