Practice Greenhealth dates to 1998, when the American Hospital Association and the US Environmental Protection Agency joined forces to curtail pollution in healthcare facilities. The goals of the group, then called Hospital for a Healthy Environment (H2E), were virtual elimination of mercury waste, reduction of the healthcare sector's total waste volume, chemical waste minimization, and a variety of educational and information sharing activities focused on pollution prevention and toxics minimization.
In September 2001, H2E became a partnership that also included Health Care Without Harm (HCWH), and the American Nurses Association (ANA).
Current Practice Greenhealth members include hospitals and healthcare systems, healthcare providers, manufacturers and service providers, architectural, engineering and design firms, group purchasing organizations, and affiliated non-profit organizations. One of its offshoots is the Healthier Hospitals Initiative.
The awards are interesting, and help promote beneficial practices such as recycling. When I meet with friends in the Society of Plastics Engineers they tend to disparage Practice Greenhealth and the HHI because of their connection to Health Care Without Harm, an advocacy group that targeted medical incineration and now has PVC in its cross hairs.
Plastics professionals I know say that Healthcare Without Harm, and by extension, the HHI and Practice Greenhealth, "are like Greenpeace", a group that at time used guerilla tactics to fight PVC. There are criticisms that the officials making the attacks on PVC at specific hospitals lack technical knowledge about plastics.
Although I am not a supporter of using DEHP materials in IV sets, particularly for infants, I agree that hospital opponents of PVC seem to lack technical understanding of what they are doing and have difficulty articulating the substitutes and the safety of the substitutes.
At times, the drive to push out PVC unilaterally seems more emotional than scientific, something like the recent decision to ban plastic bags in Brookline, MA. Opponents to the Brookline bag ban refused to consider pro-plastic arguments (e.g. they use less energy than paper based on life-cycle studies).
That's unfortunate because the overall goals to make hospitals healthier are laudable.
In my opinion, one of the Practice Greenhealth awards lends itself to the circus type of atmosphere around PVC-it's a DEHP-free award, which "is given to the hospital or system that demonstrates the most success with replacing DEHP-containing medical devices with safer alternatives, particularly with vulnerable patient populations."
The award is sponsored by Hospira, which has skin in the anti-PVC game--it sells a non-DEHP I.V. syringe adapter. The alternative material is not identified on the Web page. I also found that to be the case in Kaiser Permanente case studies on DEHP replacement on the Practice Greenhealth Web site. In one case KP switched from Baxter Interlink IV administration sets to Baxter's Clearlink product line. There's no indication on the Practice Greenhealth Web site or on the Baxter web site what materials are used in the replacement products.
Adding to my concern, one of the case studies indicates that the purchasing department used a reverse auction to source the alternates. Reverse auctions are electronic systems in which vendors bid against each other in real time in a frenzy to get the business.
The winner of the DEHP-free award last year was Bon Secours St. Francis Medical Center-Richmond in Midlothian, VA. I could find no mention on the Practice Greenhealth Web site or on the hospital's Web site of what they did to win the award. They just won the award.
What are the alternatives to DEHP materials? How safe are they? Has Practice Greenhealth done any third-party testing to determine their acceptability? Or are we going to find out 20 years later that they have health issues?
I think the underlying missions of groups like Practice Greenhealth are solid. But I think there needs to be a better technical filter when dealing with plastics.