A half-million-dollar penalty against a hospital system represents the culmination of what has been a very active year of healthcare scrutiny by the Environmental Protection Agency (EPA).
"I definitely think there is an uptick in activity that will be with us for some time to come," said Charlotte A. Smith, RPh, MS, HEM, director of PharmEcology Services in Wauwatosa, WI, a division of WM Healthcare Solutions, Inc.
The U.S. Department of Veterans Affairs' (VA) Eastern Kansas Health Care System recently settled with the EPA over violations to the Resource Conservation and Recovery Act (RCRA) allegedly found at Dwight D. Eisenhower Veterans Medical Center in Leavenworth, KS, and Colmery O'Neil Veterans Medical Center in Topeka, KS.
RCRA (pronounced RICK-rah) governs hazardous waste management across all industries.
Civil fines against the VA totaled $51,501. On top of that, the VA agreed to invest nearly $482,069 for new systems to better track and manage chemical wastes in the two hospitals. The total penalty was considerable by EPA standards when it comes to hospital enforcement.
Meanwhile, earlier this year, the EPA proposed a rule that would reclassify RCRA-governed hazardous pharmaceutical wastes, in theory ensuring larger quantities of these wastes are collected and disposed of properly (i.e. not flushed down the drain or disposed of in municipal waste streams).
If finalized, the regulation would make it easier for hospitals struggling with following RCRA to the letter, and will force hospitals that are doing little at present to start a disposal program for pharmaceutical waste.
Mainstream press articles about medications discarded in water supplies, increased awareness about drug waste, and the change from the Bush to Obama administration all point to renewed interest by the EPA in hospital affairs, Smith said.
"We continue to hear of EPA audits both for pharm waste and other regulatory issues in healthcare," she added.
More emphasis may come from a new study published earlier this month in the Journal of the American Medical Association, which concluded the healthcare industry accounts for 8% of the U.S. "carbon footprint," a term used to describe the total greenhouse gas emissions attributable to an organization or industry.
"I think there is increasing awareness that hospitals are large contributors to both the economy and then, by association, carbon footprint, so there is a raised awareness surrounding hospitals as they relate to energy use, waste generation, toxicity, and also large amounts of new construction and renovations," said Janet Brown, director of facility engagement for Practice Greenhealth, a national membership organization that promotes environmental improvements in healthcare.
In other healthcare-related actions this year, the EPA:
- Mandated that hospitals run full loads in ethylene oxide (EtO) sterilizers and log them, with some exceptions. EtO is a gas used to sterilize heat- and moisture-sensitive medical instruments. The EPA found that, taken together, EtO sterilizers account for a significant source of pollution.
- Is increasing oversight of hospital disinfectants after one-third of 325 registered substances failed EPA verification of labeled claims by manufacturers.
- Updated rules for hospitals that house medical waste incinerators. There are only 57 active medical incinerators in the entire country.