Hazardous Chemicals in Health Care Facilities

Healthcare workers and patients are routinely exposed to harmful chemicals in many healthcare facilities. By implementing least-toxic practices and utilizing safer alternatives wherever possible, healthcare facilities can become models of health for the entire community, rather than sources of contamination.

How are Patients and Healthcare Workers Exposed?

There are a number of routes of exposure. Products common to the health care setting that contain toxic chemicals include:

Baby bottles (phthlates or bisphenol-A)
Medical gauges, thermometers, sphygmomanometers, dental amalgam, laboratory chemicals and preservatives such as thimerosal (mercury)
LCD displays, fluorescent lamps, and computer equipment (mercury)
Cathode ray tube (CRT) monitors (lead)
IV pumps, televisions, computers, hospital beds, waiting-room chairs and hospital privacy curtains & computers (brominated flame retardants)
Industrial paints (volatile organic compounds) and flooring (PVCs, dioxin)
Cleaners and disinfectants (glutaraldehyde, formaldehyde, ammonia, phthalates, glycol ethers, triclosan, volatile organic compounds)
Fragrance chemicals (volatile organic compounds, phthalates)
IV bags and tubing (PVCs, dioxin, phthalates)
Disposable gloves (PVCs, dioxin, phthalates)
Stain-resistant clothing (perflourinated compounds)
Pesticides sprayed on the lawns and indoors (carbaryl, cyfluthrin, glyphosate, Roundup, 2-4, D, pyrethrins)
Pesticides used to treat head lice and scabies (lindane, permethrin, pyrethrum)
Pesticide residues in cafeteria food (organophosphates, carbaryl, 2-4, D, glyphosate)

Antibacterial hand sanitizers may contain triclosan, also called Microban, Irgasan, Lexol, Ster-Zac, Cloxifenolum, and Biofresh. There is evidence to suggest that triclosan is capable of interfering with hormones in multiple species. Studies show that triclosan can disrupt thyroid function in people. It is persistent and can bioccumulate. People may also breathe air that is poisoned with chemicals used in industrial strength cleaners. Some chemicals used in cleaners have been linked to asthma and others are associated with reproductive harm. See our Cleaning Products page for more information about adverse health effects that have been linked to synthetic chemical ingredients used in cleaning products.

Hazardous Chemicals in Health Care: A Snapshot of Chemicals in Doctors and Nurses

Alaska Community Action on Toxics collaborated on an investigation of chemicals found in the bodies of health care professionals. The biomonitoring project tested for 62 distinct chemicals and found that all 20 participants had toxic chemicals associated with the health care profession in their bodies.

Download the Hazardous Chemicals in Health Care report
Download our fact sheets on the six categories of chemicals tested for in the project:

Waste Management Practices Can Lead to Exposures Beyond the Health Care Setting

Certain waste management practices emit pollutants into the surrounding environment, affecting people, fish and wildlife well beyond the walls of the health care facility. Due to the difficulty and expense of managing waste in remote areas, most rural Alaska clinics incinerate their medical waste, releasing dangerous air pollutants such as dioxin and mercury.

Alaska Community Action on Toxics conducted a representative survey of ten rural Alaska village clinics and ten regional health care facilities for the Environmental Protection Agency (EPA) in 2005.
Ninety percent of the village clinics surveyed burned a portion of their wastes, using either the “burn pit” at the village landfill or a burn barrel outside the clinic.

Survey results also indicated that the most significant problems in waste management for rural health care facilities are lack of options for waste management strategies and exorbitant shipping costs. Additional problems raised included lack of knowledge and understanding of waste management regulations and the reliance on clinic health care staff to manage wastes at rural health clinics.

Report: A Survey of Waste Management Practices at Alaska’s Health Care Facilities

What Can Patients Do?

Contact your state legislators and Congress to rally support for legislation on the state, national, and international level that reduces the production and sale of toxic chemicals.
When possible, choose health care facilities that are utilizing least toxic products and practices. Contact the facility’s administration, Green Team or the sustainability coordinator to find out more about the facility’s purchasing policy or methods of medical waste disposal.
Because utilization of safer products may vary by hospital department, ask the unit supervisor about the use of products that may contain toxins on that unit. For example, the Providence Hospital Neonatal Intensive Care Unit keeps medically fragile neonates safer by utilizing phthalate-free IV tubing.
If your hospital or health care facility does not utilize least toxic products, contact the hospital administrators and the board of directors regarding your concerns about toxic products used in their facility. Present information on facilities that have improved their purchasing policy.
Ask your hospital to join Practice Greenhealth.
If your hospital incinerates medical waste, contact your hospital’s board of directors regarding your concerns about medical waste incineration and the release of dioxin.

What Can Health Care Professionals Do?

Support legislation on the state, national, and international level that reduces the production and sale of toxics by contacting your legislators. Ask your facility to publicly support this legislation.
Educate your patients, coworkers, and staff about toxic chemicals in consumer products and in the health care environment. Emphasize the importance of preventing exposure to toxins and discuss safer alternatives.
Talk to your supervisors, union representatives, and hospital administrators about an environmentally preferable and least-toxic purchasing policy. The Green Guide for Health Care is a helpful tool in establishing best practices.
Join your facility’s Green Team and educate them about the importance of choosing least-toxic products.
Ask your hospital’s board of directors to join Practice Greenhealth, the nation’s leading membership and networking organization for establishing environmentally sustainable practices.
If your hospital does not want to institute a least-toxic, environmentally preferable purchasing policy for all goods, ask that they start by purchasing a few environmentally preferable products. Green cleaning products, toxic-chemical free skin lotion and unbleached, recycled paper goods are highly consumable products that need to be replaced frequently. Replacing these products will reduce the facility’s toxic footprint and can overcome the preconception that going green requires sacrifices.
Ask your institutional purchaser to let you know when the next major purchase will occur. When the decision nears, provide information about least-toxic products and the importance of reducing toxic chemicals in the health care environment.
Ask vendors to disclose whether their products contain carcinogens, persistent bioaccumulative toxics, mutagens, asthmagens, or reproductive toxicants. This can alert vendors of the preference for least-toxic materials.
Ask that your facility industrial products and services be certified by Greenseal.
If your hospital incinerates medical waste, contact your hospital’s board of directors regarding your concerns about medical waste incineration and the release of dioxin.

Additional Resources:

Practice Greenhealth is a membership and networking organization for institutions in the healthcare community that have made a commitment to sustainable, eco-friendly practices. Members include hospitals, healthcare systems, businesses and other stakeholders engaged in the greening of healthcare to improve the health of patients, staff and the environment.
Health Care without Harm works to transform the health care sector worldwide, without compromising patient safety or care, so that it is ecologically sustainable and no longer a source of harm to public health and the environment.
Green Guide for Health Care is a best practices guide for healthy and sustainable building design, construction, and operations for the healthcare industry.