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Summer 2001 Circulate to: ____
Support Services ____ Safety ____
Infection Control ____ Plant Operations ____
Other Improving Environmental Performance This newsletter is dedicated to helping you understand your hospitals' environmental performance and developing a plan to improve it. This includes examining product purchasing, policies and practices, waste management, energy conservation and water conservation. The U.S. Environmental Protection Agency (EPA) is responsible for regulating outdoor air, water and waste. You may have heard of the Clean Air Act and the Clean Water Act. But have your heard about RCRA, the Resource Conservation and Recovery Act? Many regulations designed to afford a measure of protection for the environment stem from these acts. Every hospital has obligations to meet regulatory requirements under these various acts. Things such as wastewater emissions, air emissions and hazardous wastes are examples of aspects of your facility's operations that must meet specific criteria. Hospitals are vital institutions in most communities and support a number of important functions ranging from basic health care services, to emergency care and outreach programs. The very nature of hospital organizations require that they consume enormous amounts of resources including water, energy and natural resources. To learn how to optimize your organization's use of resources and implement resource conservation programs, read on and visit the following web sites. There are many federal programs available that offer technical support and other resources to participants. RCRA Online (http://www.epa.gov/epaoswer/hotline/rmods.htm) RCRA is the Resource Conservation and Recovery Act, which was enacted by Congress in 1976. RCRA's primary goals are to protect human health and the environment from the potential hazards of waste disposal, to conserve energy and natural resources, to reduce the amount of waste generated and to ensure that wastes are managed in an environmentally sound manner. The RCRA hazardous waste program regulates commercial businesses as well as federal, state and local government facilities that generate, transport, treat, store or dispose of hazardous waste. Each of these entities is regulated to ensure proper management of hazardous waste from the moment it is generated until its ultimate disposal or destruction. All hospitals are generators of some hazardous wastes that have to be properly managed and reported under RCRA. State environmental regulators manage the hazardous waste programs. Most states have pollution prevention divisions that offer direct technical assistance to waste generators. For a general understanding of your organization’s obligations under RCRA, check out the on-line learning modules. These modules describe the basic federal requirements and programs. Check with the Ohio Environmental Protection Agency to learn about any state-specific requirements. WasteWise (http://www.epa.gov/wastewise/index.htm) WasteWise is a free, voluntary EPA program through which organizations eliminate costly municipal solid waste, benefiting their bottom line and the environment. WasteWise is a flexible program that allows partners to design their own solid waste reduction programs tailored to their needs. Your organization can benefit from joining WasteWise. Waste reduction makes good business sense because it can save your organization money through reduced purchasing and waste disposal costs. WasteWise provides free technical assistance to help you develop, implement and measure your waste reduction activities. WasteWise offers publicity to organizations that are successful in reducing waste through EPA publications, case studies and national and regional events. These events also provide networking opportunities for organizations to share waste reduction ideas and success stories. Interested in learning more or considering joining
WasteWise? Call the WasteWise Helpline at 1-800-EPA-WISE. ClimateWise ClimateWise, a unique government-industry partnership sponsored by the U.S. Environmental Protection Agency (EPA) with technical support from the U.S. Department of Energy, helps businesses turn energy efficiency and environmental performance into a corporate asset. That's right: What's good for business is good for the environment, too! ClimateWise, a voluntary program, was designed to help the United States honor its international commitment to reducing greenhouse gas emissions to 1990 levels by the year 2000. Climate change prevention measures can continue to be a prime focus of international negotiations in the future. ClimateWise can help strategically position businesses, putting them in step with these evolving global trends. Companies participating in ClimateWise are finding that improving energy efficiency and reducing greenhouse gas emissions save them money and boost productivity. Becoming a partner is easy. To join, companies complete a one-page partnership agreement; submit a ClimateWise Action Plan within six months that identifies specific cost-effective energy efficiency and pollution prevention measures; and report results annually while striving for continuous improvement. In return, participants in the ClimateWise program receive EPA help in identifying actions that both save energy and reduce costs. For example, ClimateWise partners receive an innovative action plan development software program that provides more than 50 case studies, a list of proven energy efficiency technologies and tools to quantify the results of their actions. Also, ClimateWise companies can receive access to free pollution prevention and energy efficiency assessments. In addition, companies receive public recognition for their efforts. Many communities have established Climate Protection Task Forces. Your hospital's participation in these programs can send a powerful signal to your community that the hospital is committed to community environmental health. Water Conservation - WAVE
Program (http://www.epa.gov/owm/genwave.htm) Hospitals use thousands of gallons of water each day. How many toilets, sinks, dishwashers and showers are present at your facility? Does your facility have a laundry? Radiology department? Physical therapy unit, groundskeeping program and interior fountains? There are many ways to look at minimizing use of water and practicing conservation. First, it is helpful to determine current water usage. Check with your city water authority for data on current water usage. Next, consider opportunities for improving efficiency of water usage. Some examples to explore include:
WAVE (Water Alliances for Voluntary Efficiency) is a non-regulatory water-efficiency partnership created and supported by the U.S. EPA. WAVE's mission is to encourage commercial businesses and institutions to reduce water consumption while increasing efficiency, profitability and competitiveness. New members sign a Memorandum of Understanding (MOU), agreeing to survey water-using equipment and - where profitable - install water-efficient upgrades within a pre-arranged time frame. Members also agree to design all new facilities with water-efficient equipment. Progress reports and program results are reported to the EPA. The EPA is committed to helping all WAVE members publicize their water-efficiency programs. Support includes: nationwide public service advertising; in-room promotional materials; press releases and public appearances. Members also receive FREE water-use analysis software, technical support and access to a nationwide help line. Water-efficiency measures, like those proposed by WAVE, can reduce water and sewer costs by up to 30 percent. Significant savings in energy, chemical and maintenance expenses are also possible. The typical payback period is less than 3 years. How do I join? For more information, please contact: WAVE
Program Director, U.S. EPA, 1200 Pennsylvania Avenue N.W., Mail Stop 4204M,
Washington, DC 20460. Or call (202) 564-0623 or 564-0624. Fax: (202) 501-2396.
E-mail: flowers.john@epa.gov or martin.valerie@epa.gov. More on Water
Conservation and Efficiency Water Recycling Benefits: http://www.epa.gov/region9/water/recycling/index.html High Efficiency Toilets: http://www.epa.gov/owm/toilets.htm Energy Conservation Energy Facts
In many communities, hospitals are among the largest consumers of energy resources. This is in part due to the tremendous energy demand for maintaining HVAC systems, energy-intensive medical devices and equipment and lighting. There are a number of changes that can be made to minimize energy demand and consumption. Some of these include:
Transportation One in every nine persons in the United States is employed in a health care-related field. That represents an enormous health care workforce traveling to and from work each day. For every mile driven in a fossil fuel-powered vehicle, nearly a pound of air pollution is created. This section lists several interesting Web sites and other information that could assist your facility to reduce air pollution associated with transportation. How Much Do You
Really Know About Transportation and Environmental Issues? Take the
Environmental Quiz! Consider that every employee must get to work, every patient and family member visiting must have a means of transport to get to the hospital. How accessible is your hospital? Are private single occupancy vehicles the only way to get there? Is your facility accessible by public transportation? How many staff and patients utilize public transit to reach your site? What incentives are provided to encourage people to take public transit, car pool, ride share, etc.? Has your organization begun to explore the use of alternative transportation? Electric cars, fuel cell vehicles, bio-diesel and other modes of fueling vehicles are emerging and available technologies. Have you considered 'greening' your organization's fleet? Have you considered sponsoring a walk to work, bike to work or carpool to work day and celebrating your employees' efficiencies? Many of the emissions from automobiles are responsible for the climate change problems that are currently happening worldwide. Each organization can take steps and organize efforts to begin to reduce your facilities CO2 emissions and improve the microclimate and macroclimate of your community. Consider how supplies are delivered to your site. Are supplies delivered daily to a warehouse and then shuttled to your campus, or are you ordering ahead and minimizing the frequency of deliveries? Engaging in resource conservation is a community benefit, as the new activities your facility undertakes will improve the environment of your community. Environmental conditions are closely linked to human health. Ever Wonder How
'Green' Your Vehicle REALLY is? http://www.epa.gov/autoemissions Green Vehicle
Guide available on line. Why Participate in These Programs? Why should your hospital participate in any of these programs? With all that hospital managers have to do in today's hectic and fast changing health care environment, signing on to another program that you will have to manage may seem to be an additional burden you can live without. Yet, a number of hospitals are participating. The reasons they give for joining up include: 1. Official recognition for many efforts that they would do regardless of joining the program. Recognition of a hospital's commitment to environmental health and the well being of their community is a valuable asset. 2. Specific technical assistance and aids such as software to help assess options and track results. 3. It's FREE! 4. Participation in these programs give hospitals an opportunity to measure their efforts against other hospitals and industries to see how they are doing and what other opportunities are available to them. This can lead to well-informed choices that provide positive public relations and real and sustainable cost savings for operations. We Recover Silver From Wastewater in Radiology, But Are
We "Keeping Score"? Silver is a heavy metal that is regulated under RCRA. Silver
is generated primarily in radiology as it is a component to fixer/developer
solutions and an ingredient in x-ray film.
Silver has the capacity to disrupt ecosystems if too much of it gets
discharged in wastewater. Facilities that process film of any sort should keep
their wastewater emissions to less than 5 PPM. Installation of a silver recovery
unit in the line of the wastewater system serves to recover the majority of
silver emissions. There are several processes that recover the silver. These
include electrostatic and ion exchange recovery methods. Many companies exist
to service radiology units within hospitals. Be sure and list silver recovery
on your facility's list of pollution prevention initiatives. A number of hospitals are now starting to evaluate or employ digital imaging systems that are "waterless," reducing wastes and the necessity to manage them. Is this on your hospital's checklist of improvements? Premarket Guidance: Single-Use Devices The Food and Drug Administration (FDA) announced the availability of the draft guidance entitled “Premarket Guidance: Reprocessing and Reuse of Single-Use Devices; Draft Guidance for Industry and FDA Staff.” Submit written requests for single copies on a 3.5” diskette
of the draft guidance document to the Division of Small Manufacturers
Assistance (HFZ-220), Center for Devices and Radiological Health, Food and Drug
Administration, 1350 Piccard Dr., Rockville, MD 20850. Send two self-addressed
adhesive labels to assist that office in processing your request, or fax your
request to 301/443-8818. End to Mercury Thermometers Urged The American Academy of Pediatrics says doctors and parents should stop using mercury thermometers, a once-ubiquitous household item that is already on its way to the medical junkyard. Alternatives such as digital thermometers are widely available. If mercury thermometers are broken, the vapors can be absorbed by the body. In addition, burning and other inadequate disposal of the thermometers can release mercury into streams. Long-term exposure to mercury can cause neurological damage in children. Mercury-contaminated fish can cause fetal damage if eaten by pregnant women. The academy's recommendation was reported in the July issue of its journal, Pediatrics. Several cities and hospitals have banned mercury thermometers and some major store chains have stopped selling them, but "there's a lot of them in medicine cabinets," said Alexis Cain, a scientist with the Environmental Protection Agency. "Having a doctors group say we can do without this" is helpful. But he said parents should take their mercury thermometers to a hazardous-waste collection center instead of throwing them in the trash. FDA Approves New, Disposable
Needle-Free Shot The Food and Drug Administration approved a new disposable device that uses jet injection instead of a needle to deliver medications. Device manufacturer Equidyne Corp. said yesterday that the disposable device, Injex, transmits drugs through the skin with a high-pressure stream of liquid. According to Equidyne, the injection is painless, taking less than a second, and removes the risk of needlestick injury along with the difficulty and cost of disposal. Drug therapies administered by patients at home and delivering certain subcutaneous vaccines are among its possible uses. The company said it will begin manufacturing the product in the U.S. once a license and supply agreement is signed. August 8 Pollution Prevention Seminar On August 8, the Ohio Hospital Association and the Ohio EPA Office of Pollution Prevention are presenting a pollution prevention (P2) seminar entitled “Our Waste, Our Responsibility: Understanding Hazardous Waste Management in Health Care” in Columbus. Space is limited for this one-day seminar, so please pre-register by calling Stacey Walton at OHA (614/221-7614) to request a registration form. There is a $25 registration fee and lunch will be provided, along with a 100-page P2 Guide. Below you will find a tentative agenda for the program. August 8 Pollution
Prevention Seminar Tentative Agenda 9:30 am Opening & Logistics 9:45 am P2 Overview & Stories from the Field Introduction to pollution
prevention opportunities in health care settings. Presentation explores
specific hazardous materials used in different departments within a hospital
and demonstrates pollution prevention approaches. Stories from the field illustrate
the pitfalls to avoid and opportunities to seize! This presentation can help
your facility address the JCAHO standards for the environment of care. Hollie Shaner RN, MSA and Glenn
McRae 10:45 Break 11:00 MERCURY: Understanding the Silver Stuff Dave Heinlein, Safety and
Health Coordinator, Bowling Green State
University, shares his research and knowledge on mercury. Develop an
appreciation for the hazards and issues associated with mercury. Few in health
care recognize this “silver stuff” as a health and environmental hazard. (Many
people report ‘playing’ with mercury as a child.) Participants can expect to
deepen their understanding of the health hazards and become proficient in
talking points necessary to expedite the phase out of mercury-containing
products in your facility. Come prepared with a full working knowledge of your
facility’s current policies and approaches to mercury management. 11: 30 The
Alphabet Soup of Regulations – Do You Know
Your Environmental ABC’S? (RCRA, DOT, LT90, SQG, LQG, CESQG, TSDF,
POTW, CAA, CWA, OFFERORS, UST, SPCC,
EPCRA, PPM, CFR, SARA, TSCA, CERCLA, NESHAP, FWPCA, NPDES, HTMA, NEPA) This session introduces participants to
a host of environmental regulations
health care organizations need to be in full compliance with. 12:15 Lunch 1:00 Breakout Sessions: Key Tools for Successful Environmental Management A) Mercury Challenge B) Not About Red Bags 1:45 Breakout Sessions: Key Tools for Successful Environmental Management A) Mercury Challenge B) Not About Red Bags 2:30 Wrap up: Setting Priorities for Your Facility Coaching your team, bringing it
home. This is your opportunity to work with the workshop organizers to
determine what you will do tomorrow back at your facility. What are the key leadership initiatives that
can be put into place so that your facility understands the rules and
opportunities in order that your actions in environmental management occur as
proactive, cost-effective measures and NOT as a result of fines, citations or
incidents threatening the health of workers. 3:30 Q&A, Evaluations |
