HCWH Europe Newsletter: Global Green and Healthy Hospitals Network


 Health Care Without Harm Europe
In this issue
Members Updates
Issues: Energy | Medical Waste | Procurement | Mercury | Chemicals | Pharmaceuticals | Biocides
Other News
Anja Leetz
This newsletter gives you a roundup of latest EU development on HCWH key subjects (energy, mercury, pharmaceuticals, biocides and chemicals) and alerts you of interesting publications and upcoming conferences. Find out how to become a founding member of the Global Green and Healthy Hospitals Network

While most of you are getting ready for a well-deserved summer break we wanted to alert you to register for CleanMed Europe before you go away. In case you are not sure why to attend then be kindly invited to watch our short video here. We have great keynote speakers and cover many aspects of sustainability in healthcare in the parallel session, which will inspire you for your own work. A great start to the autumn season!

I hope to meet many of you at CleanMed Europe in September 2012 and wish you a relaxing holiday season!

Best wishes

Anja Leetz
Executive Director – HCWH Europe


Become a founding member of the Global Green and Healthy Hospitals Network
PPT on Climate Change and the Role of Healthcare Professionals
This initiative is based on the Global Green and Healthy Hospitals Agenda, a document that provides a comprehensive framework consisting of ten interconnected goals to support hospitals and health systems everywhere in the world to achieve greater sustainability and to contribute to improved public environmental health. The Network is quickly becoming a vibrant international community of hospitals, health systems and member organisations, all seeking to implement and the agenda, achieve measurable outputs and share best practices. You can find out more about the agenda and the network at www.greenhospitals.net

To date, Founding Network Members include the Sustainability Unit of England's National Health Service, the Indonesian Hospital Association, the Australia Hospitals and Health Care Association, Thailand's Department of Health, the Healthier Hospitals Initiative in the United States and individual hospitals in countries such as Argentina, Brazil, Costa Rica, Italy, India, Mexico, Nepal, Sweden and UK.
Data needed for new HCWH project on fair and ethical trade
New HCWH Climate and Health News Service
Health Care Without Harm Europe is developing a new international project on fair and ethical trade for the health sector to raise awareness on how products are produced and traded globally and within the European market. In order to determine the focus of the research of the project HCWH is currently looking for data on the most commonly purchased products (in terms of quantity and cost) of European hospitals. If you represent a hospital, a procurer, a health association or a local authority that could help us to get aggregated data, please get in contact with Grazia Cioci at grazia.cioci@hcwh.org.
Updating the NHS Adaptation to Climate Change Guidance
Updating the NHS Adaptation to Climate Change Guidance

The NHS is looking for contributions to update their adaptation guidance. The guidance summarises the current knowledge on adapting to climate change in NHS organizations. It describes what climate change adaptation is, why it is a priority for the NHS and how organisations can include adaptation in their Sustainable Development Management Plans (SDMPs). Contributions and suggestions can be sent to Imogen.tennison@sdu.nhs.uk
Members Update

Seventeen French medical facilities on their way to premium environmental management

The Committee of Sustainability and Health (Comité de Développement durable en Santé, C2DS) and the Ministère de L'Écologie, du Développmentn Durable et de l'Énergie of France agreed on a cooperation to share costs and accompany 17 organisations in the medical sector to register under EMAS. Last November the C2DS launched a new EMAS project aimed at medical facilities. The C2DS encouraged its 259 member organisations to register under EMAS, receiving an immediate response of 17 hospitals, retirement homes and similar organisations. At the kick-off meeting in January 2012, representatives of the 17 institutions committed themselves to hand in their first environmental statements within the next twelve months. more | Visit C2CS web

New study shows that PVC/DEHP blood bags pose a significant risk to human health

The study was commissioned by the EU Life+ project PVCfreeBloodBag a cooperation of four European companies and two of our Swedish members: the Jegrelius Institute for Applied Green Chemistry and the Karolinska University Hospital. PVC is constituted in part by DEHP, a phthalate classified as a reproductive disruptor that has been phased out of healthcare and healthcare products, except for blood bags. The project PVCfreeBloodBag aspires to produce a PVC-free bag and aims for a phase out of current blood bags in Europe.

Breaking News, July 2012: Thanks to this study the EU Commission has now asked the Scientific Committee on Emerging and Newly Identified Health Risks for a scientific opinion on the safety of medical devices containing DEHP. Well done Jegrelius and Karolinska! more
New tool will enable investors to evaluate the chemical industry

ChemSec presented in June 2012 a concrete criteria catalogue, with 38 indicators, to enable financial investors to assess the performance of the chemical industry. ChemSec wants to turn financial investors into important allies able to increase pressure on the chemical industry, tackling the problem of hazardous chemicals at its source. Financial investors would be able choose sustainable investments and in that way force companies to become more transparent, develop safer alternatives and move away from hazardous chemicals. more

Chemical exposure and health concerns

ChemSec compiled a wealth of knowledge on the links between chemical exposure and health concerns. Easily graspable information is now available on their website providing links between hazardous chemicals and cancer, obesity, diabetes, thyroid function, neurotoxicity, and female and male reproductive health. more


Greener inhalers for the UK

The Center for Sustainable Healthcare will lead a research on why metered dose inhalers (MDIs) are still the majority of inhalers prescribed in UK. MDIs use propellants that can act as powerful greenhouse gases and have a higher carbon footprint. In the past, chlorofluorocarbons (CFC) were the most common propellants and after their ban, many European countries moved directly to a new type of inhalers based on dry powder (DPI). The research will try to establish if there is any good clinical evidence to support the continued use of MDIs and identify other barriers to changing to a greener solution.  more


Construction with ecological criteria

Gesundheits- und Spitals-AG (gespag) from Austria, supervised the new headquarters of the Operator of the Upper Austrian Regional Hospitals. The major aim was to create a pilot project for the sustainable construction of health facilities using ecological criteria. A second goal was to understand the difficulties of working with materials that fitted those criteria and improve knowledge transference to the site manager and construction companies. Only approved materials were used at the construction site based on datasheets sent two weeks ahead of use by contractors. A few materials not in conformance were detected during inspections but overall results were very positive and will be used to adapt guidelines for the construction of new health facilities.   more

OECD Environmental Outlook to 2050: The Consequences of Inaction

A new report by the Organization for Economic Cooperation and Development (OECD) released in March 2012 presents the latest projections of socio-economic trends over the next decades and their impact on human health and the environment. Air pollution is expected to be the number one cause of environmentally related deaths worldwide, if no new policies are introduced, ahead of other environmental risks as water quality or sanitation. OECD countries are anticipated to have one of the highest ozone-related mortality rates because of their ageing population. Key findings
WHO: Measuring health gains from sustainable development

In the context of Rio+20 UN Conference on Sustainable Development WHO published a set of key briefings from a recent WHO analysis and expert consultation. Measuring health indicators can tell us how well development is advancing in social, environmental and economic terms. The briefings examine the health impacts of climate change mitigation strategies and include policy briefs on Agriculture, food and nutrition security, Disaster risk management, Energy, Jobs, Sustainable cities and Water. more
Exposure to chemicals during development related with susceptibility to disease

Exposure to environmental contaminants before birth may result in increased susceptibility to disease later in life was the consensus statement that emerged from a conference that took place last May and was now published in the Environmental Health journal. The statement was presented in the final session of the PPTOX III, Environmental stressors in the development origins of disease: Evidence and Mechanisms" and describes how nutritional imbalance, infections, stress and exposure to certain chemicals in the womb can lead to disease manifestation in adults years or decades later depending on exposure and timing. more
Articles on health and climate change

A series of articles on climate change and health issues are available free of charge through BMJ. Topics covered include health risks of climate change, Suggestions at the policy level, resource security and inequity.
How the low carbon economy can improve health The health impacts of climate change
Climate change and resource security Politics and policies: making change happen
Climate change: what needs to be done
Health risks, present and future, from global climate change
Contraction and convergence: the best possible solution to the twin problems of climate change and inequity
Berlin: Low Dose Effects and Non–Monotonic Dose Responses for Endocrine

Active Chemicals: Science to Practice
Date: 11–13 September 2012

Key topics: This workshop seeks to lay out the evidence for low dose effects and non–monotonic dose responses in relation to endocrine active chemicals, with the goal of establishing whether the current observations are sufficient to re-examine the ways in which chemicals are tested for endocrine disrupting properties and how risk to human health may be managed.

Who should attend?: Toxicologists, environmental health scientists, regulatory authorities and risk assessors interested in all aspects of endocrine disruptors/endocrine disruption.

Mainz: 3rd International Fresenius Conference – Endocrine Disruptors

Date: 17-18 September 2012

Key topics: Non–european testing strategies and criteria; New mechanisms and dose-response analysis; Weight of evidence approaches; EU Regulatory developments and perspectives.

Who should attend?: Researchers in the field of toxicology and ecotoxicology from universities and industry, consultants from regulatory authorities and testing laboratories, risk assessors, and NGOs.

Stockholm: Promoting Hospital-Primary Care Collaboration for Rational Use of Medicines – Workshop and Site Visit

Date: 11–13 September 2012

Key topics: Visit to the Stockholm Healthcare Region to show a new model for improving quality of medicine use in metropolitan Stockholm.

Who should attend?: Medical executives, advisors and researchers in charge of enhancing the quality and efficiency of medical prescribing and medicine use in healthcare institutions, in particular at the interface between hospitals and primary care.

Coventry: Health Protection 2012

Date: 11-12 September 2012

Key topics: Latest scientific advances and practices to prevent and reduce infectious diseases; minimize the impact of radiation, chemical and environmental hazards and prepare for potential or emerging threats to health.

Who should attend?: Those working across the breadth of health protection - from public health services and hospitals, industry, environmental health, emergency planning, laboratories and research institutions.

Malmo: 8th EcoProcura Conference

Date: 19–21 September 2012

Key topics: The conference will focus on what the proposed and latest legislation, strategies, guidance and practical solutions mean to public authorities implementing SPP and procuring innovation.

Who should attend?: Purchasers from all levels of government, suppliers, police makers.

Paris: Policy makers meeting – Human Biomonitoring in Europe

Date: 22 September 2012

Key topics: Discuss operational aspects of the draft concept for a European HBM framework.

Who should attend?: Policy makers from EU Member States.

Malmo: CleanMed Europe 2012

Date: 26–28 September 2012

Key topics: Sustainability within the health care sector. Presentation of cutting-edge practices related to designing and building greener hospitals, creating healthier food systems and promoting preventive medicine.

Who should attend?: Professionals of the healthcare sector, Environmental Managers, Facility Managers, Waste Managers, Energy Managers, Procurement Experts from hospitals and local councils/regions.

more | watch promotional video
Krakow: 3rd EPH Annual Conference of Environment and Public Health in Modern Society

Date: 25-28 October 2012

Key topics: EPHmodern Conference consists of specialized scientific and policy orientated seminars. In 2012, the major focus will be in genetics, epi–geneticis, endocrine interactions, and radiation; and in, urban and regional approaches in environmental and health research and prevention in Europe.

Who should attend?: Scientists, policy makers and professional groups and actors in the field of environment and health at all levels of European society.

Berlin: 3rd Annual Health 2.0 Europe

Date: 6–7 November 2012

Key topics: Innovation for the health system.

Who should attend?: Health entrepreneurs, IT solution providers, health professionals, patient organizations, health authorities, public and private insurance organizations, medical devices and pharmaceutical companies, telecom groups, VC and financiers, policy makers and academics.

Gothenburg: 21st International HPH Conference

Date: 22–24 May 2013

Key topics: It is a forum of learning and exchange on health promotion in and by health services.

Who should attend?: Health practitioners, consultants, scientists and politicians that hosts on average 500 delegates every year. Further information, including an option for online abstract submission, will be online here.

Agreement on the Energy Efficiency Directive (EED)

An agreement was finally reached on the Energy Efficiency Directive between the European Parliament, the Council and European Commission negotiators. The directive aimed to achieve a 20% energy saving by 2020 and help the EU economy become more competitive by creating growth and up to 400 000 additional jobs. Member States will have to set an indicative national energy efficiency target for 2020 by April 2013. Several organizations have already criticized the agreement for being too weak, with many efficiency measures proposed by the Parliament having been watered down significantly compromising the 20% reduction target.  more
Energy is a health issue

WHO organised an event during RIO+20 on Energy is a Health issue: Enabling the Millennium Development Goals for health & women's empowerment. Topics covered included health and sustainable energy access in homes, health facilities and communities.more
Medical Waste
UK Campaign to reduce medicine waste

A new campaign is being launched all over UK to raise awareness and encourage patients to only order medicine that they need. The campaign is being launched in cooperation with GPs and pharmacists across the country. Unused medicines represent a large amount of waste – an estimated £44 million a year in Scotland or £3.5 million in Bedfordshire and Luton, for example. The campaign will also encourage patients to return unwanted medicines to be safely disposed and to have regular reviews of their medicines with their pharmacists or prescribing doctors and to use them more effectively.  more
Down to Zero Launch

Three new Joint Public-Private Low Carbon Procurement Compacts were launched recently by the UK Corporate Leaders Group on Climate Change (CLG) and the Department of Business, Innovation and Skills. The Compacts demonstrate to potential suppliers that there is a substantial and organised market demand for low carbon solutions in the transport, catering and biomethane areas. The joint public-private aims to generate growth and jobs in the low carbon economy by boosting the supply of affordable low carbon goods and services and creating opportunities for innovating companies.  more
Phase-out of mercury in medical devices

The fourth session of the Intergovernmental Negotiating Committee to prepare a global legally binding instrument on mercury (INC4) took place in Uruguay in June. Several health and environmental organizations and professionals, including Health Care Without Harm, were pressuring for the inclusion of a global phase-out of mercury based medical devices in the new treaty. However, with only one last round of negotiations left, the lack of progress on many major policy issues puts at risk a global accord that will protect public and environmental health from mercury pollution suggested the International POPs Elimination Network and the Zero Mercury Working Group (ZMWG). UNEP | IPEN | ZMWG
European Commission to adopt new community strategy concerning mercury – sphygmomanometers

A ban for sphygmomanometers for health uses is expected from 2014 under the new comprehensive strategy against mercury pollution proposed by the European Commission. The strategy proposes a series of actions to cut EU and global emissions and use of mercury and will be adopted if there is no opposition from the European Council of Ministers or the European Parliament. Exemptions will be available for ongoing epidemiological studies and reference standards in clinical validation studies of mercury-free sphygmomanometers. Alternative reliable measuring devices in health care are already available.   more
Updates in dental amalgam

The European Commission published in March, a draft study on the "Potential for reducing mercury pollution from dental amalgam and batteries". The report presented four policy options to reduce the impacts from the use of mercury in dentistry. From no policy change, improve of EU waste legislation, to encourage reduction or to completely ban the use of mercury, by adding it to the Annex XVII of the REACH Regulation. The ban could be achieved by 2018 and it would be expected that mercury releases from historical amalgam use would have significantly decreased 15 years after the ban took effect. The draft showed that costs for patients would likely increase by a ban but that society costs would be severely reduced with a ban bringing health benefits. This was backed by a report released by the European Environmental Bureau (EEB) on the "The Real Cost of Dental Mercury". Calculations on the report showed how, if pollution control costs, loss of common resources and health effects associated with mercury were taken into account, dental amalgams were significantly more costly than other filling materials. The ban of dental amalgams would be a normal follow-up on the EU Mercury Strategy and the EEB urged the European Commission and Member States to act immediately to phase out the use of mercury in the dental sector as quickly as possible. EC Europe web | ZMWG
Mercury in dental amalgam and resin-based alternatives in US

A new report by the Health Care Research Collaborative compared the health and environmental impacts of mercury dental amalgam with those of alternatives currently available in USA. The report shows that mercury impacts outweigh those of resin composites and glass ionomer fillings and presents successful examples of mercury substitution in several countries with little or no impact on dental health. Recommending for a planned phase-out of mercury dental amalgams and urging governments and international agencies to support the costs of the transition in impoverished areas. The Research Collaborative results from a partnership between the University of Illinois at Chicago School of Public Health, the Healthier Hospitals Initiative and Health Care Without Harm.   more
ECDs related with increased disease occurence

A new report commissioned by the European Environment Agency (EEA) shows how chemicals which disrupt the hormone system can be a contributing factor behind the significant increase in cancers, diabetes and obesity, failing fertility, and an increased number of neurological and development problems in both humans and animals. The report - "The impacts o endocrine disrupters on wildlife, people and their environments – The Weybridge+15 (1996-2011)" reviewed recent scientific literature on endocrine disrupting chemicals (EDCs). A growth of the chemical industry was linked with increasing rates of endocrine diseases and disorders, leaving scientists concerned with the role of EDCs in those processes.  more
Painkillers contaminate Germany's waterbodies

A recent literature review commissioned by the German Federal Environment Agency shed light on the occurrence of pharmaceuticals in the environment. Germany's waterbodies and soil are showing more and more traces of pharmaceutical residues. Of the 156 agents traced, 24 are classified as high priority, including the painkiller Diclofenac. Most of the substances reach the environment through household sewage through human excretion or improper disposal of old prescription medicine in the toilet. At present, there is no systematic approach to testing how these substances impact the environment.  more
New Biocides Regulation – improvements and shortcomings

A new EU regulation (528/2012/EU) concerning the authorisation and use of biocidal products was adopted on 22 May 2012. It will repeal and replace Directive 98/8/EC and be applicable as of 1 September 2013. In Europe, an estimated number of 50 000 products will fall under this regulation. The new regulation aims to improve the functioning of national authorisations and mutual recognition; reduce the number of animals tested and strengthen the rules on data waiving. The NGO PAN-Germany analysed in deep the new regulation finding both improvements and shortcomings in the perspective of environmental and consumer protection. The new regulation brings positive news in respect to product authorization and market availability but a harmonized EU framework for a sustainable use of biocides or risk reduction is lacking.  EC Europe | Pan Germany
Other News
European Commission calls for immediate actions to tighten controls, increase surveillance, and restore confidence on medical devices

After the discovery of the use of non medical grade silicone in breast implants, the European Health and Consumer Policy Commissioner John Dalli urged Member States for immediate action at the national level to provide a better guarantee of the safety of medical devices and restore patient confidence by ensuring full compliance with current legislation. Actions proposed include conformity assessments, reinforcement of market surveillance and improve the functioning of the vigilance system to ensure traceability and acquisition of long-term data to assess safety and performance.  more
SCENIHR opinion on the safety of PIP silicone breast implants

The European Commission asked the Scientific Committee on Emerging and Newly Identified Health Risks of the EU (SENIHR) to adopt an opinion on the safety of PIP silicone breast implants and its implications for human health. The Committee found evidence that seem to support that many PIP silicone breast implants were manufactured from low quality industrial grade silicone, which could result in shell weakness and leaking into the surrounding tissue that could result in local irritancy. However, the Committee determined that the limited clinical data available and the absence of epidemiological data were not sufficient to conclude that woman with PIP breast implants would have higher health risks. Proposing that further studies should be performed to establish with greater certainty the health risks if any associated with PIP breast implants.   EC Europe | Pan Germany
Take a break and watch the latest inspiring concepts on health at TEDMED

TEDMED is an annual conference on health and medicine that joins speakers from different disciplines and combine health issues with technology and personal stories. The talks can be seen online and cover topics ranging from innovative solutions for healthcare to social issues behind chronic diseases.  more

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