Ten years ago, an EPA report revealed that medical waste incinerators were a major source of airborne carcinogens, and hospitals across the country were criticized for using mercury thermometers, burning plastics, and allowing used syringes to wash up on beaches.

“It caused a real uproar in local communities,” says Adele Houghton of Health Care Without Harm, an international non-profit that was formed in 1996 in response to the waste incineration problem. The hospitals polluted the air and water, causing a rise in chronic diseases, she says. “It’s a vicious cycle—especially when your mission is supposed to be ‘first do no harm.’”

Since then, more than 5,000 medical waste incinerators have been shut down in the U.S. But hospitals are still far from eco-friendly. Polyvinyl chloride (PVC), ubiquitous in IV bags and plastic tubing, gives off the cancer-causing toxin dioxin when it’s manufactured and incinerated. And staff and patients inhale volatile chemicals like formaldehyde, which are used to disinfect hospital walls, floors, and ceilings.

Now, hospitals are becoming increasingly aware of their environmental footprint. When designing new facilities and renovating old ones, many hospital CEOs are finding abundant reasons—energy savings, better patient outcomes, staff retention, and community approval—to go green.

The green health care movement started a few years ago, around the time the U.S. Green Building Council created its Leadership in Energy and Environmental Design (LEED) rating system, the third-party evaluation of the “greenness” of a building that awards certification credits based on factors like energy efficiency, water conservation, and use of renewable building materials.

Attaining LEED certification can be challenging for hospitals because the guidelines were written mainly for developers of commercial buildings.

“A hospital runs all day, everyday, and is obviously using much more energy, much more water,” Houghton says. “So LEED wasn’t very well adapted to help hospitals reduce their energy usage.”

In 2003, a new set of guidelines came out tailored especially for hospitals. The Green Guide for Health Care (GGHC) covers both new construction and renovation of health care buildings, and is often used hand-in-hand with LEED. Today, there are eight green, LEED-certified hospitals, and about 150 new projects are now registered with LEED, GGHC, or both, says Houghton, GGHC’s pilot project coordinator.

The Discovery Health Center in upstate New York, which opened in 2003, was among the first green health care buildings. Originally, the donors had no intention of going “green.”  

“Those were the Enron years,” lead architect Robin Guenther recalls, “and there was a lot of fear that energy prices were going to escalate.”

To allay that fear, Guenther’s firm suggested ground source heat pumps to cut the building’s energy consumption by 25 percent. From there, the designers added more eco-friendly features, including renewable, non-toxic building materials like recycled steel and non-PVC pipes.

One of the biggest myths of green building is that it’s prohibitively expensive. “A lot of projects use clever design processes that allow them to have their cake and eat it, too,” Houghton says. She cites the Kaiser Modesto Medical Center in California, which covered its parking lots with porous pavement that acts as a natural filter during heavy rains, removing chemicals before the water reaches the ground. The pavement was more expensive than regular asphalt, but it eliminated the need for storm sewer drains, saving nearly $300,000.

“Today, I think that you could say we were at a tipping point in green health care projects,” says Guenther, who also co-coordinates the GGHC with Houghton. In addition to the 150 GGHC and LEED projects, “there are also a large number [of hospitals] that aren’t in either program but still talk about incorporating green features.”

The Weill Cornell Medical College campus of the New York-Presbyterian Hospital has done more than talk about making changes. For the last few years, the hospital has been working with the LEED for Existing Buildings program to switch to non-toxic cleaning products, dry hand-washing stations, and high-efficiency air filters, and has eliminated equipment containing mercury and CFC refrigerants, says Jennifer Kearney, the hospital’s energy programs director.

While changes in internal operations can be done relatively quickly, building a hospital from the ground up can take 5 to 10 years. So Guenther says architects who don’t think about sustainability during their early design phases “do so at their own peril.” In the next five years, she predicts that green design will be the norm, and communities will question hospitals that lack eco-friendly features.

“My big piece of advice is to be much more pro-active about it now, because this thing is going like a house on fire,” says Guenther.

Posted on Dec 28, 2006 at 1:20 PM
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