Contract - October 2014 - 110

Oxford University Press, 2014

Can Hospitals Heal Patients and the Planet?
By Kathy Gerwig

110

Healthcare interiors can be beautiful spaces designed to inspire
health and healing. But lurking beneath the gleaming surfaces can
be a surprising number of pollutants that are anything but benevolent.
My new book, Greening Health Care: How Hospitals Can Heal the
Planet (Oxford University Press, 2014), explores a central paradox in
healthcare: As hospitals deliver life-saving care to individuals, their
substantial environmental footprint can be harmful to environmental
health. Consider this:
* The average U.S. hospital produces about 18,000 tons of carbon
dioxide annually, and healthcare accounts for eight percent of
greenhouse gas emissions in the U.S.
* Hospitals are often among the top 10 water users in a given
community, with some facilities using up to 700,000 gallons
of water per bed per year.
* Hospitals generate about 2.3 million tons of waste per year.
* And hospitals spend billions of dollars every year on building
materials and furnishings, some of which contain chemicals
that contribute to diseases.
Fortunately, a growing segment of healthcare leaders,
including those who design and build hospitals and other healthcare
facilities, are addressing this glaring contradiction. They are embracing
environmental stewardship as part of their commitment to improving
the health of local communities so that hospitals can truly be
places of healing.
This movement toward healthier hospitals is a collaboration
among major health systems, nongovernmental organizations (NGOs),
suppliers, architects, and others that has led to significant environmental
improvements across the healthcare sector. But there is still
considerable work to be done. One big influencer is Health Care Without
Harm, an NGO working to implement ecologically sound and healthy
alternatives to healthcare practices that pollute the environment and
contribute to disease. Its experts inspired Kaiser Permanente to remove
vinyl from its building products and medical products. In the mid-1990s,
the U.S. Environmental Protection Agency identified medical waste
incinerators as the biggest source of dioxin pollution-a powerful
carcinogen. Health Care Without Harm discovered the culprit was the
routine incineration of medical waste containing polyvinyl chloride
(PVC). Dioxin is a byproduct when PVC is burned. Even at low levels,
this pollutant can contribute to cancers and infertility. Kaiser
Permanente has used its buying power to get suppliers to offer
alternatives to PVC-based building products, including hand-

and crash rails, carpet backing, and flooring. Today, PVC-free carpets,
flooring, and furniture are readily available.
A recent decision by Kaiser Permanente to stop purchasing
upholstered furniture treated with toxic flame-retardant chemicals is
another example of the success the healthcare sector can have when it
flexes its considerable economic muscle. After the State of California
made new rules allowing furniture manufacturers to meet fire-safety
standards without using chemical flame retardants, Kaiser Permanente
announced it would no longer purchase upholstered furniture treated
with the chemicals. Four additional health systems followed, effectively
wielding $50 million in combined purchasing power annually to influence
furniture manufacturers to bring healthier products to market. We
expect this groundswell to expand to the retail market, too, making it
affordable for the average consumer to purchase healthier alternatives.
Given that healthcare spending comprises about 18 cents of every
U.S. dollar, the industry is large enough to lead a national, even global,
transformation that could incorporate environmental sustainability into
every dimension of our economy for the health and well-being of the
world's people. Greening Health Care focuses on such topics as building
greener hospitals and detoxing the health system through the use of
greener and safer chemicals, as well as on the health implications of
climate change. It shares the successes we have seen across the
industry, and lessons for architects and designers to take up the cause.
Making interiors both well-designed and environmentally
responsible is meaningful and transformative work, and I invite all those
involved in the built environment to share our vision of taking hospitals
beyond their "do no harm" mission to become restorative places for our
communities and planet.
Kathy Gerwig is vice president, employee safety, health and
wellness, and environmental stewardship officer for Kaiser
Permanente, one of the largest healthcare providers in the U.S.,
with 190,000 employees and physicians serving more than nine
million members. Gerwig is responsible for developing, organizing,
and managing a nationwide environmental initiative for the
organization. Under her leadership, Kaiser Permanente has become
widely recognized as an environmental leader in the healthcare
sector. Her book, Greening Health Care: How Hospitals Can Heal
the Planet, examines the intersection between healthcare and
environmental stewardship arguing that hospitals can and should
play a critical role in supporting the health of the planet.

contractdesign.com

OCTOBER 2014

COVER: COURTESY OXFORD UNIVERSITY PRESS

Greening Health Care: How
Hospitals Can Heal the Planet
by Kathy Gerwig

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Contract - October 2014

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