P2 Healthcare Industry

On June 24, 1998, the American Hospital Association (AHA) and the US EPA signed a landmark agreement to advance pollution prevention efforts in our nation's hospitals. Specifically, the Memorandum of Understanding Exit EPA disclaimer (MOU) calls for the elimination of mercury-containing waste from hospitals waste stream by 2005; the reduction of the overall volume of waste (both regulated and non-regulated waste) by thirty-three percent (33%) by 2005 and by fifty-percent by 2010; and the identification of hazardous substances for pollution prevention and waste reduction opportunities. Below you will find resources to help hospitals meet the goals of this MOU. However, please note that the resources on this Web site were specifically developed for hospitals. Other non-hospital specific pollution prevention resources can be found on EPA Region 2's Pollution Prevention Web site and may prove useful to hospital employees as they try to reduce their hospital's environmental footprint.

General Resources Energy Efficiency
Environmentally Preferable Purchasing Green Buildings
Mercury Elimination Waste Minimization
Water Conservation Resources for Dentists

General Resources

Hospitals for a Healthy Environment (H2E) Exit EPA disclaimer - is a joint project of the American Hospital Association, the Environmental Protection Agency, Health Care Without Harm, and the American Nurses Association. Its primary goal is to educate health care professionals about pollution prevention opportunities in hospitals and healthcare systems.

Health Care Without Harm Exit EPA disclaimer - is an international campaign with over 170 participating organizations focused on transforming the health care industry so it is no longer a source of environmental harm by eliminating pollution in health care practices. The campaign is working with hospitals and other health care institutions to phase out the use of mercury and other toxic pollutants in health care products and practices.

Going Green: A Resource Kit for Pollution Prevention in Healthcare Exit EPA disclaimer - (2002, free) This kit was developed by Health Care Without Harm to assist health care providers/administrators in their efforts to reduce health care industry pollution from their facilities. A "work in progress," this Resource Kit contains steps that range from the simple to the complex, but all will have a measurable impact on your facility's environmental performance. It is also available in Spanish.

"Greening" Hospitals Exit EPA disclaimer (1998, free) This document, which was developed by Health Care Without Harm, is an analysis of pollution prevention in America's Top Hospitals. It is based on survey results obtained from 50 of the nation's top hospitals, derived from the list of the top 135 hospitals in the nation compiled by U.S. News and World Report.

Energy Efficiency

Energy Star for Healthcare - Healthcare organizations spend over $6 billion on energy each year to meet patient needs. Every dollar a nonprofit healthcare organization saves on energy is equivalent to generating new revenues of $20 for hospitals or $10 for medical offices. For-profit hospitals, medical offices, and nursing homes can boost earnings per share by a penny by reducing energy costs just 5%. This Web site was developed by EPA's Energy Star Program to help healthcare facilities achieve these energy savings. 

For more general (non-hospital specific) resources on energy efficiency, please visit,  EPA Region 2's Energy Efficiency Web site.

Environmentally Preferable Purchasing

How-to-Guide on Environmentally Preferable Purchasing for Hospitals Exit EPA disclaimer - This web-based guide introduces Environmentally Preferable Purchasing (EPP), describes why hospitals should be doing EPP, and takes a hospital from EPP team formation to the completion of a pilot EPP project. The guide also includes information on overcoming obstacles, tracking success, creating publicity, negotiating with Group Purchasing Organizations, and evaluating the validity of vendor claims.

The Sustainable Hospitals Project Exit EPA disclaimer provides technical support to the healthcare industry for selecting products and work practices that eliminate or reduce occupational and environmental hazards, maintain quality patient care, and contain costs. It is a project of the The Lowell Center for Sustainable Production which draws on the resources and expertise of the University of Massachusetts Lowell, including the Toxics Use Reduction Institute (TURI) and the Department of Work Environment. Their Web site includes information about alternatives to products containing mercury, latex, polyvinyl chloride (PVC) and other potentially harmful materials.

Health Care EPP Network Information Exchange Bulletin Exit EPA disclaimer -This bi-monthly newsletter provides updates on health care environmental purchasing innovations from across the country. 

For more information about environmentally preferable purchasing in general, please visit EPA Region 2's EPP Web site. 

Green Buildings

Whole Building Design Guide - Healthcare Exit EPA disclaimer The Whole Building Design Guide is a comprehensive, internet-based portal to a wide range of federal and private sector, building-related guidance, criteria and technology, including guidance and resources on sustainable design. They recently added an entire section devoted to healthcare facilities.

Building Green Hospitals Checklist Exit EPA disclaimer This checklist from the Canadian Coalition for Green Health Care is posted on the Canadian Centre for Pollution Prevention Healthcare EnviroNet.

American Society of Healthcare Engineering (ASHE) Exit EPA disclaimer Vision statement and comprehensive check list of green design and construction goals and strategies plus award program to recognize health care sector design professionals and facilities for projects in the area of green design and construction.

Healthy Building Network Exit EPA disclaimer Provides resources for designing and building healthy health care facilities, including goal setting documents, teleconference trainings and case studies of green health care facility project.

H2E 10 Step Guide to Composting in Health Care Facilities (PDF 363KB) Exit EPA disclaimer- A quick and easy 3 page guide to getting started on a composting project in your facility.

For more resources on building green, please visit EPA Region 2 Green Buildings Web site.

Mercury Elimination

Reducing Mercury Use in Healthcare (free. 1999) is a How-To Manual for hospitals to assist them in starting mercury pollution prevention programs or accelerating programs that have already begun. New federal regulations greatly reduce the amount of mercury that is allowed to be discharged from a municipal wastewater system or an incinerator. By implementing the best management practices described in this manual, you can reduce the level of mercury in the environment and avoid the need for increased regulations in the years to come.

Mercury Use Reduction & Waste Prevention in Medical Facilities (1997. free) is an interactive environmental education software program developed jointly by Purdue University and the U.S. EPA to provide information on the proper handling and disposal of mercury wastes produced by medical facilities.

Protecting by Degrees Exit EPA disclaimer - This brochure was developed by Health Care Without Harm provides recommendations on what parents, hospitals and policy makers can do to reduce mercury pollution.

Mercury in Medical Waste: Keeping Mercury Out of Medical Waste(1998. free) - This U.S. EPA Region 5 fact sheet explores the dangers of mercury as a solid waste and in incinerators, gives pollution prevention suggestions, and explains EPA programs dealing with Mercury.

Mercury in Medical Waste: Use of Alternative Products - (1998, free) This U.S. EPA Region 5 fact sheet gives suggestions on how to avoid mercury disposal and provides alternatives to mercury products.

Free PDF reader available Mercury Reduction in Florida's Medical Facilities: Improving the Management of Mercury-Bearing Waste Exit EPA disclaimer (1998, free) is a report developed by the Florida Center for Solid and Hazardous Waste Management.

Waste Minimization

Free PDF reader available Pollution Prevention Guide to Hospitals (excluding medical wastes) Exit EPA disclaimer - (1998, free) This guide was developed by the California Environmental Protection Agency's Office of Pollution Prevention and Technology Development to assist general medical and surgical hospitals in evaluating their operations for waste minimization opportunities.

Free PDF reader available Best Management Practices for Hospitals and Medical Facilities Exit EPA disclaimer (1995. free) - This document was developed by the City of Palo Alto, California's Regional Water Quality Control Plant and contains information on pollution prevention opportunities for hazardous waste streams commonly found at hospitals and medical facilities.

Waste Reduction Activities for Hospitals Exit EPA disclaimer - (2002. free) is a fact sheet developed by California's Integrated Waste Management Board. All activities on this fact sheet have been implemented by some hospital in the United States or have been provided by a medical professional.

Water Conservation

Every drop counts Exit EPA disclaimer From North Carolina, this is a 5 page water conservation checklist for hospitals and medical facilities.

Water Efficiency Practices for Health Care Facilities Exit EPA disclaimer From the New Hampshire Department of Environmental Services, this fact sheet provides lots of good water conservation information by topic, specifically for healthcare..

Water Conservation at Work Exit EPA disclaimer This checklist from the Southwest Florida Water Management District will help facility managers evaluate the appropriateness of water-saving adjustments for improving the efficiency of your health care facility. Remember, water savings often bring energy savings, too.

Healthcare Water Conservation Case Studies Exit EPA disclaimer Hospitals across the country are implementing water conservation projects and saving lots of water and lots of money. Many of these projects have short payback periods and continue to save facilities water and money every year after implementation.  

Benchmarking: Best Practices in Water Conservation
This document provides benchmark water data for over 240 hospitals throughout the United States and is available for a fee of $500 from H2O Applied Technologies, Siobhan Costello at 617-574-1196. The fee may be applied toward a feasibility study of your facility.

For more information on water conservation in general, please visit EPA Region 2's water conservation Web site.

Resources for Dentists


Free PDF reader available Mercury Pollution Prevention Poster for Dental Offices Exit EPA disclaimer (2000. free) - This Mercury pollution prevention poster for Dental offices was developed by the City of Palo Alto California's Regional Water Quality Control Plant.  

P2 resourcesHealthcare Industry Compliance Assistance Center

For information on this page, contact: buxbaum.diane@epa.gov

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