How Hospitals Systematically Harm People

The minute you're admitted into the hospital, you confront a disturbing paradox: Most hospitals aren't particularly healthy places. As a patient, you're likely to encounter toxic chemicals, eat lousy food, breathe unhealthy air and suffer stress triggered by an often-dismal and alienating environment. Even worse, you may find yourself at the mercy of drug-resistant "super bugs" or overworked staff members who make mistakes -- all in a place that's supposed to help you heal. It's enough to make you sick. And sometimes it does.

In the U.S. alone, an estimated 2 million people a year contract infections in hospitals, and nearly 100,000 are expected to die from them this year, according to the U.S. Centers for Disease Control and Prevention. Although such statistics are deeply troubling, hospitals around the world also contribute to a subtler but equally insidious threat: They expose patients and staff to a host of substances and practises that can harm their health.

For example, hospitals use cleaners and disinfectants containing chemicals that can trigger asthma and other problems. A major study by Spanish researchers published in The Lancet last July hints at the extent of the problem. The study found nurses twice as likely as workers in other fields to develop asthma on the job, due to chemical exposure.

Needless to say, patients breathe the same air as the nurses. Fumes from disinfectants and other cleaners as well as pesticides contribute to indoor air pollution, a particular threat to patients with weakened immune and respiratory systems. These chemicals can also irritate the eyes, nose and throat, and trigger symptoms ranging from headaches to nausea to loss of coordination.

Another problem, perhaps the most obvious, is hospital food. Not only unappetizing, it was probably produced with pesticides, artificial preservatives, hormones and unnecessary antibiotics. To make matters worse, the usual alternative to a bland hospital meal comes from the fast-food joints encouraged to operate in many hospital lobbies. These sorts of things send people like Gary Cohen through the roof.

"About 30 hospitals have McDonald's restaurants in their lobbies," says Cohen, co-founder of Health Care Without Harm, an international organization that pushes hospitals to make changes that support the health of their patients, workers and communities. "Here we are with 60 million Americans who are obese and 120 million who are overweight and we're feeding people in hospitals food that contributes to obesity. Stuff like that just amazes me."

Many hospitals fail to recognize how their everyday choices, involving everything from food to chemicals to their physical and emotional environments, affect the health of their patients. Until recently, that is. Change is afoot in some of the most unlikely places.

Little more than a decade ago, most hospital administrators thought burning medical waste was the safest way to protect patients and communities from infectious disease. In 1995, the U.S. Environmental Protection Agency (EPA) issued a wake-up call: Medical waste incineration had been found to be a leading source of dioxins, arguably the deadliest carcinogen.

"It was incredible that the very institutions devoted to healing people were actually poisoning them," says Gary Cohen. In the years since the report was published, more than 5,000 medical-waste incinerators have been closed in the U.S., as have scores more in Europe and elsewhere. Although the problem hasn't gone away (dioxins are found in everyone, including newborns), closing medical-waste incinerators was the first step for many hospitals toward beginning to examine healthier ways of caring for their patients and communities.

When Kathy Gerwig, vice-president for workplace safety at the Kaiser Permanente health-care network in the U.S., learned that burning the vast amounts of polyvinyl chloride (PVC) used in hospitals produces dioxins, she and her colleagues promptly started looking for alternatives. They first reduced hospital waste and switched from vinyl to nitrile exam gloves. "That was a success because we learned something very important," Gerwig says. "Changes we initiated for environmental reasons often had other advantages."