How Health Care Without Harm Began
Health Care Without Harm began in 1996 after the U.S. Environmental Protection Agency identified medical waste incineration as the leading source of dioxin emissions, one of the most potent carcinogens, as well as responsible for a large percentage of mercury pollution. At that time, emerging environmental health research was documenting that low doses of persistent chemicals could damage the health of the developing child both in the womb and in first critical few years of childhood.
In response to this serious problem, 28 organizations came together in California to form the coalition Health Care Without Harm (HCWH). We believe that given the mission of healthcare to “first, do no harm”, the healthcare industry has a moral and mission-related responsibility to address its own environmental footprint as well as become leaders in society in supporting a sustainable economy and healthy communities.
Since its founding, HCWH has grown into a broad-based international coalition of hundreds of organizations and thousands of hospitals and health partners in more than 50 countries, with offices in Reston (Virginia), Brussels, Buenos Aires and Manila and strategic partners located on every continent.
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For two decades, Health Care Without Harm has had a significant impact on major health systems, health ministries, health care workers, medical device manufacturers, group purchasing organizations and environmental policy. Here is a look back at some major achievements of the past 18 years:
- Climate Change and Public Health: HCWH has played a leading role in rebranding climate change as a public health issue and working with the healthcare sector to “lead by example” in reducing their carbon footprint and beginning the transition to renewable energy sources and other low carbon solutions.
- Medical Waste: More than 4,500 medical waste incinerators have closed in the United States, and hundreds have closed across Europe, as many hospitals have switched to safer, non-burn waste treatment technologies that are safer and cost effective. The Philippines passed a national ban on incineration. Globally, HCWH has worked with the United Nations Development Programme and the World Health Organization to demonstrate the efficacy of non-burn medical waste treatment technologies and has developed training programs on medical waste management for hospitals and clinics all over the world.
- Medical Waste in Vaccination Programs: In a first-of-its-kind demonstration in the world, HCWH partnered with the Philippine Department of Health in 2004 to provide measles vaccines to 18 million children and safely dispose of vaccination syringes without polluting the air by burning them.
- Mercury: The market for mercury thermometers has been virtually eliminated in the US, as almost all hospitals and all major pharmacies have switched to safer non-mercury devices. Twenty states in the US have passed laws to ban or limit the sale of mercury-containing medical devices. The European Union has banned both mercury thermometers and blood pressure devices. Under the Minamata Treaty, signed in October 2013 and entered into force in August 2017, mercury-based measuring devices will be phased out of global production and use by 2020.
- Environmentally Preferable Purchasing: The top group purchasing organizations in the US – representing more than 70% of buying power for the nation’s health care industry - have committed to take mercury products off contract, list DEHP-free/PVC-free medical devices in catalogues, identify products that contain brominated flame retardants, and educate their customers about environmentally preferable purchasing. HCWH is also working in Europe and in international forums to support large scale environmental purchasing to drive the market to a broad set of safer chemicals, healthier products and innovative technologies.
- Toxic Chemicals and Plastics: Major hospital systems are phasing out PVC medical devices due to health concerns, after the US Food and Drug Administration, European Union and a Health Canada expert panel warned that phthalates leaching out of the devices may harm some patients. The world’s leading medical device manufacturers have pledged to develop PVC-free product lines. The health care industry’s demand for non-toxic products has driven the innovation of PVC-free flooring and wall protection products, and has driven down the price of latex-free, vinyl-free nitrile gloves. More than 50 medical societies, cities and states have passed resolutions to reduce PVC, dioxin, mercury or medical waste incineration. Similar momentum is happening across Europe.
- Safer Chemicals Policy: With support of health care professionals and institutions across Europe, the European Union passed a major reform of chemicals policy, which will provide health and safety data for thousands of chemicals and help move the market toward safer alternatives. HCWH is working to embed a similar framework into chemical policy in the United States, medical device directives in Europe and environmental purchasing strategies through major health systems and the United Nations system.
- Healthy Food in Health Care: HCWH developed a program to transform the food purchasing practices of healthcare in support of sustainable agriculture and healthier food for patients and healthcare employees. In the United States, over 450 hospitals are changing their food purchasing practices in the following ways: supporting farmer’s markets on their grounds, buying local and sustainable food, linking healthier food practices with employee and community health, buying antibiotic-free meat, setting up organic farms, running cooking classes, and many other innovative programs to link healthy food with basic clinical care. Similar strategies are being deployed by hospitals and health systems all around the world.
- Green Building: HCWH and other partners developed the first health-based green building system for hospitals, the Green Guide for Health Care, which became the catalyst and foundation for the U.S. Green Building Council's LEED for Healthcare. Over 265 major healthcare projects, representing over 40 million square feet of healthcare construction, have adopted the GGHC as their framework for design and construction.
- Clinicians as Champions of Change: HCWH has organized nurses to be leading advocates for environmental responsibility in the health care industry as well as advocates for environmental health policy. Read about nurses who are driving change in their facilities via The Luminary Project. HCWH has also developed educational and advocacy strategies for doctors and nurses on climate change and public health issues and bringing health professionals into the public health debate about the future of coal and other polluting fossil fuels.
- CleanMed Conference: HCWH’s flagship event, CleanMed, has become the world’s largest health care conference on environmentally preferable medical products and green building. The event is held annually in the United States and Europe.
- Healthier Hospitals Initiative: HCWH, Practice Greenhealth and the Center for Health Design joined together with leading hospital systems in the U.S. to form the Healthier Hospitals Initiative, a sector wide campaign to embed sustainability into the core operations of American healthcare. HHI is free to every hospital in America and offers a wealth of strategies, case studies and support to achieve environmental improvements and cost savings for less waste, safer chemicals, leaner energy, healthier food, and smarter purchasing. Over 500 hospitals have sponsored HHI and hundreds more are enrolled in it.
- Global Green and Healthy Hospitals: At the international level, HCWH launched Global Green and Healthy Hospitals to build a global learning community for sustainable healthcare. Hospitals and health systems on every continent are participating and Cisco Systems is collaborating with HCWH to develop a world class on-line social platform that can facilitate communication and networking among hospitals all around the world to accelerate innovation and scaling up solutions.