Reducing Toxic and Hazardous Waste in the Health Care Community
Products and services containing toxic substances are used in many health care environments on a daily basis. These products and services are often necessary for sanitation, basic aesthetics, or medical purposes. Education on the harm these substances can cause, as well as their sources and healthier alternatives, is needed by health care providers to better equip them with the decision-making power to choose products and services that protect the health of their patients, workers, and the broader community.
Corporate policies specifying which toxic chemicals cannot be used are known as safer chemical policies. Safer chemical policies are becoming increasingly prevalent as organisations realize the harmful effects of many ubiquitous chemicals and opt to use safer, greener products and services.
Funded by Environment and Climate Change Canada – EcoAction Community Funding Program, this two-year clean water initiative will reduce toxic and hazardous waste generated by health care facility operations through the identification, implementation, and evaluation of innovative, toxics-free technologies and chemical use strategies.
Working collaboratively with BC Lower Mainland GreenCare, Ontario’s Chatham-Kent Health Alliance, Synergie Santé Environnement, the Coalition for Healthcare Acquired Infection Reduction, Class 1 Inc., Aqueous Solutions, and Tersano Inc., approximately 250 kilograms of toxics and other hazardous waste will be reduced per year by replacing chemical agents with safer alternatives and implementing systems that reduce or eliminate the need for chemical use.
The results of these pilot efforts will be used to develop comprehensive best practices to strategically reduce chemicals in health care facilities. Webinars, case studies, reports and other outreach materials will be developed based on the key successes and lessons learned and distributed nation-wide to the broader health care community.
Safer Chemicals Past Webinars
Safer Chemicals Webinar
Using safer chemicals and new technologies for green cleaning in health care facilities
April 27th, 2018
Download here or View slides here.
Green Cleaning Articles
Three recently published articles in the American Journal of Infection Control explore the efficacy of non-toxic options for disinfecting surfaces:
- 1. Reduced health care-associated infections in an acute care community hospital using a combination of self-disinfecting copper-impregnated composite hard surfaces and linens
- 2. Evaluating the effectiveness of ultraviolet-C lamps for reducing keyboard contamination in the intensive care unit: A longitudinal analysis
- 3. Evaluation of an ultraviolet C light–emitting device for disinfection of electronic devices
August 2016: Reduction of Hospital Environmental Contamination Using Automatic UV Room Disinfection published in InfectionControl.tips
Endocrine Disrupting Chemicals Webinar
Inventory of Endocrine Disrupting Chemicals in Canadian Neonatal Units
Soigner sans nuire reduire l'exposition aux perturbateurs endocrinens en milieu hospitalier
May 8th, 2018
Download the slides in English here or Watch the webinar in English here.
Download the slides in French here. Or Watch the webinar in French here.
Safer Chemicals Case Studies
Green Cleaning Case Study Overview
Pollution prevention is a growing concern for hospitals. This is a reason for valuing green cleaning (patient, staff and visitors, purchasing, and release of less harmful chemicals). Lower Mainland Health Organizations in British Columbia, Chatham-Kent in Ontario and St. Matha’s in Nova Scotia established pilot project to analyze green cleaning processes on how they could change or improve current cleaning practices.
Case Study Objective
Reduce toxic and hazardous waste generated by health care facility (HCF) operations to water through identifying, evaluation and implementation of innovative green cleaning processes and product use strategies. Minimize waste generated and toxic chemicals used by the health care system and supporting operations through seeking alternative forms of cleaning.
Results from Vancouver Coastal Health and St. Martha’s Hospital
Both St. Matha’s Hospital and Vancouver Coastal Health (VCH) tested Aqueous Ozone systems to reduce levels of waste and harmful chemicals. VCH projected a drastic reduction in use of general cleaners and water use per year. Furthermore, through this pilot project they would also benefit from a reduction in 2, 538 litres per year of harmful chemicals.
Results from Chatham-Kent Hospital
Ultraviolet light (UV) disinfection at Chatham-Kent involved studying 3 key areas in patient rooms. Studies of UV light disinfection displayed that when UV devices were “turned on”, it often displayed a trend towards lower or even a zero-microbe count compared to the “UV Off” condition. Using UV light did not removal all need for conventional cleaning products but largely reduced the amount and lifecycle of harmful microbes in patient rooms.
- Steps taken by various hospitals may include:
- Assessing current practices and inventory products
- Establishing goals
- Testing and review data from pilot project
- Implementation of green cleaning technology in various facilities
- Explore a monitoring and evaluation framework for post green cleaning technology implementation
- Nurturing a green cleaning environment through systems thinking and policy development
Challenges and lessons learned
Green cleaners are new products and often they do not have strong use-histories. Various barriers include the scale and duration of pilot projects impacting results. Having a training period and implementation of new technology is important to gaining full use from green cleaners. The Chatham-Kent pilot project noted that UV disinfection does not remove all need for conventional cleaning practices but may reduce reliance on conventional cleaning products. Furthermore, being price sensitive impacts decisions to adopt green cleaning technology.
The resulted outcome is a reduction in harmful chemicals and other forms of waste. Through technical partnerships, these hospitals have explored options that have less of an environmental impact.
These three hospitals required an understanding of current practices, while seeking and assessing viable alternatives.
Endocrine Disrupting Chemicals Case Study Overview
Endocrine Disrupting Chemicals (EDCs) have a known impact on the development and function of the endocrine system. Newborns are known to be the most vulnerable to the effects of EDCs. Through an evaluation of Pierre Boucher Hospital’s Neonatal Intermediate Care Unit, Synergie Sante Environnment created an inventory of current products containing EDCs.
Case Study Objective
Reduce exposure of guests, patients and staff to suspected Endocrine Disrupting Chemicals (EDCs)
74 products used in Pierre Boucher Hospital’s Neonatal Intermediate Care Unit were listed in the inventory of products. Through research from product labels, contacting suppliers and manufacturers, the results from the inventory included:
- 21 products contain EDCs
- 25 products are EDC free
- 28 products composition is unknown
These action steps are aimed at reducing the amount of products containing EDCs in Neonatal units:
- Target substances of concern
- Perform an inventory on medical equipment
- Find the composition of product materials
- List the equipment to be replaced, define criteria for purchasing new equipment
- Evaluate the functionality of new equipment (by staff)
- Purchase in large quantities if appropriate (Call for tenders)
Through this pilot project, SSE created a list of alternative products to EDCs. EVA, silicone, polyethylene, polyurethane, are alternative products but studies are limited. They recommend that Silicone seems to be the best alternative to EDCs. Removing EDCs from Neonatal units involves communication, sensitization, and taking a participatory approach.
Challenges and lessons learned
Creating a focus is important to eliminating Endocrine Disrupting Chemicals in Neonatal Units. The results of the inventory are limited by the access to information on products from suppliers and manufacturers. There should not be a reduction in quality of products through adopting alternatives. The price of adopting alternatives should be competitive with other products containing EDCs.
It should be noted that the process for hospitals to remove EDCs should be ongoing and involve a variety of departments, suppliers, and manufacturers.
- Engage technical partners to provide innovative technological systems and information on toxics-reduced chemicals for health care.
- Develop background research on best practice strategies for toxics reduction in health care operations.
- Engage partner facilities willing to implement (pilot) new systems and strategies; formalize their organisational commitments to pilot projects.
- Develop implementation plans with partner facilities for introduction of new systems and strategies.
- Establish baselines of chemical purchasing, chemical use, and hazardous waste generation at pilot facilities; develop a standardized evaluation procedure to compare year 2 results to initial baselines.
- Oversee implementation of new systems and strategies (chemical reduction measures) at pilot health care facilities.
- Conduct ongoing mid-project evaluation of toxics reduction achieved by pilot projects (reduction measures); assess findings to determine whether implementation plans can be modified to optimize results.
- Develop best practices and case studies of pilot projects as well as communications strategy for introducing findings to national health care community.
- Complete pilot projects with final evaluation and validation of toxics reductions achieved according to established baselines.
- Perform communications/awareness activities to distribute pilot findings and recommendations to national health care community; assess level of interest in pursuing additional or expanded reductions projects at partner or other facilities.
Performance Indicators/ Results
- Reduction or diversion of kilograms of toxic or harmful waste
- Participants in Activities
- Volunteers participating directly in project
- Jobs Created
Coalition Project Staff:
Kent Waddington, Communications Director – Project Lead
Dan Ritchie – Project Secondary
Linda Varangu, Executive Director – Project Advisor
For further information, contact:
Canadian Coalition for Green Health Care
1-613-720-4889 or firstname.lastname@example.org
This project was undertaken with the financial support of:
Ce projet a été réalisé avec l’appui financier de: