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A NATIONAL EFFORT is under way to enlist medical research and health care facilities in programs to conserve energy and control pollution. The move will include medical schools, hospitals, clinical laboratories, and research institutions. A proposal to get professional societies, industry, and government agencies to develop and implement environmental energy conservation and pollution control programs was accepted by a leadership group of members of the Rockville, Md–based National Association of Physicians for the Environment (NAPE) at a meeting last month in Washington, DC. "One seventh of the gross national product of the United States is taken up by health care products and services, yet no organized national effort has been undertaken to involve this massive system in environmental concerns," said John Grupenhoff, PhD, executive vice president of the NAPE, at the Washington meeting. He described the association's move as the "greening" of health care facilities and declared that "pollution prevention is disease prevention." Urgency Impels Effort There is some urgency driving the effort. Representative John Porter (R, Ill) has promised that he will double the current $13-billion budget of the National Institutes of Health (NIH) in the next 5 years. "This will mean much greater activity and therefore an increase in the kinds of waste that can be very damaging to the environment," said Porter in a taped interview played at the Washington meeting. Porter is chair of the Subcommittee on Labor, Health and Human Services, Education and Related Agencies of the House Committee on Appropriations and was a major force behind the 7% increase in the NIH budget for next year. "Wouldn't it be a great irony if the health care industry and the biomedical research community in the United States ignored environmental matters and caused the kind of pollution that can adversely affect the health of our country?" he said. "Obviously, it is a tremendous responsibility on the health care industry and research to take environmental matters into account. I don't think that either health care workers or biomedical researchers put this at a high enough priority. They need to look at the huge effect that their activities have on our economy and on our environment. I think they can begin to do that by focusing on energy efficiency." Porter noted that the NIH has taken the lead in reducing the use of environmentally damaging products, such as mercury, and that during the past 3 years the institutes have saved several million dollars through energy-efficiency programs. "This is an effort that must pervade the entire research community," he said. Porter has been directly involved in establishing a program of energy-efficient lighting in Congress. "I believe that energy efficiency has a great deal to do with environmental protection, and I understand that NAPE is working with the Environmental Protection Agency [EPA] to bring this message home to the health care and research community," he added. Every 10,000 kilowatt-hours of electricity used means the generation of 55 lb of nitrogen oxides, 154 lb of sulfur dioxide, and 15,000 lb of carbon dioxide, according to Michael D. Maves, MD, chair of the council formed by NAPE to address the energy-efficiency issue. Maves is executive vice president of the American Academy of Otolaryngology–Head and Neck Surgery, which is based in Alexandria,Va. He was unable to attend the meeting but said in a prepared statement that, by upgrading facilities, as much as 40% of energy costs could be saved. Previous attempts by the NAPE to develop a broad-scale environmental clean-up program among health facilities failed because some health care organizations decided against joining a physician's organization. However, the groups agreed to participate in a larger coalition that embraces the interests of all health care institutions. National Council Proposed The NAPE's response was to propose a National Council on Health Care and the Environment that would include, in addition to physicians, a broad spectrum of such health professionals as nurses, pharmacists, members of voluntary health groups, public health officials, and medical administrators. This proposal was accepted at the Washington meeting and, if comments from speakers are any guide, the effort has every sign of succeeding. The National Institute of Environmental Health Sciences at the NIH strongly supports the concept, said Samuel H. Wilson, MD, the environmental institute's deputy director. Commenting after the meeting, Wilson said that the NAPE's move is an opportunity to substantially enhance the research environment and health care facilities. "It makes a lot of sense to remove hazards from the research facilities. At the same time, developing a sense of commitment and leadership in this area can have a big benefit throughout society. So I applaud the NAPE initiative, their leadership, and their vision in identifying this approach and this mechanism for enhancing the status and environment of our facilities." E. Lander Medlin, executive vice president of the Association of Higher Education Facilities Officers, also spoke at the meeting. "We have much in common with you, we share a common goal and we are interested in collaborating with NAPE," she said. "We see partnership as a way of working with the biomedical research community in this greening effort." Medlin's organization represents some 3600 universities, colleges, and educational facilities, including all US medical schools, as well as government laboratories and specialized medical facilities. "We have a wonderful opportunity here working with the National Institute of Environmental Health Sciences and with NAPE in an effort to provide pollution prevention and medical waste reduction and to provide for energy-efficient buildings," Medlin said. She pointed out that there is no need for enforcement regulations. "Although there may be exceptions, in general, the cost savings to be made are such that it is no longer difficult to decide to spend funds on conserving energy and reducing pollution. Reducing energy consumption reduces pollution. It also saves money." Medlin cited the results of a case study done in 15 colleges and universities that showed savings of $17 million in just 1 year from energy conservation projects. "If you extrapolate that to 3600 institutions, this translates into billions of dollars of savings," she said. "It is an investment in greening, and it is sound financial management as well." A few days after the NAPE's Washington meeting, the American Hospital Association signed a voluntary agreement with the EPA to reduce the waste generated by hospitals and, specifically, to eliminate mercury from hospital waste by 2005. In discussions during the meeting, hospitals had been criticized for unnecessarily burning their waste, including medical devices that contain mercury. Lynn R. Goldman, MD, the EPA's assistant administrator for prevention, pesticides, and toxic substances, said at the Washington meeting, "We believe that only 2% of hospital waste needs to be incinerated, yet some hospitals are incinerating between 75% and 100% of their waste. We are not yet seeing enough of an effort toward pollution prevention, source reduction, reducing waste at the source rather than incinerating it." Looking Ahead In addition to eliminating mercury, cleaning up laboratory waste material, and increasing energy efficiency, the group plans to take steps to deal with general solid waste, including the disposal of paper, aluminum, plastics, and Styrofoam. Another problem they intend to tackle is the management of hazardous chemical wastes, particularly so-called mixed wastes: chemical wastes combined with radioactive materials. These are expensive to manage and present complex disposal issues, coming as they do under regulation by both the EPA and the Nuclear Regulatory Commission. Longer-range plans include encouraging the development of new alternative technologies for handling hazardous waste and projecting the operational nature and needs of laboratories and clinical facilities a decade from now.
JAMA – American Medical Association
Published: Aug 12, 1998
Keywords: health care facility,mercury,pollution,biomedical research,health personnel,schools, medical,environmental health
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