Green Commuting in the Health Care Sector: Obstacles and Best Practices.

OBJECTIVE: Fossil fuel transportation by health care providers contributes to the prevalence of diseases they treat. We conducted an exploratory study to understand obstacles to, and best practices for, greener commuting among health care providers. METHODS: We surveyed staff of three hospital clinics as to how they commute and why, and interviewed key staff of five hospital leaders in green commuting about their programs. RESULTS: Factors that might change respondents' commuting choices from driving alone included financial incentives, convenience, and solutions to crime and safety concerns. Successful green commuting programs offer benefits including free or reduced transit passes, shuttle buses to transit stations, and free emergency rides home. CONCLUSIONS: Exemplary programs throughout the country demonstrate that modifying those factors within reach can impact the amount of fossil fuel energy used for health care provider transportation.

Integrating environmental and human health databases in the great lakes basin: themes, challenges and future directions.

Many government, academic and research institutions collect environmental data that are relevant to understanding the relationship between environmental exposures and human health. Integrating these data with health outcome data presents new challenges that are important to consider to improve our effective use of environmental health information. Our objective was to identify the common themes related to the integration of environmental and health data, and suggest ways to address the challenges and make progress toward more effective use of data already collected, to further our understanding of environmental health associations in the Great Lakes region. Environmental and human health databases were identified and reviewed using literature searches and a series of one-on-one and group expert consultations. Databases identified were predominantly environmental stressors databases, with fewer found for health outcomes and human exposure. Nine themes or factors that impact integration were identified: data availability, accessibility, harmonization, stakeholder collaboration, policy and strategic alignment, resource adequacy, environmental health indicators, and data exchange networks. The use and cost effectiveness of data currently collected could be improved by strategic changes to data collection and access systems to provide better opportunities to identify and study environmental exposures that may impact human health.

Can sustainable hospitals help bend the health care cost curve?

As policymakers seek to rein in the nation's escalating health care costs, one area deserving attention is the health system's costly environmental footprint. This study examines data from selected hospitals that have implemented programs to reduce energy use and waste and achieve operating room supply efficiencies. After standardizing metrics across the hospitals studied and generalizing results to hospitals nationwide, the analysis finds that savings achievable through these interventions could exceed $5.4 billion over five years and $15 billion over 10 years. Given the return on investment, the authors rec­ommend that all hospitals adopt such programs and, in cases where capital investments could be financially burdensome, that public funds be used to provide loans or grants, particularly to safety-net hospitals.

Occupational injury disparities in the US hotel industry.

BACKGROUND: Hotel employees have higher rates of occupational injury and sustain more severe injuries than most other service workers. METHOD: OSHA log incidents from five unionized hotel companies for a three-year period were analyzed to estimate injury rates by job, company, and demographic characteristics. Room cleaning work, known to be physically hazardous, was of particular concern. RESULTS: A total of 2,865 injuries were reported during 55,327 worker-years of observation. The overall injury rate was 5.2 injuries per 100 worker-years. The rate was highest for housekeepers (7.9), Hispanic housekeepers (10.6), and about double in three companies versus two others. Acute trauma rates were highest in kitchen workers (4.0/100) and housekeepers (3.9/100); housekeepers also had the highest rate of musculoskeletal disorders (3.2/100). Age, being female or Hispanic, job title, and company were all independently associated with injury risk. CONCLUSION: Sex- and ethnicity-based disparities in injury rates were only partially due to the type of job held and the company in which the work was performed.

Providing employer-arranged occupational medical care: conflicting interests.

It is said that ethics comprise principles of good conduct or standards governing the conduct of the members of a profession. These standards are unbending and strict, yet the reality is that occupational health professionals are subject to many conflicting pressures. Most of these stresses arise from the fact that employers and insurance companies, not worker-patients, fund OH services, and these two entities have overlapping, yet distinct, interests. OH professionals must consider the health and safety of individual workers as their top priority, while also addressing myriad other concerns. This is the moral challenge confronting practitioners.