[OPINIONATED] Sustainability or Healthcare Services?
Sustainability or Healthcare Services?
By: Khang Nguyen
As the global demand for healthcare rises, so do the concerns for the environmental impacts of one of the largest industries in the world. Accounting for over 10% of most of the world’s developed countries' gross domestic products in 2022, the healthcare industry is undoubtedly among the fastest-growing industries [1]. Additionally, the World Health Organization has also recently launched multiple global initiatives, such as aiding civilians amidst conflicts in Ukraine and Palestine, ensuring food and health security in Iran, and safeguarding human rights to healthcare in Jordan. It is clear that the global demand for accessible healthcare services is at an all-time high, but is there another factor we forgot to account for?
That's right, the healthcare industry is also leading the global greenhouse gas emissions, responsible for over 4.4% of the world’s carbon footprints [2]. For the records, that is a whopping 1.64 billion metric tons out of the record high of 37.4 metric tons in 2023 [3]. This enormous emissions mostly came from energy usages of hospitals and pharmaceuticals, as most still heavily rely on natural gas-generated electricity for their daily operations such as ventilation, lighting, and heating. With the clinical operating room being by far the most energy-intensive process, with strict sanitary requirements for constant ventilations and sterilisations. These imposed regulatory measures tremendously push back energy conservation initiatives for many hospitals. As remarked by director Jon Utech of Cleveland Clinics, they need to exchange the facility’s air up to 20 times every hour when the operating rooms are in use, expending over $2 million a year in energy consumption in just ventilations for 1 clinic alone [4]. Similarly to the hospital sector, the pharmaceuticals industry is also incredibly energy-intensive, alongside its rigorous regulations. Pharma manufacturers have to maintain a critical warehouse environment in terms of temperatures, humidity, and pressures for their demanding products. Many labs, research facilities, and industrial plants across the pharma industry are among the highest energy consumers, resulting in over $1 billion in annual expenditure on energy.[5]
The healthcare industry’s impact on the environment isn't only limited to carbon footprints but also its enormous production of waste and landfills each year. The healthcare industry produces approximately 5 million tons of waste each year across all of its facilities and operations [4]. Although most of the medical wastes generated by the activities of these facilities are general or non-hazardous wastes, they still take up 85% of the 87 000 metric tons of global medical wastes annually [6]. Not to mention these also greatly contribute to the amounts of landfills and the global greenhouse gas emissions. On the other hand, wastes generated by medical facilities that are considered hazardous can take the form of infectious, pathological, chemical, or radioactive wastes. All of which greatly threatens the environment, from air pollutants to contaminating soils, waters, and wildlife habitats. The poor waste management practices of the healthcare industry have also given rise to many diseases, such as hepatitis B&C and cholera from water pollutants, as well as pulmonary diseases and asthma from careless incineration, which is a common method of medical waste management. So, with all of these considered, should we start prioritising environmental conservation over our own healthcare services?
Firstly, it is impossible for any industry to completely erase all of their carbon footprints and environmental impacts, making these global issues much more complex than a one-dimensional yes-or-no solution. It is important to understand the limitations to implementing all of these environmental initiatives in the long terms, as well as the dire global demands for accessible healthcare in the short terms. Implementing sustainability practices such as redirections into renewable energy, the likes of solar energy, wind energy, or hydropower, is extremely financially intensive and time-intensive. Meaning that pharmaceuticals will have to redirect their funds away from research and developments of potentially life-saving drugs or hospitals have to orient focuses into managerially demanding projects instead of prioritising healthcare processes, which is extremely energy intensive. This social and economic pressure is even more prominent in developing countries, where most facilities lack the infrastructure and operations to properly manage waste [7]. Popularising unregulated methods of disposal of medical wastes such as incinerations, landfills, or water dumping as they are incredibly cost-effective. Although implementing renewable energy sources can significantly reduce carbon footprints and even potentially cut costs on energy in future medical operations, the returns aren’t always guaranteed and have extremely long periods before breaking even the investments.
Medical facilities around the world were able to find the perfect in-between to the global debates of sustainability over services. Cape Breton Regional Hospital of Nova Scotia, New Brunsiwck acknowledged the impossibility of prioritising either extremely important fronts and implemented the utilisation of industrial wood chips to heat and regulate its facilities, providing up to 60% of the facilities total energy [8]. Bioenergy in the form of industrial biomass that has no value, i.e., grass clippings, plant husks, and wood chips, can be repurposed through catalysts in place of fossil fuels to generate electricity. Likewise, Cleveland Clinics Foundation has invested $7.5 million in “Green Funds” in 2016 towards improving its infrastructure and facilities to Leadership of Environmental Energy Design (LEED) standards. By replacing over 49,000 fluorescent lights and ballasts with less heat-intensive light-emitting diodes (LEDs) across 14 facilities and research centres, the clinic saved 28.6 million kWh annually, a saving of over 19% [4]. Despite the substantial amounts of initial investment, the clinic estimated a payback period of only 4 years with an annual return of $2 million on energy saved.
In case-after-case, a 20–60% improvement in energy efficiency is definitely possible without compromising the healthcare operations behind the projects. Through appropriately allocating finances and resources to keep the constant flow of operations while gradually implementing a more sustainable, circular business model. As environmental health is being recognized for its vital roles in maintaining public health, small energy efficiency is definitely a step forward to a completely green future for healthcare.
The healthcare industry’s impact on the environment isn't only limited to carbon footprints but also its enormous production of waste and landfills each year. The healthcare industry produces approximately 5 million tons of waste each year across all of its facilities and operations [4]. Although most of the medical wastes generated by the activities of these facilities are general or non-hazardous wastes, they still take up 85% of the 87 000 metric tons of global medical wastes annually [6]. Not to mention these also greatly contribute to the amounts of landfills and the global greenhouse gas emissions. On the other hand, wastes generated by medical facilities that are considered hazardous can take the form of infectious, pathological, chemical, or radioactive wastes. All of which greatly threatens the environment, from air pollutants to contaminating soils, waters, and wildlife habitats. The poor waste management practices of the healthcare industry have also given rise to many diseases, such as hepatitis B&C and cholera from water pollutants, as well as pulmonary diseases and asthma from careless incineration, which is a common method of medical waste management. So, with all of these considered, should we start prioritising environmental conservation over our own healthcare services?
Firstly, it is impossible for any industry to completely erase all of their carbon footprints and environmental impacts, making these global issues much more complex than a one-dimensional yes-or-no solution. It is important to understand the limitations to implementing all of these environmental initiatives in the long terms, as well as the dire global demands for accessible healthcare in the short terms. Implementing sustainability practices such as redirections into renewable energy, the likes of solar energy, wind energy, or hydropower, is extremely financially intensive and time-intensive. Meaning that pharmaceuticals will have to redirect their funds away from research and developments of potentially life-saving drugs or hospitals have to orient focuses into managerially demanding projects instead of prioritising healthcare processes, which is extremely energy intensive. This social and economic pressure is even more prominent in developing countries, where most facilities lack the infrastructure and operations to properly manage waste [7]. Popularising unregulated methods of disposal of medical wastes such as incinerations, landfills, or water dumping as they are incredibly cost-effective. Although implementing renewable energy sources can significantly reduce carbon footprints and even potentially cut costs on energy in future medical operations, the returns aren’t always guaranteed and have extremely long periods before breaking even the investments.
Medical facilities around the world were able to find the perfect in-between to the global debates of sustainability over services. Cape Breton Regional Hospital of Nova Scotia, New Brunsiwck acknowledged the impossibility of prioritising either extremely important fronts and implemented the utilisation of industrial wood chips to heat and regulate its facilities, providing up to 60% of the facilities total energy [8]. Bioenergy in the form of industrial biomass that has no value, i.e., grass clippings, plant husks, and wood chips, can be repurposed through catalysts in place of fossil fuels to generate electricity. Likewise, Cleveland Clinics Foundation has invested $7.5 million in “Green Funds” in 2016 towards improving its infrastructure and facilities to Leadership of Environmental Energy Design (LEED) standards. By replacing over 49,000 fluorescent lights and ballasts with less heat-intensive light-emitting diodes (LEDs) across 14 facilities and research centres, the clinic saved 28.6 million kWh annually, a saving of over 19% [4]. Despite the substantial amounts of initial investment, the clinic estimated a payback period of only 4 years with an annual return of $2 million on energy saved.
In case-after-case, a 20–60% improvement in energy efficiency is definitely possible without compromising the healthcare operations behind the projects. Through appropriately allocating finances and resources to keep the constant flow of operations while gradually implementing a more sustainable, circular business model. As environmental health is being recognized for its vital roles in maintaining public health, small energy efficiency is definitely a step forward to a completely green future for healthcare.
Citations:
1)Healthcare spending as a percentage of GDP by country 2022 | Statista. (2022). Statista; Statista. https://www.statista.com/statistics/268826/health-expenditure-as-gdp-percentage-in-oecd-countries/
2)Mercer, C. (2019). How health care contributes to climate change. Canadian Medical Association Journal, 191(14), E403–E404. https://doi.org/10.1503/cmaj.109-5722
3)IEA in. (2023). Executive Summary – CO2 Emissions in 2023 – Analysis - IEA. IEA. https://www.iea.org/reports/co2-emissions-in-2023/executive-summary
4) Budd, K. (2019). Hospitals race to save patients — and the planet. AAMC. https://www.aamc.org/news/hospitals-race-save-patients-and-planet#:~:text=Hos
pitals%20and%20labs%20emit%204.4,to%20reduce%20its%20carbon%20footprint.&text=The%20statistics%20are%20staggering.5)Pharma Companies Cutting Energy Consumption To Gain A Competitive Advantage. (2024). Centrica Business Solutions. https://www.centricabusinesssolutions.com/us/blogpost/pharma-companies-cutting-energy-consumption-gain-competitive-advantage#:~:text=As%20such%2C%
1)Healthcare spending as a percentage of GDP by country 2022 | Statista. (2022). Statista; Statista. https://www.statista.com/statistics/268826/health-expenditure-as-gdp-percentage-in-oecd-countries/
2)Mercer, C. (2019). How health care contributes to climate change. Canadian Medical Association Journal, 191(14), E403–E404. https://doi.org/10.1503/cmaj.109-5722
3)IEA in. (2023). Executive Summary – CO2 Emissions in 2023 – Analysis - IEA. IEA. https://www.iea.org/reports/co2-emissions-in-2023/executive-summary
4) Budd, K. (2019). Hospitals race to save patients — and the planet. AAMC. https://www.aamc.org/news/hospitals-race-save-patients-and-planet#:~:text=Hos
pitals%20and%20labs%20emit%204.4,to%20reduce%20its%20carbon%20footprint.&text=The%20statistics%20are%20staggering.5)Pharma Companies Cutting Energy Consumption To Gain A Competitive Advantage. (2024). Centrica Business Solutions. https://www.centricabusinesssolutions.com/us/blogpost/pharma-companies-cutting-energy-consumption-gain-competitive-advantage#:~:text=As%20such%2C%
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