Diagnosing chemical footprints in pediatric health care
The list of companies investing in chemical footprinting is on the rise.
More than 20 brands including adidas, Beautycounter, Becton Dickinson, Herman Miller, GOJO Industries, HP, Johnson & Johnson, Levi Strauss & Co., Seagate Technology and Walmart reported on their chemicals management progress in August, as measured in the annual Chemical Footprint Project report. Then in September, Walmart committed to reduce its chemical footprint by 10 percent by 2022, with the goal of reducing more than 55 million pounds of priority chemicals.
Now, concerned with the vulnerability of pediatric patients to exposure from hazardous chemicals, health care providers are scrutinizing the chemicals contained in the products they use on a daily basis.
Beginning in the early 2000s, many health care organizations including Dignity Health (PDF) moved to eliminate DEHP phthalate from medical supplies. More recently, in 2016, Kaiser Permanente set a 2025 goal to increase its purchase of products and materials that meet environmental standards, including avoiding hazardous chemicals, to 50 percent.
Chemical footprinting is the process of evaluating the presence of hazardous chemicals in products, manufacturing processes, supply chains and/or packaging. Chemical footprints provide data for evaluating performance and benchmarking progress away from hazardous chemicals to safer alternatives.
A new report by the non-profit Clean Production Action, "Chemical Footprint of Products Commonly Used in Pediatrics Departments," evaluates over 250 products commonly used in a hospital pediatric patient room. These include medical supplies, personal care products, furniture and furnishings, and cleaning and disinfecting products. The findings included:
- Slightly less than half (45 percent) of the 253 products evaluated contained one or more chemical of high concern (CoHC) to human health and the environment. The CoHCs reported in products included polyvinyl chloride (PVC) plastic, phthalates, Bisphenol A (BPA), and other carcinogens and reproductive toxicants identified by California Proposition 65 (aka Prop 65).
- Intravenous, enteral feeding and respiratory therapy products were the medical supplies with the greatest number of products containing CoHCs.
- Antimicrobials and antibacterials are becoming common additives to products that come into contact with patient skin, including patient ID bracelets and cribs.
In summary, the findings indicate that suppliers are using CoHCs in almost 50 percent of products that commonly come in contact with pediatric patients.
With chemical footprint data in hand, health care organizations can engage suppliers in searching for alternatives that use inherently safer chemicals and have a baseline for measuring their progress in reducing their footprint. As Kyle Tafuri, director of sustainability at Hackensack-Meridian Health, explained, "Having chemical footprint data reveals where CoHCs are in products, which in turn helps us make better purchasing decisions that advance our mission of health."
The research revealed that PVC, phthalates and other Prop 65 chemicals are the most widely found CoHCs in pediatric medical supplies. If health care suppliers eliminated PVC and its associated CoHCs from the medical supplies reviewed in this survey, they would eliminate 75 percent of the CoHCs in medical supplies. And a number of products, including all the personal care products, featured one or more supplier selling one product with CoHCs, while another supplier sold a comparable product without CoHCs. For these products, the chemical footprint analysis provides a ready pathway to identifying suppliers using safer chemicals.
Integrating chemical footprinting and acting upon the results in health care requires collecting, managing and analyzing the data. The following actions would simplify the process for all health care organizations interested in tracking and reducing CoHCs in products:
- Consensus: Agree to a common list of CoHCs for health care such as the Chemical Footprint Project’s list of CoHCs.
- Reporting: Require suppliers to (or prefer suppliers that) report chemical ingredients to a common template such as the HPD Open Standard developed by the Health Product Declaration Collaborative.
- Certification: Use a third-party certification of products such as GreenScreen Certified, that identifies products that do not contain CoHCs. Such a certification greatly would simplify communication between suppliers and health care organizations as to the presence or absence of CoHCs in products.
This first chemical footprint of products used in pediatric patient rooms demonstrates how health care organizations can measure and reduce their chemical footprints, highlights the need to perform additional research to fill data gaps and identify products that do not contain CoHCs, and clarifies the value of investing in systemic initiatives that will enable the rapid measurement and reduction of chemical footprints.