Healthcare P2 Resources

Pollution Prevention Healthcare Sites (General)

(This information provided by Bill Quinn and the Arizona Department of Environmental Quality)

P2 and Compliance Assistance Information for the Healthcare Industry. This site provides pollution prevention and compliance assistance information for the healthcare sector. It is intended to be a comprehensive resource, covering all the varieties of hospital wastes, and all the rules that apply to them, including both federal regulations and the specific rules that apply in your state. Located at:

Practice Green Health is the nation’s leading membership and networking organization for institutions in the healthcare community that have made a commitment to sustainable, eco-friendly practices. In January of 2008, Hospital for a Healthy Environment (H2E) was reorganized and renamed Practice Greenhealth, in order to more accurately reflect its new role as a membership. Located at:

Health Care Without Harm is working to implement ecologically sound and healthy alternatives to health care practices that pollute the environment and contribute to disease. Health Care Without Harm is an international coalition of hospitals and health care systems, medical professionals, community groups, health-affected constituencies, labor unions, environmental and environmental health organizations and religious groups. Located at:

Sustainable Hospitals provides technical support to the healthcare industry for selecting products and work practices that reduce occupational and environmental hazards, maintain quality patient care, and contain costs.

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Greener Hospitals: This manual provides practical advice to help healthcare facilities improve their environmental management systems and performance. By clearly outlining the benefits of sharing best practices and developing formal environmental management systems, we feel that this document will better prepare healthcare facilities to meet the rising expectations of regulators and their local communities. Located at:

Hospital Pollution Prevention. EPA Region 9 works with hospitals, tribes, state and local agencies, and non-governmental organizations to prevent pollution from hospitals.

Region 9’s Hospital Pollution Prevention work includes developing tools and resources such as posters and fact sheets, and supporting training.

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The following topics of interest are addressed (click on the topic to view the resources):

Laboratory Chemicals

Healthcare and research laboratories use numerous hazardous materials, including chemicals and biological agents that present potential hazards to workers, patients, the public and the environment. While these materials may be beneficially used in laboratories, they may also have the capacity to cause inadvertent damage to people (both to those using them and to bystanders exposed to them), and to other creatures and objects in the environment. It is advisable to know what to look for when purchasing or specifying laboratory chemicals, and what to watch out for when using them.

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GreenHealthy – Environmental Leadership for Healthcare.

Serving more than 2,500 U.S. hospitals and 73,000-plus other healthcare sites, the Premier healthcare alliance is working to transform healthcare. Located at:

Green Guide for Health Care. The healthcare sector’s first quantifiable sustainable design toolkit integrating enhanced environmental and health principles and practices into the planning, design, construction, operations and maintenance of healthcare facilities.

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Greening Hospitals (University Hospitals)

Shows cases of greening efforts at University Hospitals (Cleveland, Ohio) across the spectrum of associate facilities including listing priority operational goals such as Waste Reduction and Recycling, Energy and Water management, Green Purchasing, Green Building, and Toxics Reduction and Elimination, and Indoor Air Quality Management. Examples of priority goals and successes are given by opening the pages listed under the banner “Greening UH”.

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Pollution Prevention Strategies / Manuals

Checklist for Healthcare Success Development of this checklist was funded by EPA Region 7 in an effort to provide Kansas healthcare facilities with a tool which helps them identify environmental compliance concerns and related pollution prevention (P2) opportunities that may reduce compliance


Hospital Pollution Prevention Program. The California Department of Public Health has been working with hospitals statewide to develop plans that will assist in pollution prevention. These plans include goals for the virtual elimination of mercury, implementing systems improvements, as well as lessening the creation of solid, medical, and hazardous waste.

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Hospital Pollution Prevention (P2) Strategies waste generation is an integral part of the healthcare system. Patients come into the hospital, services are provided, and wastes are generated in the process. To achieve desired outcomes the systems within a facility must be working harmoniously and not against each other. Located at:

Practice Greenhealth ECO-Checklist for Operations. This Eco-Checklist has been designed to provide a quick snapshot of where a healthcare organization sits on the green spectrum and highlights the range of environmental programs being implemented in healthcare. Whether your organization is just beginning its sustainability journey or is looking for ways to assess and measure progress, this tool was designed for you. Located at:

Health Care Waste Reduction and Recycling. CalRecycle’s Health Care Waste Reduction and Recycling Team is ready to assist the health care community. The team explores ways to reduce the amount of waste generated at a facility, and suggests customized source reduction and recycling efforts. Its goal is to help establish a statewide infrastructure of sustainable waste reduction, reuse, and recycling programs for the health care industry. Located at:

Guides to Pollution Prevention-Selected Hospital Waste Streams. This guide provides an overview of hospital waste generating processes and presents options for minimizing waste generation through source reduction and recycling. Reducing the generation of these materials at the source, or recycling the wastes on or off site, will benefit hospitals by reducing disposal costs and lowering the liabilities associated with hazardous waste disposal. The hazardous wastes generated by general medical and surgical hospitals are small in volume relative to those of industrial facilities; however, the wastes are of a wide variety.

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EPA P2 Healthcare Industry:

Pollution Prevention Guide for Hospitals (excluding medical wastes). This Guide was developed by the Office of Pollution Prevention and Technology Development to assist general medical and surgical hospitals in evaluating their operations for waste minimization opportunities. The Guide contains three sections.

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An organizational Guide to Pollution Prevention EPA/625/R-01/003 August 2001. Located at:

EPA Facility Pollution Prevention Guide EPA 600/R-92/088 May 1992

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EPA Pollution Prevention Website:

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Cleaning in Healthcare Facilities: Reducing human health effects and environmental impacts (April 2009) This document summarizes the main health and environmental impacts related to conventional surface cleaning; describes a systems approach for designing and implementing healthier and environmentally friendlier cleaning strategies for the healthcare sector; and indicates areas where future research and policy initiatives are needed. Located at:

Green Cleaning and Infection Control – Practice Greenhealth page (infection control)

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Pollution Prevention for Disinfection and Cleaning Processes

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Cleaning for Health – Products and Practices for a Safer Indoor Environment (INFORM)

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EPA factsheet on Microfiber Mops

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Concept of Green Teams for P2 Planning

Participate on a Green Team. By forming your own Green Team, you have the opportunity to organize a group of friends, co-workers, church members, neighborhood friends, etc., and promote a supportive atmosphere.

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Health Care Without Harm is working with health care providers and manufacturers to identify products that contain DEHP and replace them with safer, affordable alternatives.

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Physicians for Social Responsibility Presentation

Design of Building

Green Guide for Health Care the health care sector’s first quantifiable sustainable design and facilities operations toolkit integrating enhanced environmental and health principles and practices into the planning, design, construction, operations and maintenance of their facilities. This Guide provides the health care sector with a voluntary, self-certifying metric toolkit of best practices that designers, owners, and operators can use to guide and evaluate their progress towards high performance healing environments. Located at:

EPA Cool Roofs. A California study found that cool roofs provide an average yearly net savings of almost 50 cents per square foot. This number includes the price premium for cool roofing products and increased heating costs in the winter as well as summertime energy savings, savings from downsizing cooling equipment, and reduced labor and material costs over time due to the longer life of cool roofs compared with conventional roofs. Every flat tar roof should be painted white.

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Energy Reduction

DOE, NREL Release Reports on Cutting Energy Use in Half in Commercial Buildings

September 24, 2010. – Reports detail strategies to save energy in large office buildings and large hospitals. The U.S. Department of Energy and its National Renewable Energy Laboratory (NREL) have released two technical reports that provide recommendations on how to achieve 50% energy savings in large office buildings and large hospitals. Conducted by NREL’s Commercial Buildings Group, under the direction of DoE’s Building Technologies Program, the studies support DoE’s goal of significantly improving the energy efficiency of new and existing commercial buildings across the United States.

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Large Hospital 50% Energy Savings: Technical Support Document details the technical analysis performed and the resulting design guidance that will enable large hospitals to achieve whole-building energy savings of at least 50% over the above standard.

Technical Support Document: Strategies for 50% Energy Savings in Large Office Buildings evaluates the potential for new large office buildings to achieve a 50% net onsite energy savings compared to a baseline standard (as defined by ANSI/ASHRAE/IESNA Standard 90.1-2004). The report found 50% energy savings can be achieved in both low-rise and high-rise office buildings in a broad range of U.S. climates.

The Advanced Energy Design Guide for Small Hospitals and Healthcare Facilities -This guide can help in the design of new healthcare facilities that are 30% more energy efficient than current industry standards using ANSI/ASHRAE/IESNA Standard 90.1-1999 as a benchmark. This saves energy but also supports the other design goals important to healthcare.

facilities: to improve the patient experience, enhance the healing environment, increase staff retention, lower construction and operating costs, contribute to an environmentally conscious building design, and improve the bottom-line performance of the healthcare facility. Located at:

Perform an Energy Audit Performing an energy audit, or a baseline energy evaluation, is a crucial step to assessing and improving energy efficiency. Located at:

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. Located at:

Total Energy Management Concept. There is clearly superior value in consolidating all of an organization’s energy assets into one package. For optimized feasibility, integrating both facility and process systems (as applicable) with an overall sustainability objectives is ideal.

Energy Master Planning is a valuable fundamental building block for all high-energy-consuming organizations, notably those with a significant investment in laboratory facilities, for reducing energy usage, utility costs and promoting sustainability. But more importantly, this process will facilitate efficient, long-term management of a company’s energy assets. Article located at:

Establishing an Energy Management Program and Identifying Energy Savings Opportunities: – This guidebook is intended to encourage manufacturers to develop a strategic plan for energy decisions, just as they would for other key business decisions. A major focus of an energy management plan is performing a self-assessment to identify energy savings opportunities.

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Perform an Energy Audit Performing an energy audit, or a baseline energy evaluation, is a crucial step to assessing and improving energy efficiency. Located at:

Different Levels of Energy Audits: Energy Audits come in several flavors: ASHRAE has definitions for a Level One and Level Two. Energy Ace has added to that a Level Zero. Level Zero is a “walk-through” energy audit and it literally just that – a walk-through. It’s inexpensive and facility managers can get good energy ideas from a walk through audit, but will receive no analysis, cost estimates, or savings estimates – just a list of 15-20 things he can do or ought to consider. Level Zeroes are excellent for the property owner who owns multiple facilities and wants quick screenings of these to determine which are candidate for more detailed energy audits.–12568

Cool Roofs will Revolutionize the Building Industry (PDF 119 KB): Fact sheet on cool roof applications within the building industry prepared by Oak Ridge National Laboratory.
Outdoor Solid State Lighting Technology Deployment Federal Energy Management program encourages acceleration, evaluation and deployment of outdoor solid state lighting (SSL) technologies, which can deliver 50% energy savings or up to 75% when paired with controls. This initiative provides the resources needed to help avoid widespread misinformation and make good decisions resulting in cost-effective technology deployment that delivers quality lighting and reliable energy savings. These resources are organized across the following topics: SSL Street and Roadway Lighting ; SSL Site Lighting (Parking Lot/Structure) ; Case Studies; Additional SSL Resources Located at:

Food Waste

EPA Food Waste Page. This section of the Organic Materials website provides information about economically, socially and environmentally beneficial food waste management. Located at:

Environmentally Preferable Purchasing

EPA Environmentally Preferable Purchasing (EPP). Environmentally Preferable Purchasing (EPP) helps the federal government “buy green,” and in doing so, uses the federal government’s enormous buying power to stimulate market demand for green products and services. Geared first to help federal purchasers, this site can help green vendors, businesses large and small — and consumers. Located at:

Green Purchasing Guide for Hospitals (Greece) Green Procurement of services or products is a relatively new approach targeting private and public organizations that are interested in improving their environmental performance by claiming and procuring environmental friendly products and services.

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San Francisco EPP Approved Green Products. San Francisco Department of Environment created the SF Approved List to share the best in authoritative green purchasing information within City government and with the world at large. Located at:

Hospitals for a Healthy Environment. What we buy matters. Buying products with reduced environmental and human health impacts is vital to sustainable healthcare. Environmentally Preferable Purchasing (EPP) is the act of purchasing products/services whose environmental impacts have been considered and found to be less damaging to the environment and human health when compared to competing products/services. EPP can be the key to saving money and reducing waste while meeting the needs of patients.

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Health Care without Harm. A comprehensive green purchasing program is one of the most effective strategies a hospital has at its disposal for systematically greening its operations.

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Greenseal. Companies want to communicate sustainability. Customers want to identify products that are healthier and greener. But how can they confidently engage with each other? For more than two decades, Green Seal has made that possible, certifying goods and services that meet the highest standards of environmental quality and performance.

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The State Electronics Challenge (SEC) is a voluntary program that encourages state, tribal, regional, and local governments, including schools and other public entities, to:

  • Purchase greener electronic products.
  • Reduce the impacts of electronic products during use.
  • Manage obsolete electronics in an environmentally safe way.

A checklist details the program requirements for each lifecycle phase of the Challenge, as well as the general requirements that apply to all Partners.

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Laboratory Pollution Prevention

AMES Laboratory P2 Plan (2009). This plan specifies the activities and methods that have been and will continue throughout Ames Laboratory to reduce the volume of wastes generated at the Laboratory.

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Laboratory Pollution Prevention. Practicing pollution prevention can have significant benefits for your lab; it can save money, increase employee safety, and reduce your regulatory burden and environmental impact. These benefits can be seen in the examples from Arizona laboratories contained in this booklet.

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Laboratory Pollution Prevention (2005). Successful P2 begins with a strong commitment to prevent generation of wastes. The following sections describe several areas labs can look at in identifying strategies to reduce wastes, including material handling, operating practices and policies, employee training and loss prevention.

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Checklist of Laboratory best management Practices (Palo Alto). Use this form for a quick assessment of water quality practices in your laboratory.

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Medical Waste Management

“Know Where to Throw” posters and stickers: Red bag waste. Putting things in red bags that do not need to be there can significantly increase facility disposal costs, and can have negative environmental health implications. The California Integrated Waste Management Board is pleased to provide colorful posters and stickers to help coordinate and promote your waste reduction efforts.

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Waste Management (HealthCare without Harm). Safer no-burn technologies are available in lieu of incineration to effectively treat and disinfect medical waste. Health Care without Harm is collaborating with health care systems, NGOs, governments and international agencies such as the World Health Organization to research and promote environmentally sound and healthy alternatives to medical waste incineration.

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Mercury Elimination

Environmental Best Practices for Health Care Facilities (Nov. 2002). Hospitals most frequently commit to becoming mercury-free based on an ethical motivation to protect human health and the environment. This desire often supports the hospitals’ mission statements, which commonly include a goal of “assessing and improving community health.” As significant users of products containing mercury, hospitals have an opportunity to play a key role in protecting public health by minimizing the use and release of mercury into the environment.

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Mercury Assessment Toolkit (Mercury Manager Ver. 1.01) (Excel)

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California DHS – A Guide to Mercury Assessment and Elimination in HealthCare Facilities and Toolkit. The California Department of Public Health has been working with hospitals statewide to develop plans that will assist in pollution prevention. These plans include goals for the virtual elimination of mercury, implementing systems improvements, as well as lessening the creation of solid, medical, and hazardous waste. Located at:

Pharmaceutical Waste

P-Listed Acute Hazardous Waste. New EPA Interpretation for Acute Hazardous Waste Should Reduce Regulatory Burden for Managing Hazardous Waste at Health Care Facilities. For generators that are managing containers that held P-listed commercial chemical products and that are not RCRA empty per 261.7, three suggestions are provided on how to manage the residues remaining in the containers. Refer to EPA’s November 4, 2011 memo.

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Best Management Practices for Unused Pharmaceuticals at Health Care Facilities. Pharmaceuticals are being discovered in our nation’s waters at very low concentrations. While the sources of these pharmaceuticals may be numerous, EPA has been studying unused pharmaceutical disposal practices at health care facilities. This study was prompted by the concern that potentially large amounts of pharmaceuticals are being flushed or disposed of down the drain, ultimately ending up in rivers, streams and coastal waters.

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EPA Pharmaceuticals and Personal Care Products (PPCPs) as Environmental Pollutants. Studies have shown that pharmaceuticals are present in our nation’s water bodies. Further research suggests that certain drugs may cause ecological harm. The EPA is committed to investigating this topic and developing strategies to help protect the health of both the environment and the public.

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H2E Pharmaceutical Waste.

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Recycling Programs

American Medical Association.This site promotes organizations that provide medical equipment to underserved areas via recycling programs. Local hospitals and clinics are urged to be involved in such programs.

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Earth 911. Guide to local resources including recycling centers, how to recycle, pollution prevention, and how help protect the environment. North America’s most complete directory of local recycling and proper disposal options. With a Web site attracting over 4.5 million visitors annually, it delivers the data, information services platforms and media tools that leading brands and industries need to engage consumers, track recycling and proper disposal programs and demonstrate compliance.

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Recycling Works. The Illinois Department of Commerce and Economic Opportunity’s RECYCLING WORKS: A Tool Kit for Reducing Waste in the Workplaceis designed to provide businesses, schools, universities, and other institutions with up-to-date information to evaluate and establish waste reduction programs that are compatible with operations, cost-effective, and sustainable.

Sterliants and Disinfectants

Reducing Ethylene Oxide and Glutaraldehyde Use. This fact sheet provides background information on the uses and hazards of both chemicals, describes environmentally preferable alternatives, and provides detailed case study and cost information to help your hospital evaluate alternatives to EtO and glutaraldehyde. Located at: