Sustainability Roadmap for Hospitals

• Disposable food service ware is bulky, light and wasteful.
• Potential negative impacts include:
  • Depletion of nonrenewable resources–fossil fuels;
  • Contribution to global warming;
  • Generation of air and water pollutants from manufacturing, shipping and disposal;
  • Introduction of toxic chemicals into the environment during production, use and disposal; and
  • Contamination of food from leaching chemicals.
• Product Availability and Product Evolution
  • The biobased food ware market is experiencing rapid growth. This rapid growth means new and potentially im­proved products at lower cost are constantly entering the market. The challenge for purchasers is ensuring consis­tent quality and performance in products. The advantage for health care, with its volume and purchasing power, is the opportunity to direct investments among food service ware manufacturers into products that are significantly more environmentally sustainable.
• Composting
  • Use of certified compostable biobased food service ware can maximize the advantages of a hospital food waste diversion program. While certified compostable food service ware is increasingly available and many yard waste collection programs are operational, municipal and in­stitutional food waste collection is in its infancy. Health care institutions can play an influential role in advanc­ing municipal composting by collaborating with local governments and private organizations.
• Using disposable food service ware in your eateries does not portray an environmentally-friendly message to the community.
• Consider switching inpatient and dining services away from disposable food service ware.
• One of the most prevalent environmental concerns amongst staff is the elimination of disposable food service ware products, specifically polystyrene foam products.
• Polystyrene foam products are produced from fossil fuels, a non-renewable resource. Polystyrene foam products are composed of Styrene, benzene and ethylene. Extraction and use of these chemicals is harmful to both human and environmental health.
  • Benzene is extracted from coal or gasoline and is considered a mutagen, carcinogen and flammable. Coal mines are very detrimental to human and environmental health.
  • Styrene is extracted from petroleum and is considered a mutagen, flammable, reactive and a neurotoxin.
  • Ethylene is a flammable substance.
• Biodegradable products are produced from renewable resources, such as corn, potatoes, perennial grasses and bagasse (sugar cane waste). Bagasse is the biomass remaining after sugarcane stalks are crushed to extract their juice.
• The health effects caused by chemical migration from food/beverage containers (primarily due to a leaching caused by heat exchange) into food is under serious investigation. This would apply to polystyrene foam products. The precautionary principle implies that there is a responsibility to intervene and protect the public from exposure to harm where scientific investigation discovers a plausible risk in the course of having screened for other suspected causes. Practice Greenhealth state, “Styrene, used to manufacture polystyrene-the primary petroleum-based plastic in disposable food service ware-has been shown to leach into food and drinks, especially those that are high in fat or contain alcohol”.
• Many cities including New York, Seattle, Portland, San Francisco and Chicago have banned / or are considering the ban of plastic/polystyrene products.

1. Cost benefits: Biobased products may cost more than non-biobased food service ware. However, prices are becoming more competitive due to improvements in manufacturing, in­creasing production volume, and rising petroleum prices. Health care purchasers are addressing the cost issue by reducing their use of disposables and passing increased costs onto customers. It may also be possible to offset the increased cost of biobased products through reduc­tions in fees to waste haulers achieved from diverting these products and associated food waste to compost sites instead of landfills and incinerators.

2. Environmental benefits: biodegradable food service ware is made from a renewable resource and can be composted at end life.

3. Social benefits: biodegradable food service ware doesn’t leach chemicals during use and sends a strong environmental message to your patients, staff and community.

For a list of sustainability purchasing considerations and a sample vendor/manufacturer survey refer to Healthcare Without Harm’s Choosing Environmentally Preferable Food Service Ware – Reusable and Sustainable Biobased Products resource.

1)     Develop project team. Below are suggested participants with responsibilities outlined:

a)     Food Service Buyer– price comparisons/analysis, product ordering and volume monitoring.

b)     Food Service Manager – product testing, transportation, delivery and storage logistics.

c)     Supply Chain representative – price / contract negotiation, transportation and delivery logistics.

d)     Communications/Marketing representative – product promotion, tell the story of why converting from disposable to a biodegradable alternative.

e)     Sustainability Coordinator – overall program development and implementation.

2)     Collect biodegradable samples from current food service provider and other appropriate vendors.

a)     Understand the entire life-cycle of the biodegradable product to ensure it is sustainably sourced, manufactured, processed, etc.

b)     Healthcare Without Harm has developed a resource, Choosing Environmentally Preferable Food Service Ware – Reusable and Sustainable Biobased Products, that outlines sustainability criteria to consider when purchasing biodegradable kitchen ware and provides a “Sample Survey for Manufactures of Biobased Food Service Ware”.

3)     Pilot the biodegradable samples with a small test group to understand durability, quality, appearance, how they perform under hot and cold conditions, etc. Make sure to test different food dishes – soupy, greasy, etc. to ensure the biodegradable samples meet your performance expectations.

4)     Work with the biodegradable product vendor/manufacturer, your local composter and/or on-site composting program to ensure the product is truly biodegradable.

a)     Has the product been certified compostable by any of the following:

i)      Biodegradable Products Institute (US)

ii)     AIB Vincotte Inter (Germany)

iii)    Australian Environmental Labeling Association (Australia)

iv)    Biodegradable Plastics Society (Japan)

v)     DIN CERTCO (European Union)

b)     If the product has not been certified compostable by one of the above-listed organizations, has the product been proven compostable by an ASTM-approved lab or received additional testing by CedarGrove.

5)     Choose the biodegradable product that meets the organizations needs and meets applicable standards.

6)     Conduct cost analysis of converting from disposable to biodegradable products. Utilize a total cost of ownership methodology to ensure that purchase price, operational use and disposal costs are taken into consideration.

a)     Typically when switching to biodegradable alternatives the organization will incur a pricing increase. Consider reviewing the following options to pay for the cost premium:

i)      Users will be charged a premium for using biodegradable kitchenware, or

ii)     The organization will incur the cost premium, or

iii)    A combination of the two options

7)     Consider employing a phased approach to eliminate disposable products and replace them with biodegradable products. A phased approach could include:

a)     Phase 1: Provide re-usable mugs to all staff members and have them available for visitors in the organizations eateries.  Try to determine what % reduction this would have in reducing disposable cups and the potential associated cost savings. As an incentive for staff to use their re-usable mugs vs. disposable cups, provide discounts to those who bring in their mug.

b)     Phase 2: Integrate biodegradable products at selected product levels. During phase two, try to understand what the anticipated % reduction in disposable usage is.

c)     Phase 3: Integrate biodegradable products at all product levels to achieve complete elimination of disposable products. 

d)     Phase 4: Extend the program to patient care areas.

8)     Educate through various channels to promote the program and its triple bottom line benefits.

9)     Provide product to appropriate distribution sites and hold a celebration/kick-off event.

• Harvard University Food Waste Composting Case Study
• Case study-Switching to reusable trays in the NYC school system (scroll to number 5-Waste prevention in Schools)
• Composting at Oregon Health & Science University
• Ross Memorial Hospital – A successful vermicomposting program feeds over 4 tons of worms
• Composting at Fletcher Allen Medical Center

1. GGHC (v2) Operations: Waste Management Credit 3: Food Waste Reduction.

Choose reusable textiles

1. EPA Green Cafeterias Program
2. Hospitals for a Healthy Environment 10-Step Guide to Composting in Healthcare Facilities