Hospitals' Carbon Footprint: Harming Or Healing?

Hospitals are major contributors to global carbon emissions, with the United States producing the greatest share of healthcare emissions worldwide. The healthcare industry in England is responsible for 18 million tonnes of CO2 emissions, amounting to 30% of the public sector's greenhouse gas emissions. Hospitals produce large amounts of waste, particularly in operating theatres, and high energy usage, with hospitals having the highest energy intensity of all publicly funded buildings. The transportation of goods and services also contributes significantly to hospitals' carbon footprint. However, hospitals are taking steps to reduce their carbon footprint by adopting renewable energy sources, reducing waste, and implementing circular practices.

Energy use

Hospitals are major contributors to global carbon emissions. The healthcare industry in England, for instance, is responsible for 18 million tonnes of CO2 emissions annually, accounting for 30% of the public sector's greenhouse gas emissions and 3.2% of the country's total CO2 emissions. In the United States, the healthcare sector's contribution is even higher, at 8.5% of the country's total greenhouse gas emissions.

The acute sector, including hospitals, contributes significantly to these emissions, with acute Trusts being the source of 65% of NHS CO2 emissions related to building energy use. Hospitals have the highest energy intensity of all publicly funded buildings, emitting 2.5 times more greenhouse gases than commercial buildings. Therefore, hospitals' energy use is a critical area to address in reducing their carbon footprint.

Hospitals' energy consumption is driven by various factors, including the need for heating, lighting, and power for medical equipment. The energy used for heating, ventilation, and air conditioning (HVAC) systems can be significant, especially in intensive care units and operating theatres, which require sterile environments and specific temperature and humidity conditions. Medical equipment, such as MRI machines, CT scanners, and dialysis machines, also contributes to high energy demand. Additionally, hospitals require a constant and reliable power supply to ensure the proper functioning of life-saving equipment and the preservation of temperature-sensitive medications and biological samples.

To reduce their energy consumption and carbon footprint, hospitals can implement a range of measures. Firstly, improving insulation, optimising heating and lighting systems, and encouraging staff to switch off computers and monitors when not in use can lead to substantial energy savings. Modern hospital architectural designs can incorporate energy-efficient features, such as better insulation, natural lighting, and energy-efficient appliances. Secondly, hospitals can transition to renewable energy sources, such as solar, wind, or geothermal energy, to reduce their reliance on fossil fuels. Partnering with other healthcare providers can help hospitals achieve the necessary scale for renewable energy adoption. Thirdly, hospitals can improve the energy efficiency of their existing systems by adopting EcoDesign principles, such as Philips' fully sealed magnet that reduces the helium requirement for MRI diagnostics. Finally, hospitals can focus on reducing waste and improving the sustainability of their supply chains, as the production and transportation of goods and services procured by the health sector account for a significant portion of their carbon emissions.

Waste management

Hospitals are some of the biggest carbon polluters, with the global healthcare industry responsible for two gigatons of carbon dioxide annually, or 4.4% of worldwide net emissions. In the United States, the healthcare sector accounts for 8.5% of the country's carbon footprint, with hospital care contributing 36% of that.

To address this issue, hospitals are implementing creative solutions to reduce waste and their carbon footprint. For example, OSU has introduced reusable sharps containers in some rooms, which are safely disposed of and then cleaned and put back into circulation, preventing thousands of dispensers from ending up in landfills. Stanford Health Care works with clinicians to avoid overstocking supplies that are underutilized in surgeries, reducing waste and costs. The University of California, Davis Medical Center encourages medical staff to consider leaving certain items off medical carts for specific procedures, reducing the likelihood of unnecessary waste.

Another strategy is to promote waste reduction and reuse. Harvard hosts laboratory free-cycle days, offering everything from lab equipment to office supplies for free, encouraging reuse and waste reduction. Composting or donating excess food to local organizations is another way hospitals are reducing food waste and supporting the community.

Hospitals are also focusing on the proper treatment and management of healthcare risk waste (HCRW) to minimize its environmental impact. HCRW, which includes waste from patient diagnostics, immunization, surgery, and therapy, must be treated before disposal to prevent pollution and the spread of illnesses. However, the current treatment methods contribute to climate change, emphasizing the need for more sustainable waste management systems in hospitals.

Overall, waste management is a critical aspect of reducing hospitals' carbon footprint, and hospitals are actively exploring innovative solutions to minimize waste and its environmental impact.

Patient journeys

Hospitals contribute to carbon footprints in several ways, and one significant aspect is through patient journeys. This encompasses the entire patient experience, from initial transportation to the hospital to discharge and ongoing outpatient care.

Patient Transportation

Transportation

Transport of Goods and Services

The transportation of goods and services procured by the health sector accounts for a large amount of carbon emissions. This is considered an indirect emission, as health systems do not have direct control over it. However, hospitals can influence these emissions by adopting sustainable procurement practices. For example, purchasing food and other consumables from local suppliers can reduce the carbon footprint associated with transport. Additionally, hospitals can work with suppliers who prioritize climate protection and incorporate sustainable practices into their operations.

Staff Travel

Staff travel also contributes significantly to the carbon footprint of hospitals. Hospitals can encourage active and sustainable transport options for their staff by providing incentives and infrastructure. This includes promoting walking, cycling, and the use of public transportation. Hospitals can collaborate with local authorities to develop suitable routes for active transport and provide secure storage and changing facilities for cyclists. Additionally, car-sharing schemes and incentives for low-carbon vehicles, such as electric or hybrid cars, can be encouraged. Reimbursement policies can be structured to favor staff who choose more sustainable transportation methods.

Patient Travel

The use of telehealth and digital tools can reduce emissions from patient travel by offering remote monitoring, diagnosis, and treatment options. This reduces the need for patients to travel to hospitals for appointments, thereby decreasing carbon emissions. NHS Virtual Wards, for example, have demonstrated a reduction in carbon emissions and cost savings through the use of digital tools for remote patient monitoring.

Public Health and Prevention Initiatives

While not directly related to transportation, public health and prevention initiatives can also play a role in reducing carbon emissions associated with patient travel. By promoting green spaces, physical activity, and healthier diets, hospitals can contribute to improving local health outcomes and reducing the need for healthcare services. This, in turn, can lead to a decrease in carbon emissions from patient transportation.

Overall, hospitals can significantly reduce their carbon footprint in the area of transportation by adopting sustainable procurement practices, encouraging active and sustainable staff travel, utilizing telehealth and digital tools for patient care, and promoting public health and prevention initiatives. These measures not only benefit the environment but can also lead to cost savings and improved staff morale.

Renewable energy sources

Hospitals are major contributors to carbon emissions, with the healthcare industry in England responsible for 18 million tonnes of CO2 emissions annually. This amounts to 30% of total public sector greenhouse gas emissions and 3.2% of the country's total CO2 emissions. Hospitals in the US also produce the greatest share of healthcare emissions globally and have the highest per-capita healthcare climate footprint.

Given the significant environmental impact of hospitals, adopting renewable energy sources is a crucial strategy to reduce their carbon footprint. Here are some key renewable energy sources that hospitals can consider:

Wind and Solar Power

Wind and solar power are clean, readily available, and inexpensive sources of renewable electricity. Hospitals can invest in on-site wind turbines or solar panels to generate electricity, reducing their reliance on fossil fuels. This approach not only reduces their carbon footprint but also increases their resilience to disruptions in the electric grid during extreme weather events.

Biomass

Biomass is a renewable energy source derived from organic plant material. When burned, biomass releases carbon that was captured from the atmosphere, unlike fossil fuels, which release ancient carbon sequestered in the earth's crust. However, to ensure carbon neutrality, new plants must be grown to sequester the carbon emitted from burned biomass. There are two types of biomass fuels:

• Open-loop biomass fuels: These are sourced from by-products not originally intended for fuel use, such as agricultural or sawmill residues.
• Closed-loop biomass fuels: These are plants specifically grown and harvested as fuel crops, such as switchgrass.

While biomass can be used for electricity generation, there are concerns about sustainable forestry, carbon, and local health impacts. The burning of biomass can release harmful pollutants, especially if waste construction materials are included in the fuel mix. Therefore, hospitals considering biomass should carefully evaluate the fuel supply chain and potential local health consequences.

Small Hydro Technologies

"Run of river" and "kinetic flow" technologies are small hydro solutions that have gained popularity due to their reduced environmental impact compared to traditional large dam hydroelectric projects. These technologies utilize the kinetic flow of a stream, minimizing negative effects on wildlife and habitats, while still providing renewable energy.

Anaerobically Produced Biogas

Biogas is formed when organic material decomposes in an anaerobic (oxygen-free) environment. The principal component of biogas is methane, which can be used as a heating fuel or for electricity production. However, impurities in biogas require special cleaning or emissions control equipment.

By transitioning to these renewable energy sources, hospitals can significantly reduce their carbon footprint, improve their resilience, and contribute to the global effort to mitigate climate change.

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