Mass General physician: Pollution is healthcare's hidden harm

With hospitals generating nearly 7,000 tons of solid waste daily, healthcare is a significant source of health-damaging pollution — and healthcare leaders must consider how clinical decisions affect both patient safety and public health, a physician writes in a STAT op-ed.

Four insights from the op-ed, written by Jonathan Slutzman, MD, an attending physician in Massachusetts General Hospital's emergency medicine department:

1. Part of the reason so much pollution comes from the healthcare sector is the facilities themselves, Dr. Slutzman says. Since hospitals operate 24 hours a day, 365 days a year, they require constant lighting, heating, cooling and electricity for diagnostic and treatment equipment. They also use potentially harmful chemicals to keep patient care areas and equipment clean and safe.

2. Much of the materials hospitals and healthcare facilities use end up as waste, and the average U.S. hospital generates 29 pounds of waste per bed daily.

 "The single largest factor driving healthcare pollution is clinical care," Dr. Slutzman says. "Every diagnostic and therapeutic choice that physicians and patients make affects nearly every category of environmental impact — waste generation, chemical use, water consumption, energy use, and, indirectly, building construction."

3. "Clinicians must always keep the best clinical care of their patients front and center," Dr. Slutzman writes. "But that doesn't mean more is always better."

For example, healthcare leaders should consider how clinical decisions drive healthcare's effect on the environment and recognize the different environmental outputs involved in each patient encounter.

4. Although it is critical for hospitals and healthcare facilities to prevent infection transmission, excessive prevention practices have upstream and downstream effects on public health with diminishing returns for patient safety, Dr. Slutzman writes. One trend Dr. Slutzman highlighted is healthcare facilities' focus on single-use equipment without considering whether it is safer than reusable equipment or whether it presents potential harm to environmental and human health.

"It's time for healthcare providers to look at the cradle-to-grave life cycle of the products we use and the processes we implement, considering all of the environmental inputs and outputs," Dr. Slutzman writes. "Healthcare decisions ought to consider both patient safety and public health, neither in a vacuum."

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