Healthcare Organizations Are Polluting The Air And Harming Public Health, But That Can Change

Healthcare Organizations Are Polluting The Air And Harming Public Health, But That Can Change

The healthcare industry accounts for 8.5% of U.S. greenhouse gas emissions and toxic air pollutants. … [+] Exposure to high levels of air pollution can cause a variety of health issues, ranging from mild irritation of the throat to heart problems, and can even lead to premature death. One major source of this health hazard is healthcare. Globally, the healthcare industry accounts for about 4.5% of greenhouse gas emissions and toxic air pollutants, a large enough emissions profile to rival most countries. “If it was on a list of nations, it would be the fifth country in the world,” said Sonia Roschnik, international climate policy director for Health Care Without Harm. In the U.S., healthcare accounts for an even great proportion of emissions. A recent analysis in Health Affairs shows that healthcare organizations and the medical supply chain are responsible for about 8.5% of U.S. greenhouse gas emissions and air pollutants. This figure rose by 6% between 2010 and 2018. The authors estimate that in 2018 alone, this pollution led to the loss of 388,000 disability-adjusted life-years, the cumulative number of years of life lost due to illness, disability or early death from the pollution. The healthcare industry, while it’s meant to promote longevity and wellbeing, threatens health by emitting harmful carbon-dioxide-trapping gases and air pollutants. “I feel conflicted as a health care provider because every time I’m providing care, I’m causing harm someplace else,” said Jodi Sherman, associate professor of anesthesiology and epidemiology at Yale University and senior author of the Health Affairs analysis. Sherman and her colleagues used health expenditure data from the Centers for Medicare and Medicaid Services (CMS) and emissions data from the Inventory of U.S. Greenhouse Gas Emissions and Sinks to estimate healthcare emissions both at the national and state level. The researchers input the data into an internationally standardized model that estimates the emissions associated with spending in different economic sectors. Using these results, the researchers determined the emissions released by the healthcare industry and which parts of the industry were the biggest polluters. “We’ve shown that the health sector in the US is responsible for 8.5% of our nation’s greenhouse gas emissions and similar fractions of toxic air pollutants,” said Sherman. The medical supply chain accounted for about 82% of healthcare emissions, purchased energy accounted for 11% and healthcare operations accounted for 7%. This pollution came at a high cost to human health. Using their emissions data and methods commonly used to calculate disability-adjusted life-years (DALYs) from greenhouse gases and air pollution, Sherman and her colleagues estimated that healthcare emissions resulted in the loss of between 244,000-531,000 DALYs, with a median of 388,000 DALYs. “We’re similar in magnitude to deaths due to preventable medical errors,” said Sherman. But when a 1999 landmark report published by the Institute of Medicine revealed the magnitude of deaths from preventable medical errors, it sparked public outcry and led to the formation of the government Agency for Healthcare Research and Quality. Sherman said that the same hasn’t happened for healthcare emissions. “Nobody [in power] is paying attention to this issue.” But the harms stemming from pollution can be prevented. In the U.S., some healthcare systems have taken it upon themselves to reduce their carbon footprint. Sherman’s institution for example, Yale-New Haven Health, has stopped using a non-essential, environmentally harmful inhaled anesthetic, desflurane. “Inhaled anesthetics are very potent greenhouse gases. They’re released directly off of facility rooftops and vented to the outdoor atmosphere,” said Sherman. “The [United Kingdom’s] National Health Services estimated that [on average] 5% of an entire facility’s footprint is coming from inhaled anesthetics.” Another target is the medical supply chain. “One of the three biggest categories contributing to the problem of healthcare pollution is medical devices and supplies,” said Sherman. Not only does the manufacture and transportation of supplies emit pollutants, but single-use items like gloves and masks create waste, and could be used more efficiently. “The PPE, the masks we’ve used in this pandemic, if they were designed to be reusable and low carbon, you could make a huge difference,” said Roschnik. Sherman also stressed that however successful individual facilities or even larger systems are at greening their operations, unified systemic change is needed. A step toward that is mandating that organizations report their emissions. Some U.S. healthcare systems voluntarily report their environmental impacts, but that’s the exception rather than the rule. Mandated reporting could incentivize hospitals to track their impact, and the U.S. already has the framework for it. “If we mandate reporting through the Centers for Medicare and Medicaid [Services] existing infrastructure, that may be the quickest way to leverage transition of the healthcare system in the U.S. to net zero,” she said. “This is a call to the new administration to seriously look at the opportunity to help us help the health care sector reduce its emissions through this existing quality performance framework.” This kind of systemic change is already happening elsewhere. The U.K. has already done this and is the only place in the world with nationally mandated health system carbon accounting. “We’d been working for a long time to look at the carbon footprint of the health sector and trying to identify what the hotspots are and what to do about it,” said Roschnik. “We got to the point where we really felt [sustainability] needed to be integrated into everything you do, so that’s why we launched the Greener NHS [initiative].” Roschnik helped launched the initiative which aims to bring the health system to net zero carbon emissions by 2040. To get to net zero, the initiative outlines steps to reduce NHS emissions, like ensuring suppliers are committed to net zero emissions, developing the first zero-emission ambulances and constructing ‘net zero hospitals.’ “We’ve spent years working through what interventions will contribute how much,” said Roschnik. The benefits of cleaning up healthcare won’t stop at clinics or medical suppliers. “The healthcare industry intersects with most other parts of the global economy. If we can transform this industry it’s going to have ripple effects,” said Sherman. “And it’s part of our social mission.” I’m an independent science journalist most interested in how life experiences shape our brains and our health. But I’ll write about almost anything that’s interesting. I’m an independent science journalist most interested in how life experiences shape our brains and our health. But I’ll write about almost anything that’s interesting. I’ve been writing since I could hold a pencil, but started getting paid for it in 2018.  At Boston University, I studied neuroscience and psychology in undergrad, and then earned a master’s degree in science journalism in 2018.  I worked as a reporting fellow for the Public Health Post that spring, completed a science writing internship at Yale School of Medicine that summer, and started freelancing that fall. As a freelancer, I’ve edited content for the National Geographic Education Resource Library and written for Gizmodo, Scientific American, and others.
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