Best Practices in Carbon Mitigation

Many health care facilities occupy aging, energy inefficient build­ings; many also operate around the clock, 365 days a year. In to­tal, healthcare spends $8.3 billion on energy every year.[i]Medical facilities consume large amounts of other resources as well—for example, one medical center in the San Francisco Bay Area gen­erates an average of six tons of waste every day. Considering that health care is already responsible for 1/7th of the U.S. economy, 8% of greenhouse gas emissions and that construction adds more than 100 million square feet of medical building space every year, reducing health care’s carbon footprint is a task of national importance. The health care sector’s commitment to health can be demonstrated through development and implementation of climate change action plans.

Health care’s response to climate change requires a multi-fac­eted, practical approach. Practice Greenhealth provides several kinds of resources to help; including tips on getting started, potential mitigation programs in different sectors, and an outline of some of the many resources, model programs and guidelines available to help move the process forward. The good news in climate change mitigation is that what’s good for the environment and public health also often supports the bottom line. In addition, climate change work can reinforce a facility’s broader environ­mental stewardship goals and programs.

Initially, hospitals should approach carbon mitigation strategies through their efforts to be more energy efficient. In the long term, carbon mitigation can be pursued through a number of avenues including:

Energy for Operations

Energy used in healthcare facility operations is a significant source of greenhouse gas emissions. Burning fossil fuels to heat, cool, and power buildings produces large amounts of CO₂, and traces of CH₄, N₂O, and sulfur hexafluoride (SF₆), the most potent greenhouse gas. Water heating accounts for 28% of the energy used in U.S. health care buildings, space heating 23%, lighting 16%, and office equipment 6%. Other energy needs like air conditioning, cooking, and refrigeration together make up the remaining 27%[ii]. By conserving energy and making operations more energy efficient, facilities can simultaneously reduce greenhouse gas emissions and save money. Reducing energy use also puts less wear and tear on facility systems—resulting in longer life and less maintenance. Improved energy efficiency also improves outdoor air quality, benefiting human health by lowering particulate and toxic chemical emissions produced by fossil fuel combustion and electric power generation.

Energy and the Building

Incorporating sustainability into the design and construction of hospitals’ built (and planted) environment can significantly reduce the organization’s energy use and greenhouse gas emissions. Building and landscape design features can reduce the energy required to operate health care facilities—such as the orientation of the building, shading on windows and green roofs can reduce cooling loads while building multi-level parking structures instead of vast parking lots can decrease heat island effect. Siting decisions that adhere to integrated land use and development planning help to contain urban sprawl, thus reducing auto-dependence and transportation-related emissions. The extraction of raw materials used for building construction can cause ecological disruption, threatening natural carbon sinks. Therefore, careful material selection and furnishing choices can mitigate climate change by protecting this natural sequestration, as well as reducing fossil fuel energy required for material manufacture and transport.

Renewable Energy

Purchasing renewable energy or installing renewable energy infrastructure can decrease an organization’s reliance on fossil fuels—and decrease its Scope II greenhouse gas emissions as a result. A large number of healthcare facilities are now exploring ways to generate renewable energy onsite or partner with industry on power purchase agreements (PPA) for renewable energy infrastructure. Additionally, a growing number of hospitals are committing to buy a percentage of their energy portfolio as renewable energy from their local utility. Learn more about Renewable Energy strategies and Practice Greenhealth’s Healthcare Renewable Energy Initiative.

Waste Management

Waste disposal produces greenhouse gas emissions in several ways. Transporting waste from facilities to disposal site requires energy and produces greenhouse gas emissions. Waste disposal practices themselves also produce greenhouse emissions, along with other environmental pollutants. Anaerobic decomposition of organic matter in landfills produces CH₄(although landfills are also carbon sinks), and waste incineration emits N₂O and CO₂. Food and organics are the second largest constituent of the health care waste stream, comprising close to 20% of the solid waste volume in medical facilities with food service operations. A comprehensive approach to facility waste management including construction and demolition debris recycling, material recycling, composting of food waste, reuse, and donation reduces these emissions. It also lowers facilities’ demand for virgin resources, thus mitigating emissions produced in resource extraction, manufacturing, and product transportation.

WaterConservation

The extraction, purification and transportation of water requires energy.  Hospitals that pursue a water conservation strategy will concurrently address a carbon mitigation strategy.

Transportation

Transportation is responsible for 27% of U.S. greenhouse gas emissions, making it the country’s second largest source of emissions. It is also the most rapidly growing emissions sector[iii]. Burning gasoline and diesel fuels to power motor vehicles produces large amounts of CO2, and traces of methane (CH4) and nitrous oxide (N2O), even more potent greenhouse gases. Healthcare facilities rely heavily on transportation systems to move patients, workers, supplies, and waste, and so careful analysis and redesign of hospital transportation can have significant climate change mitigation benefits. Transportation sector emissions reduction strategies focus on reducing total travel or making travel less emissions intensive (i.e., by using higher efficiency or alternate fuel vehicles). Reducing transportation greenhouse emissions can also lower other vehicle emissions with known health impacts: nitrogen oxides (a precursor to smog); benzene (a carcinogen); particulate matter (a trigger of respiratory illness and symptoms); volatile organic compounds (some of which are potentially hazardous and a precursor to smog) and carbon monoxide (a probable human carcinogen). Learn more about Seattle Children’s Transportation Program in the Green Column of Health Care Design magazine’s March 2011 issue.

Learn more about these strategies and others to reduce carbon footprint in Practice Greenhealth & Health Care Without Harm’s document Addressing Climate Change in Healthcare Settings: Opportunities for Action.