Go green!

Congress creates guidelines for EU hospitals

Austria - A call for the EU and national governments to establish and extend a legal framework for environmental standards in society and healthcare facilities was made by the organisers of `CleanMed Europe´, the first European conference to focus on sustainable healthcare products and practices.

Addressing the gathering, Cesta Hrdinka, Executive Director of Health Care Without Harm Europe, stressed that the European healthcare sector should play a leading role in the use of environmentally safe products and technologies, and that healthcare professionals have taken an oath to ‘do no harm’, which means one of their core tasks is to protect the public from materials and procedures that cause adverse effects on the environment.

Accordingly, during the event, European healthcare experts drafted guidelines, the Vienna Declaration of Environmental Standards for Healthcare Facilities, urging the  
 Introduction of environmental protection standards
 Substitution of potentially dangerous materials and unnatural compounds, such as PVC (polyvinyl chloride), persistent toxic chemicals or heavy metals, with ones fitting into the natural materials cycles (break down easily in nature)
 Use of organically grown and fair-traded food
 Use of energy generated from renewable sources
 Efficient use of all resources
 Reduced use of disposable items as far as possible
 Reuse of medical products as far as possible
 Application of ecologically sound practices in the construction and renovation of healthcare facilities
 Preservation of green areas
 Information for staff, patients and the public on environmental aspects and activities
 Development of a comprehensive environmental policy and environment management programmes.

Waste management saves costs
It was pointed out that the most important cost-cutting measure is to prevent and reduce the amount of waste through careful handling and consumption of products, energy and water.  For example, the Austrian healthcare system, with over 300 hospitals, produces 80-100 million kilograms of waste annually. About a quarter of this is packing material and non-reusable products. The Austrian hospital in Tulln - the first hospital worldwide with an officially certified environmental management system (EMS) - has saved over 400,000 Euros since its implementation. The calculated potential savings for hospitals in the Vienna Hospital Association could amount to 10 million Euros - without any impairment of quality care - indeed, in many cases improving it, according to CleanMed.

Speaking on waste minimisation schemes in hospitals and laboratories, Harry Oosterbeek, of Valkensward, Netherlands, pointed out that systems exist to test for aerobic and anaerobic bacteria using one and the same test tube, enabling cost reductions of 90%, and waste by 50%.

Findings from several studies have shown that hospital disinfection measures often go far beyond what is actually required. Professor Franz Daschner, head of the institute for environmental medicine and hospital epidemiology, at Freiburg University Clinic, pointed out that surgical instruments are now usually disinfected thermally, leading to annual savings of around 32,000 euros - and 2.7 tonnes less disinfectant solution in waste water. Even more lucrative was the clinic’s decision to centralise the preparation of all zytostatica at the main pharmacy, which led to improvements in workers safety; a reduction in waste generated in the consumption of active substances, and of one-way items, which led to a 1.2 million euros saving in a year.

Costs incurred for a water supply plus the treatment of waste water can be saved, as demonstrated in a pilot project carried out by the Styrian hospital association (KAGes). Over the past five years renovating the water pipe system, installing water meters and regulators as well as centralised, water-saving equipment have been a major focus there, along with raising awareness about the issues. ‘This enabled us to reduce our consumption of water by 30% from 1999 to 2003 and save up to 400,000 euros in water and sewage charges on an annual basis since 1999’, said Dr Birgit Nipitsch, KAGes central environmental coordinator.

The actual potential for environmentally beneficial cost-cutting has been calculated by Professor Bruno Klausbruckner, environmental director at the Vienna Hospital Association, who said that, via the use of environmental management systems, improved waste separation and the optimised use of detergents and cleaning agents, some 8.5 million euros could be saved annually, as well as thousands of tons of unnecessary waste and harmful substances.

It was also emphasised at the congress that professionals play a key role in developing an ecologically sustainable healthcare system, particularly nurses, due to their detailed knowledge of how medical systems work and can be improved.

Best Practice Awards
CleanMed Europe awarded several hospitals across Europe for successfully piloting important environmental practice and model projects. These included the Skane region of Sweden, for their eco-procurement initiative; Mürzzuschlag (Styria) hospital, for its overall environmental strategy, and particularly for reducing food waste; the Vienna Hospital Association, for its long-term strategy to phase out PVC; Vienna’s Preyer hospital for children, for its environmental management system, and the Lainz hospital (Vienna) for its laundry reduction programme.

Many of the 40+ projects presented at the poster exhibition clearly demonstrated considerable economic benefits of environmental projects. The Vienna Hospital association estimates that German and Austrian hospitals could save up to 364 million euros through optimised laundry treatment, replacement of mineral with tap water, optimised waste separation and optimised used of cleaning and washing agents.

Dr Ake Wennmalm, Environmental Director of the Stockholm County Council underlined the fact that pharmaceutical products can seriously harm the environment. To protect the quality of drinking water, the industry must develop pharmaceuticals that are safe and biodegradable, he pointed out. 
‘The congress has shown the high quality of environmental protection programmes in Austria and all around Europe and the passion of the people engaged in these activities,’ said Bruno Klausbruckner, Environmental Director of the Vienna Hospital Association. ‘These projects not only reduce the environmental burdens from healthcare facilities but also provide other benefits such as cost savings, improved worker safety or better procedures.’

Organised by the Vienna Institute for Sustainable Healthcare, with the Vienna Hospital Association and HealthCare Without Harm, the event drew more than 300 participants from 28 countries, who represented a wide range of healthcare sectors, e.g. hospitals within the Vienna Hospital Association; manufacturers of healthcare products and numerous organisations such as Health Care Without Harm, the International Council of Nurses, the World Health Organisation, the Health Promoting Hospitals Network, European Environmental Agency, and the UNIDO. 30 exhibitors also displayed ‘green’ products and services, including organically grown and fair traded food.
Contacts: www.cleanmed.org; Institute for Sustainable Healthcare: www.inges.org. Health Care Without Harm: www.noharm.org.


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