Home' The Source : Second Quarter 2011 Contents Supply chain managers should consider a range of factors, includ-
ing raw materials acquisition, production, manufacturing, packaging,
distribution, reuse, operation, maintenance or disposal.
"Many EPP products do not cost more than other comparable
products. But it's important to look at the total cost of ownership,
not just the purchase price. For example, disposable sharps contain-
ers may cost less to buy, but when you factor in the cost of disposal,
solidifiers and other costs, reusable products have made more eco-
nomic sense for many of our hospital members," Eckl says.
Based in Reston, Va., Practice Greenhealth's members include
hospitals, health-care systems, businesses and others engaged in
the greening of health care to improve the health of patients, sta
and the environment.
EPP Benefits for HealthTrust Members
Practice Greenhealth o ers its members a number of resources,
including sample EPP policies, environmental considerations for
dozens of product and service contracts that purchasers can use
in their RFI or RFPs, guidance on setting up an EPP program, and
where to find more information, Eckl says.
EPP pays o in a number of ways for health-care facilities beyond
obvious benefits such as reduced impact on the environment, Eckl
says. It can lower costs by reducing the amount of waste to be dis-
posed of (whether solid or regulated waste), reducing the energy
or water needed, increasing work place e ciencies, and, in many
cases, using less expensive items.
Additionally, it promotes higher levels of occupational health and
safety by reducing or eliminating hazardous materials. It also can
boost employee satisfaction and, not least, help generate positive
publicity for the facility.
The process of evaluating products and services, however, can
be time-consuming for supply chain personnel who are already
stretched thin. "I hear from many of our members that they are
happy that a GPO will take on the job of going through the process
of looking at environmental attributes," Eckl says. "It's exciting
that HealthTrust is actively supporting this and adding value for
What is 'Green'?
"Defining what's green is very confusing," Eckl says. A
product labeled as green may have one environmental at-
tribute but it may also contain ingredients that can cause
human health and environmental harm. For example, carpet
may contain recycled content fibers, but it may also release
strong smells associated with indoor air emissions, expos-
ing occupants with chemical sensitivities to fumes that may
trigger asthma attacks.
There are many data gaps in what we know about the
chemicals and materials used in products. For instance, a
number of substances that cause concern today were not
covered under the Toxic Substances Control Act of 1976
(TSCA). Congress is considering requests to reform TSCA
to better protect our health, she adds.
Practice Greenhealth encourages purchasers to ask for
alternatives to products with potential to cause harm to
environmental and human health. For example, PVC or
polyvinyl chloride is the most widely used plastic in medi-
cal products. But it creates one of the most toxic chemicals known
called dioxin, both when it's produced and when it's disposed of
Even worse, many PVC products such as IV bags and tubing are
made with the plasticizer DEHP, which softens the PVC and makes
it flexible. DEHP does not chemically bond with PVC and can leach
out when it comes into contact with fluids, lipids or heat. PVC tub-
ing may contain up to 80 percent DEHP by weight.
In 2002, the U.S. Food and Drug Administration issued a notice
recommending alternatives to DEHP-containing products. Tests have
raised concerns that DEHP can harm the reproductive system in male
fetuses and newborns, and may also harm the liver and lungs.
The health-care industry has led the way in transitioning to safer
plastics, but federal action lags behind, Eckl says.
Unscrupulous manufacturers also make false or misleading claims
that a product or service is environmentally friendly. It's so common
that the term "greenwashing" was coined to describe it.
For example, the Federal Trade Commission's guide for marketing
claims defines recyclable products as those that can be collected,
separated or otherwise recovered from the solid waste stream for
use in making a new product. But that claim can be deceptive if
there's no easy way to recycle a product in a community.
Other deceptive claims include "chemical free" (water is a chemi-
cal); "nontoxic" (everything is toxic in su cient amounts); and
"all-natural" (arsenic is natural but poisonous).
Even products that have legitimate environmental claims can
cause problems, such as recycled-content paint that may release
large amounts of volatile organic compounds (VOCs) and would
not be preferable for indoor use, she says. The FTC currently is
reviewing changes to its guidelines to tighten up on definitions to
reduce confusion and deception.
EPP Hot Buttons
Besides eliminating PVC-DEHP, some of the most pressing issues
in health-care EPP include:
Removing mercury. Mercury has long been known to be highly
poisonous with devastating e ects to the nervous system. More
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