It’s In The Materials
According to Rob Albert, Vice President of Pharmacy Marketing at B. Braun Medical, Inc., there are materials present in healthcare products today that can be harmful to the environment and to patients. Materials such as Polyvinyl Chloride (PVC) and Di-ethylhexyl phthalate (DEHP), often found in infusion therapy products, were removed from the company’s products because of their potentially harmful effects. Here, Albert discusses the risks these materials may pose, and why it is important from an environmental and safety perspective for healthcare professionals to know the make-up of a product before using it in their facility.
SP: How can PVC and DEHP pose a risk to the environment?
RA: PVC-containing products pose an environmental hazard when incinerated as waste material. When incinerated, PVC causes emissions of dioxin, a known human carcinogen that also causes reproductive and developmental disorders. Additionally, if products containing DEHP are disposed of in a landfill, the DEHP plasticizer can leach into the soil and groundwater (Wams TJ: Di (2-ethylhexyl) Phthalate as an environmental contaminant – A Review. The Science of the Total Environment 1987; 66: 1-16).
SP: Are there patient safety risks associated with PVC and DEHP if they are present in infusion therapy products?
RA: PVC and DEHP are both commonly used in IV bags, IV tubing and product packaging. DEHP is added to make the plastic more flexible; however, it does not adhere to the plastic, but ‘floats’ within the vinyl structure. During certain therapies, DEHP can leach from the structure and be infused along with the IV fluid, medication and blood transfusion, thus going into the patient’s bloodstream. Blood products and several drugs, such as Paclitaxel, enhance leaching of DEHP from PVC containers. IV containers that do not contain DEHP eliminate the risk of toxicity (Bristol-Myers Squibb Company, Oncology Division, 1999). DEHP has been scientifically documented as a reproductive toxicant (Safety Assessment of Di(2- ethylhexl) Phthalate (DEHP) Released from PVC Medical Devices. US Food and Drug Administration. Center for Devices and Readiological Health, 2001.)
SP: How can avoiding the use of products containing PVC and DEHP help hospitals be green?
RA: Use of PVC- and DEHP-free products can reduce the amount of landfill waste generated and lower disposal costs. When empty, PVC-free containers weigh less than comparable PVC containers, and disposal costs are as much as 30 percent less annually. (Test data available upon request at B. Braun Medical).
SP: Are PVC and DEHP found in other medical devices?
RA: According to Healthcare Without Harm, products that may contain PVC include enteral feeding products, IV therapy products, blood transfusion products, kidney therapy products, packaging and respiratory therapy products. For a complete list, visit www.healthcarewithoutharm.com and read, “PVC Medical Devices Containing The Plasticizer DEHP: Guidelines for an Audit.”
SP: Why is it important to consider the materials in medical devices as part of the adoption of green practices in hospitals/surgical facilities?
RA: It is important to understand the impact on the environment a product has from the manufacturing process to disposal. It is also important to understand any potential impact on patients clinically. Certain plastics have been identified not only in healthcare, but in general consumer use, as potentially harmful. The adoption of green practices enhances patient safety, and demonstrates corporate and environmental responsibility.