Can health care, life sciences firms help heal the Earth?

By Elizabeth Baca, M.D., M.P.A., managing director, Deloitte Consulting LLP

The United States health sector is responsible for about 8.5% of the country’s greenhouse gas emissions,¹ and approximately 25% of global health care sector emissions.² US hospitals generate more than 6 million tons of waste each year.³ This includes everything from food waste to disposable and single-use devices to regulated medical waste, which often has to be incinerated. A single medical procedure, such as a total knee replacement, can generate nearly 30 pounds of waste.⁴ But health care and life sciences companies are coming under increasing pressure to develop strategies to reduce their carbon footprint.

For this year’s Earth Day (April 22), Deloitte Consulting LLP joined the Commonwealth Fund and the Black Directors for Health Equity Agenda (BDHEA) to produce a report that describes the impact the health sector has had on climate change. The paper also explores how decarbonization efforts could help to improve the health of the planet and its inhabitants. (The report, Accelerating health equity and business resilience through decarbonization, is available on BDHEA's home page.)

According to our research, I believe the health care sector is being pushed in the right direction. On Earth Day last year, the White House and the Department of Health and Human Services (HHS) launched the Health Sector Climate Pledge.⁵ The goal of this voluntary commitment is to cut greenhouse gas emissions in half by 2030 and achieve net zero emissions by 2050. More than 100 organizations (representing 837 hospitals) signed the Pledge before the October 28, 2022, deadline.⁶ Suppliers, health plans, and pharmaceutical companies also joined. Last month, HHS’s Office of Climate Change and Health Equity said it would remove the deadline so that organizations could continue to sign the Pledge.⁷

In addition, the Inflation Reduction Act, which was signed into law last summer, could help drive more climate-conscious strategies.⁸ The law, for example, expands tax credits for companies that adopt energy-saving renewable technologies. These credits are available to non-profit organizations, such as hospitals and health systems (a majority of US hospitals are non-profit.⁹) Moreover, the Joint Commission has made environmental sustainability a strategic priority for its accredited organizations.¹⁰

Health care and life sciences organizations are going green

Rather than focusing on the negative impact the health care sector has had on the environment, I want to highlight some of the steps the sector is taking to become more environmentally conscious. A few health systems are generating their own energy to reduce reliance on fossil fuels, and some life sciences companies are developing reusable and biodegradable products and devices to reduce waste. Here are a few examples:

• Energy independence: For many health care organizations, decarbonization starts with improving the energy efficiency of facilities. La Crosse, Wis.-based Gundersen Health System says it has been energy independent since October 2014. A combination of solar, wind, and geothermal energy, along with biogas from a landfill and a biomass boiler that uses wood waste from local lumber companies, helps the health system produce more energy than it consumes. Gundersen says its sustainability efforts generate an annual savings of $3.7 million a year.¹¹ In 2022, the University of Maryland Medical System (UMMS) partnered with a local firm to build a solar energy farm to generate power for the hospital system and the community. The medical system committed $10,000 a month, for up to 18 months, to build the farm. For the past 10 years, UMMS has been involved with another solar farm, which produces about 2% of its energy. The organization is also looking into partnering with a hydro company.¹²
• Reduced food waste: According to the United Nations Environmental Program, hospitals produce 71% of all health care-related solid waste, and up to 15% of that waste is food. A hospital that serves 6,640 patient meals per week can produce as much as 24 tons of food waste a year.¹³ Almost 40% of the food served to hospital patients is returned to the kitchen as food waste.¹⁴ The University of Nebraska Medical Center is piloting a composting program in three of its buildings. Paper towels discarded in restrooms, along with some food scraps, are being sent to a composting facility where it will be used to enrich soil.¹⁵ Mayo Clinic has operated its own recycling facility at its largest campus in Rochester, Minnesota, for 25 years. Half of Mayo’s waste is disposed of at a waste-to-energy facility, and some food waste is composted or used as animal feed at local farms.¹⁶
• Compostable surgical masks: During the height of the COVID-19 pandemic,  health care facilities generated more than 7,000 tons of waste every day—some of this waste was made up of single-use surgical masks.¹⁷ Canada-based PADM Medical recently received clearance from the Food and Drug Administration (FDA) to market a compostable plant-based medical-grade face mask.¹⁸ Most disposable Personal Protective Equipment (PPE) consists of petroleum based, non-biodegradable polymers that can take up to 450 years to decompose in landfills, rivers, lakes, and other natural environments.¹⁹
• Reusable medical devices: Many types of medical devices are used just once before being tossed into the garbage—often as regulated medical waste/red-bag waste. While a health system might spend $25 per ton to dispose of regular trash, processing medical waste can cost $480 per ton, or more, due to precautions required by state agencies.²⁰ Increased use of sustainable and reusable medical devices might help reduce medical waste. A growing number of devices, such as surgical forceps, clamps, and endoscopes, are being designed to be disinfected and re-used. The FDA is working with manufacturers to ensure reusable devices are properly sterilized between uses.²¹ However, some cleaning methods have come under scrutiny for the use of chemicals and emissions.²²
• Biodegradable tests: Lia Diagnostics, an American start-up, developed a flushable, biodegradable pregnancy test that is made of plant fibers rather than plastic. It obtained clearance from the FDA a few years ago.²³ Similarly, Morrama, a London-based industrial design studio, is exploring a biodegradable and recyclable COVID-19 test made from paper pulp.²⁴ In early 2022, the White House ordered one billion single-use plastic rapid COVID-19 tests.²⁵ Each test contains 10 grams of plastic, which translates to about 11,000 tons of plastic waste. That number is in addition to millions of other rapid tests.²⁶
• Environmentally friendly inhalers and pill containers: Metered dose inhalers (MDIs) typically contain chlorofluorocarbons. The emissions generated by 100 puffs from an inhaler is equivalent to a 180-mile car ride.²⁷ GlaxoSmithKline, which manufactures MDIs, is developing a lower-emission propellant that could cut emissions from its inhalers by 90%.²⁸ Parcel Health, a women-founded sustainable medication packaging startup in Pittsburgh is developing a recyclable, compostable, and water-resistant package for prescription pills.²⁹

Each year, Earth Day draws attention to carbon emissions, waste, climate change, and sustainability. I am optimistic that a growing list of eco-pioneers and innovators can inspire the rest of the sector to improve efforts to decarbonize. Along with working to improve the health and well-being of their customers and patients, the health care sector should look for ways to help ensure the health of the planet where we all live.

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Endnotes: 

¹ Decarbonizing the US health sector, The New England Journal of Medicine, December 2, 2021 

² Health care pollution and public health damage, Health Affairs, December 2020

³ How should US health care lead global change in plastic waste disposal?, American Medical Association, Journal of Ethics, October 2022

⁴ How a knee replacement impacts the planet, University of Pittsburgh, June 6, 2022

⁵ HHS launches pledge initiative to mobilize health care sector to reduce emissions, HHS press release, April 22, 2022 

⁶ HHS: 102 healthcare orgs have signed onto climate pledge, Fierce Healthcare, November 10, 2022

⁷ HHS reopens health sector climate pledge, HHS press release, March 9, 2023

⁸ IRS releases frequently asked questions about clean energy property credits, IRS press release, December 22, 2022

⁹ Hospitals by Ownership Type, Kaiser Family Foundation, 2022

¹⁰ Joint Commission’s 3 strategic priorities, Joint Commission, November 2, 2022

¹¹ Improved health, lower costs, safer environment, Gundersen Health System, April 2018

¹² University of Maryland Medical System goes in on a solar energy farm, Baltimore Sun, April 21, 2022

¹³ Maine hospitals can do more to reduce food waste, University of Maine, November 9, 2022

¹⁴ Reducing waste and cost to our health care system and environment, The Online Journal of Issues in Nursing, February 25, 2022

¹⁵ Composting pilot program rolls out this month, University of Nebraska Medical Center, January 12, 2023

¹⁶ Mayo Green Initiatives, Mayo Clinic 

¹⁷ Recyclablu turns upcycled medical waste into PPE, Forbes, May 19, 2021

¹⁸ PADM Medical gets first medical clearance for plant-based mask, FDA News, March 15, 2023

¹⁹ Disposable masks and their impact on climate change, Yahoo!, February 28, 2022

²⁰ Greening of the red-bag waste stream, California Department of Health Services, February 2017

²¹ Reprocessing of reusable medical devices, FDA, January 10, 2023

²² Why is carcinogen ethylene oxide used to sterilize medical devices?, Modern Healthcare, September 20, 2022

²³ Lia Diagnostics has launched its eco-friendly, flushable pregnancy test, Technical.ly, March 15, 2021

²⁴ Morrama’s biodegradable COVID testing kit seeks to address plastic waste problem, Design Week, May 2022

²⁵ Fact Sheet: The Biden Administration to begin distributing at-home, rapid COVID-19 tests, the White House, January 14, 2022

²⁶ Millions of plastic COVID tests end up in landfills, Fast Company, May 13, 2022

²⁷ Asthma inhalers emit greenhouse gases, but that can change, World Economic Forum, May 21, 2022

²⁸ Our position on: Respiratory products and global warming, GlaxoSmithKline, October 2021

²⁹ Parcel Health homepage

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