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December 2000 Circulate to: ____ Safety
____ Infection Control ____ Plant Operations ____ Other OHA/Ohio
EPA Pollution Prevention Partnership Sees Success The first year of the
OHA/Ohio Environmental Protection Agency (EPA) pollution prevention partnership
(P2) saw some significant successes, and the second year promises to see the
fruition of several important projects. The P2 campaign operates with the
general oversight of OHA’s Environmental Policy Committee, chaired by Peg Baird
of Fisher-Titus Medical Center in Norwalk. High points of the first year
included the waste-stream benchmark survey, public recognition of more than 80
participating hospitals, and the introduction of this newsletter. Additionally,
about 40 hospitals were represented at a pollution prevention workshop at the
OHA Summit in April, and about 30 were represented at a more advanced P2
program held at Kings Island Resort in November. Faculty for both programs
included Hollie Shaner and Glenn McRae of CGH Environmental Strategies, Inc.
who were hired as consultants by the Ohio EPA to assist hospitals in
eliminating mercury and reducing pollution. Another achievement was the
development of a hospital pollution prevention home page that links visitors to
other web sites with pollution prevention tools and advice. The page is linked
to the OHA web site, but can be accessed directly by visiting: www.epa.state.oh.us/opp/hospital.html.
OHA also created a P2 contact list to ultimately create either a bulletin board
or listserv for hospitals interested in reducing waste stream volume and making
their organizations "green." All hospitals received a
brochure listing steps necessary to hold a mercury thermometer exchange.
Several hospitals conducted such exchanges with employees, at health fairs or
at county fairs. Contact Stacey Walton, OHA, at 614/221-7614 or staceyw@ohanet.org for a copy of the
publication. Year two in the voluntary
partnership should see the continued publication of this newsletter as well as
the distribution of two important resource guides. The first publication is
intended to help hospitals identify, find replacements for, and dispose of
mercury. Mercury Challenge will allow hospitals to voluntarily identify
a small or broad mercury elimination project—such as replacement of mercury
thermometers—and be recognized by the Ohio EPA when the project is successfully
completed. Such projects might also be used to demonstrate performance
improvement for the Joint Commission on Accreditation of Healthcare
Organizations. The second publication is a
hospital waste management guide for waste minimization and pollution
prevention. The resource examines solid, infectious, hazardous and special
waste streams, and provides ideas for managing each in a cost-effective manner.
The guide should be published by spring. Finally, the Ohio EPA and OHA
hope to work more closely with the metropolitan hospital associations in Akron,
Cincinnati, Cleveland, Dayton and Toledo on ventures such as the Mercury
Challenge. Watch for meeting announcements. Resources
Available for Hospitals to Prepare for Bioterrorism Is your hospital ready for an
attack? Aiming to improve hospitals' level of preparedness for mass casualties,
organizations on both the statewide and national level are making available to
hospitals materials regarding the threat of bioterrorism. On the national level, the
American Hospital Association, with the support of the Office of Emergency
Preparedness, U.S. Department of Health and Human Services, convened an
invitational forum of hospital and government personnel to discuss hospital
preparedness for mass casualty. The forum, held March 8-9 in Chicago, developed
recommendations and strategies regarding community-wide preparedness, staffing,
communications and public policy. Contact Stacey Walton, OHA, 614/221-7614 for
a copy of the full report. The Centers for Disease
Control and Prevention (CDC) also recommends that hospitals have a mass
casualty plan in place. The CDC's Bioterrorism Readiness Plan: A Template
for Healthcare Facilities can be found at www.healthsafetyinfo.com/pdf/bioterrorism.pdf.
Regarding accreditation, the
Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has no
plans to add standards specific to bioterrorism, but its 2001 Emergency
Preparedness standard (EC.1.6) will require hospitals to have a plan identifying
specific procedures in response to a variety of disasters. On the state level, the Ohio
Department of Health's (ODH) Disaster Preparedness and Response Program (DPRP)
and representatives from various state agencies have developed the Ohio
Guidelines, a document to help handle biological threats, such as anthrax.
The document was developed in response to a number of biological threats
occurring in Ohio over the past two years. Ohio Guidelines can be
downloaded from ODH's Web site at www.odh.state.oh.us/ODHPrograms/DisPrep/dp_info.htm.
ODH recommends that hospitals that receive a threatening call consult Ohio
Guidelines and notify their local health department and the ODH Bio-duty Office
at 614/728-3463. For more information, contact DPRP at 614/466-5599. Hospitals
Likely to Benefit From Environmentally Sound Purchasing Does your hospital buy
products that hurt or help the environment? To help hospitals answer that
question, the U.S. Environmental Protection Agency (EPA) and the American
Hospital Association (AHA) created the Environmentally Preferable Purchasing
(EPP) program, designed to encourage hospitals to purchase medical devices and
other goods that are more environmentally sound. The program encourages
hospitals to eliminate mercury and other hazardous materials from their
facilities to reduce the impact on the environment and save money. Examples of EPP initiatives
include replacing mercury sphygmomanometers with aneriod equipment, designing a
mercury thermometer exchange program or implementing a full waste reduction
program. Dunlap Memorial Hospital is one several Ohio hospitals that completed
a successful mercury thermometer exchange program, collecting nearly 200 thermometers
in addition to providing all new mothers with a digital thermometer on
discharge. The following steps, from the
Hospitals for a Healthy Environment EPP "How-to Guide" (which can be
downloaded at www.geocities.com/EPP_how_to_guide/),
may help get your hospital EPP project off the ground: ·
Set up an
interdepartmental EPP team; ·
Evaluate your hospital's
and community's problem areas; ·
Request support from top
management and personnel directly involved in the project; ·
Determine a timeline for
the project; ·
Plan the project with
specific, measurable goals; ·
Assign project
responsibilities and completion dates; and ·
Implement the project. Once completed, it is
important to evaluate the benefit of the project to both your hospital and the
community in addition to sharing the project with the public and patients. For
more information on EPP, consult these resources: ·
American Society for
Healthcare Environmental Services at 312/422-3860 or www.ashes.org; ·
Healthcare EPP
Newsletter at 617/626-1091 or www.state.ma.us/ota/otapubs.htm#eppnet;
and ·
EPA/AHA preferred EPP
vendor list at www.geocities.com/RainForest/Wetlands/7756/EPP1.htm. Effects
of Global Warming Heating Up Just two years ago, in 1998,
the Earth's temperature was the warmest it has been in the past millennium –
and the temperature is only expected to rise into the next. The Intergovernmental Panel
on Climate Control (IPCC), formed jointly by the United Nations Environment
Program and World Meteorological Organization, projects the average global
temperature will increase 2-6 degrees Fahrenheit by 2100 and will increase even
more thereafter. Global warming is problematic because of the overwhelming
possibility that Earth's climate will be forever altered, and not necessarily
for the better. Global warming is caused by
greenhouse gases, which are pollutants that trap in Earth's heat. Greenhouse
gases are produced both naturally and by human activities. Burning fuel such as
coal, oil and gas is the most common man-made cause of global warming. The
possible effects of global warming include more frequent heat waves, which
cause more heat-related death and illness, more frequent floods and droughts,
worsened air pollution, damaged crops and depleted water supply. Additionally,
depletion of the Ozone layer, which allows more harmful ultraviolet radiation
into the atmosphere, can lead to skin cancer, cataracts and suppressed immune
systems in humans. Eventually, the overall cost of health care could increase
if the public health sector is burdened by increases in heat and climate-related
mortality and illness as well as the possibility of increased energy costs. Hospitals can help reduce the
effects of global warming. Take a proactive stance by educating staff, patients
and the community of the risks associated with global warming and the
opportunities to reduce those risks. Help lower energy use by pursuing
machinery and appliances certified by the Environmental Protection Agency's
Energy Star® program. Reduced energy use decreases carbon monoxide (CO2)
emissions into the atmosphere, which also reduces energy bills. Hospitals can
also purchase clean energy technologies such as wind, solar, biomass, small
hydro and co-generation to decrease greenhouse gas emissions. Finally,
hospitals should lead by example. Reduce solid waste, recycle and buy recycled
products. These activities help to stop global climate change by decreasing the
amount of heat-trapping greenhouse gases that are linked to everyday trash.
Providing financial assistance for employees who use public transportation, car
pool or telecommute is another way for hospitals to lead the way in reducing
global warming. For more information on
global warming, visit any of the following Web sites: EPA, www.epa.goc/globalwarming;
IPCC, www.ipcc.ch; U.S. Global Change Research
Program, www.usgcrp.gov; NASA's Goddard
Institute for Space Studies, www.giss.nasa.gov;
or NOAA's National Climatic Data Center, www.ncdc.noaa.gov.
Needlestick
Safety Beneficial to Hospitals With both national and state
legislation requiring the use of safe needle systems, reducing needlestick
injuries has continued to be a high priority for hospitals. Given the Centers
for Disease Control and Prevention estimates that 384,325 needlestick injuries
occur each year in hospitals, which is about 1,000 exposures in hospitals every
day, hospitals need to keep the issue on their radar. The Needlestick Safety and
Prevention Act, H.R. 5178, that was recently signed into law revises
Occupational Safety and Health Administration (OSHA) regulations to require
safer medical devices at OSHA-regulated hospitals. Similarly, a related bill in
Ohio, Senate Bill 183, that requires government hospitals to use safe needle
systems became effective in October. Though hospitals are dedicated to reducing
needlestick injuries among health care workers, they have concerns about cost,
in addition to questions about selecting the best devices to reduce needlestick
injuries. H.R. 5178 is available on the Internet at www.access.gpo.gov and SB
183 can be accessed at www.state.oh.us. Cost is an initial concern.
However, the high cost of needlestick injuries at about $400 for treatment and
testing per injury could far outweigh the cost of training workers to use the
devices or even the cost of the devices themselves. Often, the safety devices
may not be more expensive than conventional devices. One hidden cost that
hospitals should consider when selecting safety devices is the cost of
disposal, storage and other associated costs. These hidden costs can increase
with larger safety devices because more storage space or equipment for disposal
may be required. Overall, a safe hospital environment has benefits that
outweigh the associated costs. Benefits include a greater awareness of the
issue among health care workers, higher reporting of needlestick injuries, and
the creation of a culture of safety, which can lead to higher employee morale
and greater attention to overall safety guidelines. When choosing safety devices,
hospitals should use the PEST system, according to a recent teleconference
"Preventing Needlestick Injuries: The Time is Now," hosted by the
University of Vermont. A PEST safety device is: ·
Passive–The user doesn't have to activate the safety
feature. ·
Easy–Operating should be no more difficult than
conventional safety devices. ·
Simple–There are not a lot of components or assembly
required. ·
Throughout–Once the safety feature is activated, is
should stay activated. Ohio
Hospitals Open Doors to OSHA Two Ohio hospitals are
welcoming the Occupational Safety and Health Administration (OSHA) into their
facilities with open arms. Samaritan Hospital in Ashland
and Lima Memorial Hospital are both members of OSHA's Voluntary Protection
Program (VPP), where qualified applicants who meet all relevant OSHA standards
are removed from the agency's routine scheduled inspections list in exchange
for OSHA's assistance in bringing the facility into compliance. The catch –
OSHA inspectors are allowed on-site anytime. But the overriding benefit is
OSHA's agreement not to levy any penalties against VVP members for
noncompliance issues discovered during the survey. Created
18 years ago, the program has only three total hospital members in the nation,
Samaritan, Lima Memorial and Blake Medical Center in Bradenton, Florida. The
program is designed for organizations with ongoing, comprehensive safety and
health programs already in place. For more information on becoming a VPP
member, contact OSHA's Division of Voluntary Programs at 202/693-2213 or visit
OSHA's Web site at www.osha.gov/oshprogs/vpp/. Nitrile,
Latex Gloves Beat Out Vinyl for Safety As hospitals investigate
alternatives for latex gloves to address the risk of latex allergy among health
care workers and patients, a California study concluded that nitrile gloves
better protect against bloodborne pathogens than vinyl gloves. Researchers graded 800 latex,
800 vinyl and 400 nitrile gloves on a pass-fail system for leaks as defined by
the American Society for Testing and Materials. When tested directly out of the
box, all three types had failure rates between 1 and 5 percent. But when used
during 20 minutes of simulated clinical conditions, latex and nitrile failure
rates remained at that level while vinyl failure rates increased to as high as
61 percent. Researchers concluded that
nitrile and latex gloves are less susceptible to material breakdown and leakage
than vinyl gloves, thus nitrile and latex gloves should be used in high-risk
situations such as exposure to bloodborne pathogens, whereas vinyl gloves should
only be used in nonrigorous, low-risk situations. Also consider that despite
vinyl gloves’ appeal because of low purchase price, incineration of vinyl with
hospital waste may result in the formation of dioxin, a human carcinogen that
is released in the air. Thus nitrile gloves are both more environmentally sound
and more resistant to tearing and chemicals. For more information, visit the
Sustainable Hospitals Project (SHP) Web site at www.uml.edu/centers/LCSP/hospitals/
or contact SHP at 978/934-3386 or shp@uml.edu. Ohio
Says Yes to State Issue 1 By a margin of 53 to 47
percent, Ohioans Nov. 7 voted yes on State Issue 1, which addresses Ohio's
environmental and economic development needs. Now that voters have passed the
issue, the General Assembly will pass implementation legislation to allow the
Clean Ohio Fund to invest $400 million from the sale of bonds to improve Ohio's
environment. Issue 1 allocates $200 million to cleanups of contaminated urban
sites, commonly called brownfields, and $200 million to fund conversation
programs, create and protect greenspace, clean streams, enhance recreational
trails and preserve farmland. OHA's Environmental Policy Committee supports the
passage of State Issue 1. Special
Thanks to Pollution Prevention Program Attendees EnviroNews would like to
thank attendees representing hospitals at the Pollution Prevention Program held
at Kings Island Resort in Cincinnati Nov. 1. Dave Armstrong, Mount Carmel St. Ann's, Westerville Keith Dempsey, St. Charles Mercy Hospital, Oregon Raymond Druss, Marietta Memorial Hospital Dorothy Elsaesser, Children's Hospital Medical Center,
Cincinnati Jim Faze, Middletown Regional Hospital Jennifer Fisher, Grady Memorial Hospital, Delaware Gregory Freistuhler, Wilson Memorial Hospital, Sidney Thomas E. Griggs, Salem Community Hospital Paul Hicks, Mercy Hospital of Willard Mary Ann Hudak, The MetroHealth System, Cleveland Mike Hurd, Fulton County Health Center, Wauseon Eric King, Genesis Healthcare System, Zanesville Danny McCloud, Kettering Medical Center Lisa Meyer, Fisher-Titus Medical Center, Norwalk Kent Meyers, St. Charles Mercy Hospital, Oregon JoAnn Mungo, Massillon Community Hospital Tom Neel, The Children's Medical Center, Dayton Curtis Sourwine, Dunlap Memorial Hospital, Orrville Gary Taylor, Shriners Hospitals for Children,
Lancaster Tim Temple, Bucyrus Community Hospital Rick Wilkins, Fairfield Medical Center, Lancaster Thomas Wohlers, Fisher-Titus Medical Center, Norwalk |
