Nurse Barbara Bevan-Abel won an award for creating recycling programs for health care facilities at UCSF.
The Bay Area has been making important strides on climate action, most recently with Mayor London Breed’s unveiling of a 2021 climate action plan that aims to make San Francisco a net-zero emissions city by 2040.
Though laudable, the plan may fall short of achieving its goal if the city continues to overlook the adverse climate impact of one local industry: health care.
The health care industry has long accounted for a substantial portion of climate emissions. According to some estimates, nearly 5% of global greenhouse gas emissions can be traced to health care activities in developed countries, such as keeping hospitals running, providing emergency transportation and manufacturing medical supplies. The U.S. health care system alone is responsible for about a quarter of all global health care greenhouse gas emissions, more than that any other country’s health care system.
Though 5% may not seem like much, researchers suggest that the health care industry’s climate impact is as critical to address as the food industry’s, which arguably receives much greater attention.
Emissions alone don’t tell the full story. Indeed, medical facilities produce high volumes of nonreusable waste, including but not limited to disposable syringes, contaminated exam gloves and even expired medications. This can generate up to 40 pounds of waste for each hospital bed per day in the U.S.
Why does this matter for the San Francisco Bay Area? It’s no secret that the region is a medical hub, boasting some of the finest and largest research hospitals and care facilities. In fact, San Francisco is home to Dignity Health, one of the country’s largest not-for-profit hospital systems, and top-ranked medical schools at Stanford and UCSF. As medical students ourselves, we’re privileged to learn and live in the vicinity of such world-class institutions. And yet we’ve also seen just how much the local health care industry could improve in mitigating its climate footprint.
Paper waste and plastic packaging seem to know no bounds in hospital settings. It’s a sad irony that such waste is generated in the very places that exist to keep people healthy when we know that teeming landfills are part of what’s making some communities so sick. COVID-19 certainly hasn’t eased the strains, either. Rather, the pandemic has heightened the emphasis on single-use disposable medical supplies as hospital protocols prioritize sterility, cleanliness and patient safety.
Safety is first and foremost. Nonetheless there are safe ways that San Francisco’s health care industry can adopt a greener approach.
To start, Mayor Breed’s climate action plan should include more calls-to-action specific to the health care industry. Currently, the plan describes how two San Francisco hospitals will soon cut their greenhouse gas emissions via adjusting their food purchasing practices. However, this objective is mentioned as part of an effort to mitigate the food industry’s climate impact, not specifically the health care industry’s. By explicitly delineating an intentional partnership with San Francisco’s medical centers, hospitals and care facilities, the city could identify novel opportunities for building a more sustainable future.
It’s also worth recognizing and building upon the strides that some of the city’s institutions have already made on their own. UCSF’s Green OR Initiative, for example, focuses on increasing recycling in operating rooms, where large amounts of recyclable packaging waste can be effectively separated from contaminated supplies. While the contaminated supplies are sterilized and ultimately fed into landfills, the packaging can be intercepted from the waste stream. San Francisco has a long-standing vision for sending zero waste to landfills, and it’s critical that targeted initiatives like these be strengthened and adopted across other hospital systems in the area.
One creative success story that San Francisco can use as a model to reduce waste is from the Overlook Medical Center, part of New Jersey’s Atlantic Health System. The center’s clever intervention focuses on surgical blue wrap, a material used in U.S. operating rooms to such an extent that at least 225 million pounds of it become waste each year. In 2019, a nurse at Overlook decided to sew tote bags from the blue wrap. Some 100,000 of these durable tote bags were provided to patients in lieu of the plastic bags previously used to store personal items. Incredibly, this simple switch saved the center $30,000 as well. Overlook even went a step further by sewing blue wrap sleeping bags that were distributed to the local homeless community.
It’s not inconceivable that San Francisco could benefit from something similar.
Finally, there’s a case to be made for ramping up nonprofit support. One organization, ReCares, is working to reduce medical waste by redistributing gently used equipment like wheelchairs and blood pressure machines to individuals in need. The nonprofit currently has three sites of operation in the San Francisco Bay Area and could potentially be scaled up with the appropriate backing.
Ultimately, there’s an opportunity to take a multilevel approach to protecting the health of San Franciscans — from the operating rooms to the hospital systems to the citywide interventions that combat the health care industry’s contributions to climate change. San Francisco, with its premier medical institutions, can and should be at the forefront of mobilizing the health care industry toward larger efforts at healing the planet and embracing greater climate consciousness. This year offers a fresh slate to do so.
Henna Hundal is a public policy specialist and a medical doctor candidate at the Stanford University School of Medicine. Gurbani Kaur is a medical doctor candidate at the UCSF School of Medicine.