As the Medical Waste Manager at Beth Israel Medical Center in New York City for the last 13 years, I’ve pondered this question many times. While working at Beth Israel, I learned a lot not only about medical waste and its environmental impact, but also about medical economics and institutional policy. Reducing medicine’s environmental impact obliges hospitals and health care professionals to make changes in their day-to-day habits. As we all know, change is never easy. But given the rising rates of disease related to environmental toxins, the real question is, can we afford NOT to be environmentally responsible?

Recently, I left Beth Israel to join the Hospitals for a Healthy Environment Program as the Partner Coordinator. In my new role, I am here to assist hospitals and health care clinics in working towards the goals set by the American Hospital Association and the Environmental Protection Agency in their 1998 Memorandum Of Understanding. The goals are to reduce the toxicity and volume of health care waste and to eliminate mercury from health care practice.

This is a tall order. Improving health care’s environmental track record requires a mind shift and a change of culture. We are accustomed to purchasing medical supplies with little thought of the ecological consequences of their manufacture, processing, use, and ultimate disposal. Our society, medicine included, throws a lot of things “away,” and we don’t often reflect on where the waste ends up. Typically, we only begin to take a closer look when regulators show up at the door, or when community activists challenge our choices. But we can no longer claim ignorance: data on the adverse impact of medical waste is readily available and we can’t simply ignore the evidence.

Consider the ironies: we diagnose simple disorders using mercury-containing thermometers or blood pressure units, never considering that once we discard this equipment, the mercury—a toxic metal—will enter the air, water or soil. We treat patients with a plethora of disposable products, never noticing the vast volume of waste, the cost of its removal, or our industry’s share in filling up our nation’s waste disposal sites. We freely use toxic substances that impact the health of ourselves, our patients, and our coworkers through the shared air we breath. Inappropriately discarded needles or improperly handled hazardous medical waste can end up exposing staff to injury or illness. As professionals dedicated to preservation, restoration, and betterment of health, we must do all we can to reduce the adverse impact of our practices. Lack of action may come back to bite us down the road—as a regulatory violation and fine, negative press, injury, or lawsuit.

Recognizing the need for improvement is only half the challenge. The harder part is getting started. While many in health care embrace these ideas in theory, they aren’t sure how to get started or where to find the resources.

When I started doing this work all those years ago, I felt completely alone. Every program we instituted required extensive research, networking and investigation. Making changes still requires a lot of work, but the good news is that you and I are no longer alone. The Hospitals for a Healthy Environment (H2E) Program is here as a resource. H2E’s website offers background on issues such as mercury, laboratory chemicals, green construction, and waste prevention, and provides great methods for sharing information. To health care facilities that sign on as Partners, we offer free monthly teleconferences covering subjects like recycling computers and electronics, water conservation, green building, and managing pharmaceutical waste. H2E’s list serve is an excellent means of sharing information on any medical-environmental issue. Have a question about what do to with disposable compressed gas tanks or mercury-contaminated materials? Want to find out about waterless hand soaps? H2E provides a wealth of practical information, as well as a way to network with like-minded, environmentally conscious health professionals.

The H2E website is: www.h2e-online.org. Through the site you can register as a partner online, sign up for the list serve, educate yourself on the issues, read the Memorandum of Understanding between the EPA and the AHA, and find consultants and vendors who can assist you in your area. Should you have any questions feel free to drop a note to Janet.Brown@h2e-online.org.

Janet Brown is the Partner Coordinator for Hospitals for a Healthy Environment Program, New York, New York. H2E’s goals are to reduce the toxicity and volume of health care waste and to eliminate mercury from health care practice.