Susan Wilburn BScNursing MPH Director Global Projects Health Care Without Harm swilburnhcwhorg Outline Health sector footprint Health hazards in health care Chemical hazards in health care in use or as byproducts ID: 931691
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Slide1
Women and Chemicals in the Health Sector
Susan Wilburn, BScNursing, MPH Director, Global Projects Health Care Without Harmswilburn@hcwh.org
Slide2Outline
Health sector footprint Health hazards in health careChemical hazards in health care: in use or as byproductsImpact on Women Managing chemicals and waste – protecting women’s health
UNDP/WHO/HCWH Global and African regional medical waste management and mercury elimination WHO/HCWH Mercury elimination campaignSAICM QSP Chemical Substitution in health sector
Slide3The health sector environmental footprint
Greenhouse gas emissions
NHS-England represents 25% of the public sector carbon footprint U.S. health care industry represents 8% of their carbon footprint nationallyThe incineration of medical waste Source of dangerous air pollutants: dioxin (carcinogen and endocrine disruptor) and mercury (neurotoxicant, retards development, intelligence)
The use of hazardous chemicals indoors
Contributes to the high rates of asthma among health care workers
Reproductive hazards, carcinogens, mutagens
The huge scale of the health care sector results in unhealthy practices
Poor waste management
use of toxic chemicalsunhealthy food choicesreliance on polluting technologies
Slide4Slide5SDG 12.7:
Promote public procurement practices that are sustainable, in accordance with national policies and priorities
Slide6Chemicals in Health Sector
Where in the Health sector? Medical devices, pharmaceuticals, building materials, disinfection, cleaning, hand hygiene, emissions from waste incineration How much used ?
Tons of chemicals are used and discharged from HCFs. Used in Routine and emergencies – Zika and Ebola Crisis Linked Hazards? Occupational Health and Safety concerns and Carcinogens, Mutagens, Reproductive hazards, Endocrine disrupting chemicals, asthmagens
Slide7Health Care is Hazardous to Workers and the majority of health workers globally are female
Biological (TB, Anthrax, HIV, Hepatitis)Chemical (hazardous drugs
, disinfectants, sterilants)Ergonomic (Lifting, transfers)Stress/Violence (short staffing, shift rotate)Physical Hazards (radiation,heat,noise)
Slide8Chemical Hazards in health care
Chemotherapeutic Drugs: carcinogens, immunosuppressant Waste anesthetic
gases: Reproductive hazard and potent greenhouse gas Disinfecting and Sterilizing AgentsGlutarlaldehyde: Ethylene Oxide: carcinogen, reproductive hazardSoaps contaminated with (unnecessary) triclosan: endocrine disruptor Laser & Electro-cautery
Smoke: papilloma virus
Pesticides
Latex
Allergy: sensitizer, anaphylaxis
Slide9Hierarchy of Controls
In Order From Most to Least EffectiveElimination (jet injectors, needleless IV systems, soap &
water – eliminate triclosan in soap)Substitution (paracetic acid for glutaraldehyde, nitrile for latex gloves)Engineering Controls (ventilation, lifting devices, safer needle devices)Administrative and Work Practice Controls (staffing, no recapping) Personal Protective Equipment (gloves, masks, gowns, etc)
Slide10Best Practices & Technologies for Reducing Healthcare Waste to Avoid Releases of Dioxins and Mercury
Model Hospitals in 7 countries: Argentina, India, Latvia, Lebanon, Philippines, Senegal and Vietnam + 4 African countries: Ghana, Madagascar, Tanzania
and Zambia
Waste minimization, segregation, non-incineration treatment technologies
Mercury elimination and substitution
Slide11Minamata Convention on Mercury
Slide12PVC
and DEHP
PVC, the most widely used plastic in medical devices, has two key problems:
Dioxin, a human carcinogen, can be formed during the manufacture, incineration or burning of PVC
products.
DEHP
, a phthalate used to soften PVC plastic, is linked to reproductive birth defects and other illnesses, according to animal
and human studies.
Most common plasticizer used in PVC
Problems with DEHP include:
Some medical products up to 50% DEHP by volume
Contaminant in Intravenous Solutions
Lipophilic, leaches preferentially into blood products and Total Parenteral Nutrition (TPN
)
Substitute alternative products for PVC including: Silicone, Polyurethane, Polyethylene, Polypropylene
Replace plastic products with other durable goods. (Stainless steel basins and bedpans)
Slide13SAICM QSP on Health Sector Strategy
Hospital Fernandez, Buenos Aires, Argentina
400 bed public hospital Mercury-freeSubstituting dental amalgam in most casesEliminated hazardous
chemicals
DEHP-PVC, BPA, glutaraldehyde
Green cleaning
Slide14THANK YOU
Gracias
Xie
xie
Salamat
Kamsahamnida
Obrigado
Cam'on
Grazie
Terima Kasih