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Leading the Way to Healthier Electronics

By Sarah O’Brien and Susan Chiang, for HealthLeaders News, May 8, 2007
Electronic waste or "e-waste" is the fastest growing waste stream in the world, with 3.96 billion pounds of consumer e-waste discarded in the US alone in 2000. To make matters worse, e-waste is also highly toxic. According to US EPA, e-waste is the source of some 70% of heavy metals in US landfills. The volume of computers expected to become obsolete over the coming decade contain at least 1 billion pounds of lead, 1.9 billion pounds of cadmium and 400,000 pounds of mercury. Often dumped in landfills or burned in incinerators, these materials from computers and other electronics can be released to the environment, creating a massive public health hazard.

As healthcare moves increasingly toward electronic recordkeeping, and as the array of electronic devices used in clinical applications inexorably expands, the sector generates a significant portion of this high volume, toxic waste stream. For both ethical and legal reasons (some portions of e-waste are Resource Conservation and Recovery Act--RCRA--waste, which facilities cannot legally send to a solid waste landfill), purchasers need to consider the volume and toxicity of the resulting waste before buying computers. Furthermore, hospitals need to ensure that their waste stream is minimized, handled legally and recycled in an environmentally appropriate manner.

'Greening' the purchase of IT equipment

Up to a few years ago, specifying environmentally preferable computer equipment was extremely difficult, with dozens of attributes to assess, and very little information to help purchasers evaluate them. In recent years, however, systems have been developed to assist purchasers. In addition, our respective organizations, H2E and Health Care Without Harm, can provide healthcare purchasers with direct assistance in using and combining the different purchasing systems.

One tool is EPEAT, the Electronic Product Environmental Assessment Tool. It is a rating system developed through a national stakeholder process that identifies environmentally responsible computers. It is based on a series of 23 mandatory and 28 optional criteria. Products may achieve a Bronze, Silver or Gold ranking based on the number of criteria they meet. The EPEAT criteria are formalized as an ANSI standard through the IEEE (Institute of Electronic and Electrical Engineers). To date, 15 manufacturers have registered close to 400 different products under the system. For purchasers wishing to reduce the environmental impact of their IT buying, EPEAT is an excellent starting point.

Because EPEAT restricts its criteria to strictly environmental ones, it does not include the environmental health and worker safety issues that institutional purchasers may want to address. For this reason the Computer TakeBack Campaign, working with HCWH and H2E, has developed additional criteria that deal with important concerns such as proper end-of-life management and adequate worker protections. Our organizations urge healthcare buyers to take the lead in adopting these additional standards to encourage the electronics industry to implement more comprehensive producer responsibility practices.

Purchasing responsible end-of-life services

Ensuring proper end-of-life handling of obsolete IT equipment can also be highly problematic for facility contracting staff. Many electronics "recycling" companies in the US are simply brokers who sell obsolete and broken equipment for disassembly in appalling conditions in the developing world. But as with purchasing electronic products, obtaining environmentally sound end-of-life services is becoming easier.

The first step to reducing the environmental impacts of e-waste, is to consider appropriate reuse of equipment. Often equipment that no longer serves in a high-volume critical application such as admissions may be perfectly adequate for another office or department where it is needed primarily to connect to an Intranet or print labels. By redeploying computers internally, and considering donation or resale options when they are truly no longer useful, facilities can prevent equipment becoming waste for years after removal from their original use. (Make sure that any donation program is thoroughly scrutinized for specific redeployment of computers, with donors identified--some donation programs are fronts for dumping of unusable equipment in poor countries.)

When equipment is no longer reusable, ensure that "recyclers" are not sending it to developing countries and that there is adequate follow up on conditions under which it is recycled. Public exposure of the life-threatening working conditions of poor laborers in the developing world who break apart electronics with no worker or environmental protections has led to the development of the Electronics Recyclers' Pledge of True Stewardship (known as "the Pledge" or "E-Stewards") administered by the Basel Action Network. This voluntary pledge, which is carefully monitored for compliance, prohibits export of any materials deemed hazardous under international law and encourages the development of a vibrant recycling infrastructure inside the US. It can help purchasers identify responsible firms that they can be sure manage electronics safely at end-of-life.

Healthcare institutions are increasingly engaging with this issue:
  • Dozens of systems and facilities hold IT equipment "yard sales" for employees and community members, putting equipment back into use in their community; others donate to local schools or nonprofit organizations.

  • Premier Purchasing Partners, a group purchasing organization, used EPEAT as a preference in their IT contracting, awarding contracts to two manufacturers who collectively provide 64 EPEAT Bronze and Silver computer products.

  • The University of Texas Health Science Center has set a minimum purchasing standard of EPEAT bronze computers for their IT contracts.

  • Consorta, another group purchasing organization, awarded asset disposition and recycling contracts to two Pledge signers.


By encouraging (and requiring) the use of recycled and less toxic materials and the design of products for disassembly and reuse, purchasers can help reduce the electronics industry's negative health and environmental impacts, with reduced liability and increased productivity along all phases of the lifecycle. As a large volume buyer, the healthcare industry has the power to transform the electronics market towards greener practices and products through its purchasing choices. The tools are available to do so. Now it's a matter of taking advantage of the opportunities available.

Sarah O'Brien, environmentally preferable purchasing program manager for H2E (Hospitals for a Healthy Environment) works with GPOs and large health systems across the country to encourage "green" purchasing. She has been involved in electronics purchasing for the past six years. She may be contacted at sarah.obrien@h2e-online.org.

Susan Chiang, MPH, MPP, is the pollution prevention program director at the Center for Environmental Health. As a member of Health Care Without Harm, she provides direct assistance to GPOs and large health systems on the purchasing and management of electronics. She may be contacted at schiang@cehca.org.

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