Practice Greenhealth’s Healthy Interiors goal promotes public and environmental health and helps accelerate the transformation of the furnishings market to safer products.
What is Practice Greenhealth’s Healthy Interiors goal?
Ensure that 30% of the annual volume of furnishings and furniture purchases (based on cost) eliminate the use of formaldehyde, perfluorinated compounds, polyvinyl chloride (PVC), antimicrobials*, and all flame retardants**.
When chemical flame retardants are necessary to meet code requirements, use chemicals that meet GreenScreen Benchmark 3 or 4 or their equivalent.
*Triclosan and triclocarban are explicitly prohibited. No other added or built-in chemical antimicrobials are allowed unless they are registered with the EPA under the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA), and have published data that show efficacy in a hospital/clinical setting measured by a reduction in healthcare-associated infections (HAIs) as part of comprehensive infection control measures. Antimicrobials added to materials or products for the sole purpose of preserving the product are exempt.
** Eliminate the intentional use of all flame retardants where code permits. Products supplied must contain less than 1,000 ppm of flame retardants by weight of the homogeneous1 material where code permits.
Does the Healthy Interiors goal align with other sustainability and green building initiatives?
The furniture sector has its own sustainability standard through the Business and Institutional Furniture Manufacturer’s Association (BIFMA). The American National Standards Institute (ANSI)/BIFMA e3-2011e Furniture Sustainability Standard includes a human and ecosystem health section, in which manufacturers receive credit for reductions in the use of hazardous chemicals in products and production processes, including persistent, bioaccumulative, and toxic chemicals (PBTs); carcinogens; reproductive toxicants; and endocrine disruptors.
Manufacturers who have achieved credit 7.4.4 are eligible to apply for Practice Greenhealth’s Greenhealth Approved seal. The seal is an easy way for providers to identify products that meet the Healthy Interiors goal and should be counted as part of healthy furniture and furnishing spend.
Scope of products covered
The furnishings categories included in the Healthy Interiors goal*, eligible for the Greenhealth Approved seal, and included in BIFMA 7.4.4 certification, are:
Included in the Healthy Interiors goal, but not currently part of Greenhealth Approved or BIFMA level:
Exemption: Electronic components of furniture and furnishings are exempt from the goal.
To learn more, visit Greenhealth Approved.
What are the concerns with chemicals in furnishings?
Furnishings are made of some chemicals and materials that may be hazardous and pose risks to workers, consumers, and entire communities throughout their life cycle. For instance, some chemicals in products known as volatile organic compounds (VOCs) can vaporize into the air, and workers or consumers inhale them.
Since toxic chemicals often do not stay in place — from their use in manufacturing and products — they can migrate into food, air, water, and ecosystems across the globe. Environmental monitoring shows that PBTs are widely distributed and measurable in humans and wildlife at levels that are known to cause adverse health effects. Even wildlife and communities in “pristine” distant lands, such as polar bears and the Inuit living above the Arctic Circle, are now widely contaminated with industrial toxic chemicals, including halogenated flame retardants (HFRs) and perfluorinated chemicals (PFCs).
Building materials and products that are significant sources of indoor air pollution include cleaning compounds, adhesives, paints, carpeting, upholstery, manufactured wood products, and other components of furniture, each of which may emit VOCs, such as formaldehyde. Workers, patients, and their families are exposed to toxic chemicals from building products every day. This chemical exposure impacts everyone, from the developing fetus to senior citizens. Their impacts, while difficult to track, can be significant. Toxic chemicals, for example, are believed to play a role in rising chronic diseases and conditions, including some cancers, birth defects, learning and developmental disabilities, infertility, asthma, and neurological disorders.
Formaldehyde is a common indoor air contaminant because of its use in furniture, cabinets, countertops, insulation, wallpaper, paints, and paneling. It is present in a wide variety of other consumer products, such as antiseptics, medicines, cosmetics, dishwashing liquids, fabrics and fabric softeners, carpet cleaners, glues and adhesives, lacquers, paper, coatings, and plastics. The International Agency for Research on Cancer (IARC) classified formaldehyde as a human carcinogen in 2006. In 2011, the National Toxicology Program, an interagency program of the Department of Health and Human Services, named formaldehyde as a known human carcinogen in its 12th Report on Carcinogens.
Flame retardants are chemicals or chemical compounds for which their functional use is to resist or inhibit the spread of fire, including, but not limited to, halogenated, phosphorous-based, nitrogen-based, nanoscale, and polymeric and reactive flame retardants.
To meet certain flammability standards, chemicals that act as flame retardants are added to a wide range of products, including computers, couches, hospital beds, waiting-room chairs, and hospital privacy curtains. Unfortunately, many of these flame retardant chemicals do not remain in the product and slowly offgas into the air, dust, and water, eventually entering the food chain and building up in our bodies.
Many flame retardants are linked to a range of negative health effects. Depending on the flame retardant, effects include reproductive, neurocognitive, and immune system impacts, among others. Three common halogenated flame retardants appear on California’s Proposition 65 list as human carcinogens. Safety data on newer flame retardants are still emerging and are often not complete, but early studies suggest there is reason to be concerned about the newer alternative chemicals on the market.
When flame retardant chemicals are necessary to meet code requirements:
Per- and poly-fluorinated alkyl substances (PFAS)
Per- and poly-fluorinated alkyl substances are widely used to make everyday products more resistant to stains, grease, and water. Long-chain PFAS are found worldwide in the environment, wildlife, and humans. They are bioaccumulative in wildlife and humans, and are highly persistent in the environment. Significant adverse effects have been identified in laboratory animals and wildlife. Some studies in more highly exposed human populations show associations with pregnancy-induced hypertension, thyroid hormone abnormalities, and increased risk of various kinds of cancer. Given the long half-life of these chemicals in humans, body burdens will decrease only slowly if and when the use of long-chain PFAs is eliminated. Shorter-chain PFAs are reported to be less likely to bioaccumulate, but they are highly persistent in the environment and exposures will increase if they are used as replacements for longer-chain PFCs. Leading scientists have recently called for discontinuation of all non-essential uses of fluorochemicals.
Polyvinyl chloride (PVC)
Polyvinyl chloride plastic (also known as vinyl) is used in a wide variety of applications in the health care setting, including medical devices, disposable gloves, curtains, flooring, and other building materials. It is also used as cover fabric and for other components of some furniture. PVC manufacture requires the use of ethylene dichloride (EDC), a probable human carcinogen, and vinyl chloride monomer (VCM), a known human carcinogen. The manufacture and incineration of PVC also generates dioxin, a known human carcinogen and persistent, bioaccumulative compound. PVC without additives is brittle and not stable in the presence of heat or light. The additives necessary to confer properties such as flexibility and resistance to heat and UV light can have toxic properties.
A problematic plastic: Polyvinyl chloride in health care: A rationale for choosing alternatives - 1-31-2020.pdf
With rare exceptions, very few data support the use of antimicrobials in furniture as a means of reducing healthcare-associated infections (HAIs). Some antimicrobials pose risks to human health and the environment and may contribute to antimicrobial resistance. Moreover, the presence of antimicrobials in furniture may lead to a false sense of security and result in less stringent infection control practices. The goal is structured to allow for the use of antimicrobials where research shows that they contribute to reduced incidence of HAIs. This is an emerging and active area of research, and this goal may change as additional data are available.
What can health care do?
Health care institutions across the country have reduced exposures to harmful chemicals by eliminating known and likely hazards and switching to safer alternatives. These institutions have improved the overall health of employees, patients, and communities.
The procurement and use of furnishings that meet the Healthy Interiors goal is part of the movement to create more sustainable health care buildings and operations.
To learn more about Practice Greenhealth’s Healthier Interiors goal, visit Practice Greenhealth Healthy Interiors or email firstname.lastname@example.org.
1 We are using the definition of “homogeneous” from the Restriction of Hazardous Substances directive: “Homogeneous material” means a material that cannot be mechanically disjointed into different materials. A homogeneous material is “of uniform composition throughout.” Examples of homogeneous materials are individual types of plastics, ceramics, glass, metals, alloys, paper, board, resins, and coatings. The term “mechanically disjointed” means that the materials can, in principle, be separated by mechanical actions such as unscrewing, cutting, crushing, grinding, and abrasive processes. Example: A plastic cover is a homogeneous material if it consists of one type of plastic that is not coated with or has attached to it or inside it any other kind of materials.