Green Buildings

Cleaning Green

July | August 2008

By Diane Laux, ABC

The health of a facility affects the health of its occupants. As it turns out, some of our hospitals aren’t the healing environments we think they are. That’s because the cleaners typically used in hospitals contain irritating and toxic contaminants which pose a threat to healthcare workers, patients and guests, and to outdoor environments as well.

Many standard cleaning products contain volatile organic compounds (VOCs), many of which are neurotoxins and are implicated in respiratory irritations, headaches and skin rashes, and in long-term health issues. Research shows that exposure to cleaning agents is associated with an increased risk of new-onset asthma among nurses and housekeeping staff.

So hospitals are going green by choosing safer, milder cleaning products, and more eco-friendly alternatives. Innovation and technology have resulted in microfiber mops that require less water and disinfectant, with mop heads that are machine washable up to several hundred times. High-end HEPA filtration systems can trap and kill airborne bacteria and viruses.

“In effective cleaning and sanitizing, you want to prevent nosocomial infections, bloodborne pathogens and other diseases – these protocols need to be met above all,” said Bruce Boynick, Senior Associate with the industrial and institutional cleaners practice of The Kline Group. “There is environmental sustainability and human sustainability. Organizations need to be cognizant of and proactive in both.”

Green cleaning products represent only 2 to 5 percent of the $17.5 billion U.S. cleaning products market for household chemical, janitorial, food service and laundry chemicals. While the market share for these products is growing, there is still some ambiguity about what green means. Boynick points out that green cleaning definitions have yet to be codified. Manufacturers may define eco-friendly in one way, associations in another. There are a number of third-party certification and accreditation firms, but no universal standard. Unfortunately, at this stage there is no equivalent to the Good Housekeeping Seal™ or Underwriters Laboratories.

That said, many organizations, including manufacturers, healthcare systems and even the United States Green Building Council, follow Green Seal™ environmental standards. Green Seal’s focus is on certification standards for building maintenance and janitorial products. Hospital workers may be most familiar with GS-37, which covers industrial and institutional cleaners, including general purpose, glass, bathroom and carpet-care chemicals, and GS-40 for industrial and institutional floor care products such as finishes and strippers.

Green Seal is currently working with its stakeholders in reviewing and revising GS-37 to ensure the standard “inspires innovative, high quality and high performance products that are better for human health and the environment.”

“The education sector is very much in the vanguard,” says Boynick. “Hospitals are educating themselves on environmental issues, risk assessment and safety, and look to value chain partners for assistance in product selection, training and process change.”

Training emphasizes how to use the products safely and effectively, and is outcome-focused – reducing bioburn, for example. Using the right concentration and application technique conserves resources and helps reduce rework and reuse.

“Green initiatives in college and university settings often involve students whose motivations include a belief they are citizens and stewards of the earth,” said Boynick. “In hospital settings, large scale environmentalism is often tied to mission, particularly for those with sectarian or state designations, but it remains true across the industry.

“Therefore, a healthcare provider can potentially look to its group purchasing organization (GPO) and manufacturers and distinguish itself by requiring suppliers to meet specific green standards. For cleaning products, there are concentrated products that require less energy to ship.”

Suppliers, in turn, need to align themselves in the value chain with the end users in healthcare, as well as distributors that have incorporated sustainability in their missions and business values.

“Channel leadership can emanate from anywhere in the chain: the vendors, the suppliers of raw materials, distributors, buying groups, healthcare materials management,” said Boynick. “The overarching theme here is cooperation with other parties in the value chain that share a commitment to sustainability.”

The Kline Group has studied the cleaning product industry for more than 30 years and recently issued a qualitative assessment of green cleaning available at www.klinegroup.com.

Green Choices

Environmentalism has an amortization quality and some changes have more of an economic benefit. Hospitals can quantify and amortize an investment in energy efficient HVAC and windows. Green cleaning is more difficult.

And it’s not just about green products.

“The biggest thing that we do for our customers every day is help them reduce healthcare associated infections,” said Dave Keil, Vice President and Segment Manager, Ecolab Healthcare North America. According to Keil, patient safety is driving behaviors in hospitals. Infection prevention is the priority, and product efficacy is what is of greatest concern.

“There is no such thing as a green antimicrobial or a green disinfectant,” said Keil.

Antimicrobials destroy or suppress the surface growth of bacteria and viruses. The Environmental Protection Agency classifies antimicrobials and disinfectants as pesticides, so they can’t be classified as green.

“Infection control practitioners are not going to sacrifice efficacy for sustainability in a product, yet they and their green teams still want to impact their environmental footprint. So we have a lot of conversations about a balanced approach, looking at total impact on the environment, from raw materials, to how product is packaged and shipped, to disposal issues.”

When it comes to environmental issues, Keil says the chemistry part of a product is a small portion of the hospitals overall spending. Hospitals are just as interested in energy consumption, water conservation and reduction of waste. It’s less about a green soap and more about a total impact from those other areas.

“Healthcare providers want to have that conversation,” said Keil. “Environmentally conscious decision making is here to stay.”

Ecolab presents themselves as the worlds’ largest cleaning and sanitizing company. The company was originally named Economics Lab, but one would think the name Ecolab is a play on ‘ecology,’ because that has been a focus of the company, both in the products and services it sells and in how it conducts its operations.

“We look at sustainability in our own lifecycle and measure our environmental stewardship and social responsibility,” said Keil. “We’ve reduced our greenhouse gas emissions. We evaluate any proposed formulation material against a biodegradability profile and corporate sustainability standards permeate product development.

“But people don’t come to us to buy green products,” said Keil. “They come to find a solution to their problems.”

Akira McCrary’s problem was ensuring environmentally friendly discharge into the San Francisco Bay. McCrary is Manager of Sterile Processing at Santa Clara Valley Medical Center, in San Jose, Cal. His department is responsible for medical and surgical instrumentation for the 450-bed hospital and seven outlying clinics.

The hospital needed to move on environmental issues to comply with stringent EPA guidelines, Santa Clara County and City of San Jose regulations, and of course, those from the State of California.

Team Effort

Valley Medical’s infection control board, safety committee and its purchasing department were actively involved in the hospital’s decision to adopt environmentally friendly cleaners. One green product McCrary and the team settled on was a sterilant from Ecolab. The sterilant discharges less byproduct than the product it replaced and it is available in a small solid brick, similar to dishwasher soap. The previous product the department used only came in liquid form and in 55 gallon drums. The new product’s packaging is the size of a margarine container.

“This is California, after all,” said McCrary. “These days you have to be green in everything. Being an avid outdoorsman, I see firsthand the impacts of neglecting the environment. I love to fish – salmon, trout, striped bass – and when I see the level of waterway pollution we have it disgusts me. Rubbish, sediment, contaminants floating at the surface. The Bay is polluted enough from heavy manufacturing; I don’t want to contribute to that sad situation. I can actually have a hand in improving things.”

McCrary says the hospital does discharge solids and liquids and they do so with the environment in mind. Governmental watchdog organizations monitor hospital discharges in liquid and biohazardous waste that is put through the municipal waste system.

“Before, you could see the residual byproduct in the washers and sterilizers, but that’s no longer the case,” McCrary said. “Machines and instruments reflect that the product is working, and we don’t have to use as much. With the liquid product, we’d never use it all up because there was always two inches left in the bottom of the plastic drum liners that we couldn’t easily get to, product that would be shipped off to the landfill.”

And in addition to the environmental benefits of switching to this one greener solution, McCrary also reduced cost by 30 percent, maximized storage space, and reduced occupational health and safety claims because there were no more back injuries from moving the heavy drums.

With results like that, the hospital is reviewing green solutions hospital wide.

“I have colleagues in other hospitals that shy away from green initiatives,” said McCrary. “It’s because they were given bad information in the past by a supplier or even an internal group, and then they went ahead and acted on that info. You can’t just take someone else’s opinions. You need to ask questions, do the research, read the literature and know what your goals are in making a change in order to make a qualified decision for your organization.

“We need to do what we can in looking out for the country and the world, really, and we need to be certain our suppliers offer products and policies to reflect that,” McCrary said.