The U.S. Environmental Protection Agency is stepping up its oversight of hospitals and other health-care providers, vowing to keep closer tabs on what it calls a “largely overlooked sector.”
The EPA in June began a series of “outreach” conferences with hospitals and other providers to review environmental-compliance issues. The first meeting was in Philadelphia.
ISO 9001:2026: A Practical Opportunity to Build for What’s Next
For Rhode Island manufacturers, ISO 9001 has been much more than a certificate on the…
Learn More
“I don’t think the details of the (EPA’s health-care) initiative have been flushed out yet, but I think they’ve tipped their hand to health-care providers that they’ll be coming around,” said Jessica A. Graf, an environmental attorney at Nixon Peabody LLP in Boston. Graf received an e-mail alert regarding the EPA’s initiative.
It is unclear whether the EPA’s effort will result in hefty fines against hospitals found in violation of environmental regulations. But some industry observers say the initiative could mirror a similar EPA program that cracked down on university labs in recent years.
That initiative resulted in millions of dollars of fines against U.S. schools, including a reported $500,000 fine against Brown University last fall for allegedly dumping lab chemicals improperly. The University of Rhode Island also paid a hefty EPA fine earlier this year.
It is not a revelation that hospitals are relatively large polluters. The hospital industry nationally is the fourth-largest contributor of mercury to the environment and second-largest dioxin polluter, according to Health Care Without Harm, an international coalition of more than 300 organizations dedicated to reforming the environmental practices of the health-care industry.
“Hospitals are toward the top of the list in terms of polluters,” said Bill Ravanesi, Boston director of Health Care Without Harm.
Hospitals already have tightened their adherence to environmental regulations in recent years, thanks largely to a partnership started in 1998 between the EPA and the American Hospital Administration.
A memorandum of understanding between the two organizations created “Hospitals for a Healthy Environment.” The voluntary agreement aims to eliminate virtually all mercury waste from hospitals by 2005 while trimming overall waste by one-third.
The program has been particularly successful in reducing mercury use in New England hospitals, according to Ravanesi. He added that Maine has been a national leader in the effort to reduce the use of medical supplies and devices that form harmful dioxins when disposed.
“Hospitals in New England have been out front on this (waste-reduction) issue,” Ravanesi said.
The Lifespan health-care network in recent years has cut back its use of mercury thermometers and other mercury-based medical devices such as barometers, according to James Connors, director of environmental services at Rhode Island Hospital, the Miriam Hospital and Bradley Hospital.
The hospitals have stopped buying mercury thermometers, which Connors said accounts for 60 to 70 percent of the mercury waste that hospitals generate.
“We take a comprehensive approach to waste reduction,” Connors said. “It’s not just mercury reduction, but we’re working to reduce our solid-waste and medical-waste streams.”
Recycling is a big component of that effort: Rhode Island Hospital recycled an average of 24 tons of waste each month in 2000, he said.
Large hospitals such as Rhode Island Hospital – many of which already have environmental compliance on their radar screens – are unlikely to see EPA fines under the new initiative, according to Stephen Zubiago, a health-care attorney at the Nixon Peabody office in Providence.
But smaller hospitals with less money to devote to environmental efforts should be careful, he said.
“Environmental compliance is generally very expensive and there are some hospitals that just don’t have the resources to devote to areas that don’t relate directly to patient care,” Zubiago said. “Some hospitals are going to have issue with this, no doubt about it.”
Nixon Peabody is planning workshops for hospitals this fall to review environmental regulations that the EPA might target. Graf recommends hospitals conduct self-audits of their environmental compliance status to avoid fines down the road.
While many New England hospitals have done a good job reducing mercury use and overall waste levels, Ravanesi said little progress has been made – with the exception of Maine – in reducing other “PBTs,” or persistent bioaccumulative toxic chemicals.
PBTs are toxic chemicals that leak into the environment and accumulate in the food chain, posing risks to humans and wildlife.
For example, many plastic hospital supplies – such as catheters, intravenous tubing and blood bags – are made of polyvinyl chloride (PVC), which produce dioxins after they are burned or discarded as waste. Those dioxins and other chemicals then leach into groundwater supplies or, if burned, are released into the air.
While hospitals can spend tens of thousands of dollars on environmental compliance, they will save money in the long run by reducing the amount of hazardous and medical waste they generate, Ravanesi said.
The savings come through decreased disposal costs, which run about $1 a pound for medical waste and between $5 and $20 a pound for hazardous or chemical waste, according to Health Facilities Management magazine.
Beth Israel Medical Center in New York reportedly has saved $600,000 annually through its waste-reduction program.
