Computers & electronics in healthcare

Informed choices for asset management

Overview Strategies for environmentally conscious purchasing End-of-life solutions: Reduce, reuse, recycle

Overview of computers and electronics in healthcare

High-tech manufacturing produces millions of electronic products that provide the healthcare industry with greater efficiency, convenience and productivity. However computers and electronic products containing toxic materials pose a significant threat to public health and the environment when improperly disposed.

Hazardous components: Computers, televisions, lab analyzers, EKG monitors, and other types of biomedical electronic equipment may contain hazardous materials. Of particular concern are heavy metals such as lead (used in cathode ray tube [CRT] monitors and lead solder), mercury (used in the lights behind Liquid Crystal Displays [LCD]), and cadmium (used in batteries, resistors, CRTs, and plastic components), chlorinated plastics (PVC) used in cable wiring, brominated flame retardants (used in plastic computer housing and circuit boards).

Discarded computers and electronics are toxic hazardous waste. Studies suggest that as many as 100 million computers, monitors and televisions become obsolete in the U.S. each year. Discarded computers and other consumer electronics (so called e-waste) are the fastest growing portion of our waste stream -- growing almost 3 times faster than our overall municipal waste stream.

Currently about 70 percent of the heavy metals, including lead, mercury and cadmium, in landfills come from electronic equipment discards. The health effects of lead are well known; just 1/70th of a teaspoon of mercury can contaminate a 20 acre lake, making the fish unfit to eat. The hazardous substances found in electronics have been linked to human health effects like cancer, birth defects, and hormone disruption.

Less than 10 percent of discarded computers and electronics are currently recycled, with the remainder stockpiled or disposed of in landfills, incinerators or exported to developing countries for disassembly.

Challenges for equipment disposal: The healthcare industry is responsible for the consumption and disposal of millions of electronic devices every year. The challenge for healthcare organizations is to dispose of outdated or used devices while staying conscious of the environmental and health threats posed by information technology waste. Increased use and short life spans have made discarded computers, healthcare electronic equipment, and other consumer electronics (so-called e-waste) the fastest growing portion of our waste stream.

Due to short life spans, discarded computers, healthcare electronic equipment, and other consumer electronics (so-called e-waste) make up the fastest growing portion of our waste stream – almost three times faster than our overall municipal waste.

Because of the potential for adverse impact on public health, health care organizations are recognizing their responsibility to address the issues of the general environmental impact of their computer and electronic waste.

Compliance with existing regulations: Consideration for a comprehensive end-of-life plan for electronic equipment should include: the reduction of risk liability; data security; cost control; efficiency; and the minimizing of health risks.

There are three important federal laws that must be followed by healthcare providers:

• HIPAA – The Health Insurance Portability and Accountability Act requires confidentiality and security of health data. Healthcare providers should comply with the recent HIPAA legislation to ensure end-of-life data security for information stored on computers and other electronic equipment.
  See HIPAA’s official site or visit the HIPAA information database for details.
• RCRA – The Resource Conservation and Recovery Act manages hazardous waste disposal, including computers and electronics. To comply with RCRA and avoid serious violation and fines, for example, cathode ray tubes (CRTs) or any other piece of electronic equipment that contain hazardous materials must be managed as hazardous waste and not end up in a landfill.
  Visit the Environmental Protection Agency’s site for specific details on RCRA’s requirements.
• CERCLA – The Comprehensive Environmental Response Compensation and Liability Act (better known as the Superfund law) states that the generator of a waste material containing hazardous substances is liable for proper disposal of that material throughout its life. This is true even if ownership of the material has changed hands. To comply with CERCLA organizations should be aware that by selling or giving old electronic equipment to another party, they can be held liable for the full cost of cleanup, plus penalties, if the other party disposes of it improperly.
  Visit the EPA’s overview for more information on CERCLA.

Solutions: Healthcare facilities can address the environmental impact of computers and electronics through environmentally conscious purchasing of equipment with fewer and/or less toxic components and with options for end-of-life handling.

In addition, plans can be made at the time of purchase for extending the life of equipment, including recycling/reuse, leasing, or purchasing products that incorporate recyclability and reusability into their design.

It is best to consider reusing, recycling and "take-back" options at the time of purchasing electronic equipment, so that end-of-life handling is anticipated in the original purchasing agreements.

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Strategies for environmentally conscious purchasing

One of the opportunities for reducing the quantity and toxicity of electronic waste is the exercising of purchasing preference for environmentally preferable designs and programs.

Since only ten percent of computers and electronics are currently recycled, reducing electronic equipments’ overall toxicity at the design stage is a critical step in reducing toxic wastes.

The United States does not currently regulate mercury, cadmium and lead in manufacturing as closely as the European Union, where a directive entitled, "restriction of the use of certain hazardous substances in electrical and electronic equipment" (RoHS) was recently enacted. An alternative to regulating these materials is voluntary environmental purchasing practices by healthcare facilities. Such purchasing strategies encourage manufacturers to increase the number of products that meet high environmental standards from design and manufacture to end-of-life.

Specific purchasing strategies discussed below include use of the Electronic Product Environmental Assessment Tool (EPEAT), contractual requirements for minimal toxicity of materials and asset management plans using e-Stewards certified recyclers at the time of purchasing, as well as supplier "take-back", upgrade, or leasing programs.

Electronic Product Environmental Assessment Tool (EPEAT): When developing specifications for an electronics purchasing decision, consider use of the EPEAT procurement tool to evaluate, compare and select desktop computers, notebooks and monitors (and other electronics as developed) based on their environmental attributes. EPEAT consists of a set of voluntary environmental performance criteria, which address:

• Reduction of toxic materials
• Materials selection including recycled and bio-based content
• Design for end of life to assist in ease of recycling
• Product upgradeable to encourage longer useful life
• Energy conservation
• Availability of an end of life management system
• Measures of general corporate environmental performance
• Packaging reduction efforts including take-back programs and recycled or bio-based content.

EPEAT provides a web-based system for registering products, which meet the standard’s criteria. at one of three levels - Bronze, Silver, and Gold, followed by registry surveillance and ongoing verification. Purchasers can locate registered products on the web site: http://www.epeat.net/. When writing specifications, include in contracts terms the request for annual reports of EPEAT purchases to help track and calculate environmental benefits.

EPEAT Milestone Press release (.pdf) (71 KB)
http://www.epeat.net/NewsDocuments/EPEAT%20Passes%201000%20Mark.pdf

E-Stewards: When arranging an electronics asset management contract, consider requiring bidders to be certified as e-Stewards. The e-Stewards program is an accredited, third-party certification system built on criteria developed by the Basel Action Network (BAN) for identifying electronic recyclers who properly handle hazardous electronic components based on national and international laws. The program also recognizes manufacturers and others who commit to using only e-Steward recyclers. Those companies then become e-Steward compliant by agreeing to take part and may carry the logo

Other Contractual Guidelines:

Health Care Without Harm’s Environmentally Preferable Procurement Guidelines for Electronic Products also proposes contract requirements to consider.

• Suggestions for purchasers going beyond EPEAT (.pdf) (323KB), and
• Equipment End of Life Management Summary Form (.pdf) (259KB)

To limit liability, obtain documentation of the final destination of the waste, the company’s liability insurance, and efforts to recycle the waste, just as you would with any electronics recycler. By developing specifications that require or prefer compliance with health-based standards, health care institutions can improve the environmental and health performance of their own equipment, and also push the market in the direction of greener, cleaner electronic products.

Leasing: From an environmental perspective, leasing can have several advantages over purchase of electronic equipment. For an organization concerned about potential downstream liability under CERCLA (Superfund) for the disposal of equipment with hazardous materials in it, leasing eliminates direct liability. However, organizations also have a responsibility to ask the provider of leased equipment how they manage their own recycling. Companies providing leased computers and other electronic equipment are eligible to become e-Stewards and organizations should ensure that their providers are e-Steward compliant. Also, a lease agreement, like any purchasing instrument, can be used to specify equipment with reduced toxicity. Finally, when an organization leases equipment, the supplier has a vested interest in getting the maximum value for the equipment after its use by your organization. Thus, the supplier will take that value into account when negotiating price and lease life.

Upgradeability and take-back options: Extending the life of electronic equipment is a key to reducing waste, and one of the most environmentally sound steps to take. Seek contracts that have upgradeability options, so the equipment’s efficiency can be improved without replacement over a longer period of time. Some EPEAT-registered products may already meet the requirements related to upgradeability and end-of-life.

Many electronics manufacturers offer take-back programs for obsolete or unneeded equipment. Ask for manufacturer take-back at the time of purchase - the take-back program should be e-Steward compliant.

If manufacturers are responsible for end-of-life costs and become e-Steward compliant, they will be motivated to make the products last longer, provide technical support and parts for a longer number of years, make their products more easily recycled, and design them with less toxic materials.

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End-of-life solutions: Reduce, reuse, recycle

Solutions for disposition of computers and electronics at end-of-life should follow the hierarchy of "Reduce, Reuse and Recycle".

• Only purchase new computers when existing computers cannot be upgraded to perform the necessary tasks.
• Look for reuse opportunities within your own organization, before sending equipment outside your facility.
• If you have a large number of computers to replace each year, choose an asset disposition firm that is or uses only e-Steward certified recyclers.

Reuse

Reuse as an alternative: Reuse is the practice of donating, selling, or redirecting computers and other information technologies in order to maximize use over their lifespan. When properly executed, reuse is an alternative to recycling that assists in reducing electronic waste.

Reuse liability guidelines: Two key issues must be considered before a company sends electronics into the reuse market.

1. HIPPA compliance. Consider HIPPA requirements during IT end-of-life management. Ensure that you have a data security plan in place before releasing the equipment, and then make certain it is followed. Hospitals need to comply with HIPAA by ensuring data security before equipment is donated or reused in any form. If this condition cannot be met, it is preferable to have equipment recycled to ensure data security.
2. Legal liabilities. Be aware of your legal liabilities as the hazardous waste generator for any electronics that you sell or donate for reuse. You are legally responsible for performing "adequate due diligence" (exercising proper care) for your unwanted electronics, as well as their downstream suppliers, to ensure that the hazardous components do not end up contaminating the environment in any country.

Reuse options

• Redistribute equipment to other departments or individuals within your organization.
• Contract an asset recovery company to find a market for your used equipment.
• Asset recovery involves careful analysis and deployment of used computers. Options include: refurbishment and possible resale (sometimes with a profit split for the disposing facility); donation opportunities (with potential charitable deductions); resale of some components and recycling of the rest.
• Offer used information technology to responsible charities, which will place it with those in need. Keep in mind these organizations must ensure proper end-of-life handling of your hazardous waste, as you retain liability. Make sure that these charities do not ship equipment to developing countries, where there are few, if any, facilities for processing the hazardous material once it becomes a waste in their country.
• Visit the website of the Basel Action Network, for more information about international and national laws restricting the trade in hazardous waste.

Recycling

Recycling is a process of dismantling electronic devices into component materials to be reclaimed for new manufacture. A wide range of recycling practices, both safe and unsafe, exists for recycling computers and other electronic equipment. Recycling of electronic waste includes four phases, for all of which the hazardous waste generator is required to take responsibility.

• Ensuring proper data destruction, and certification.
• Reducing the electronic devices into component materials to be reclaimed. This is accomplished through manual disassembly or mechanical destruction such as shredding, crushing or granulation.
• After physically reducing the electronic devices, separating component materials (including hazardous ones) and sending them to their respective markets for final processing, such as secondary smelting, incineration, refining, etc.
• This final processing can occur either in relatively clean, high-tech facilities or in unsophisticated operations that are extremely polluting. For some materials there are no markets, and therefore some unwanted materials will go to landfills, waste-to-energy incinerators, etc.
• Manufacturing new products with the reclaimed valuable materials.

Accountability

Some computer recycling companies operate under stringent environmental controls and worker safety protections, while others do not. Workers dismantling discarded electronic equipment under poor working conditions can be exposed to many chemical compounds with known and suspected negative health effects. In many instances, electronic waste is shipped overseas for recycling, frequently to developing countries where weaker laws or lack of industrial infrastructure result in very toxic processing of the hazardous components of e-waste. In some cases, the export of hazardous waste from the United States to developing nations is illegal under the Basel Convention and OECD treaties. In the U.S., prison labor is often used to recycle computers. Concerns about the conditions under which recycling of electronic waste occurs should encourage a closer look at recycling companies’ labor, environmental, and export standards.

Recycling standards and initiatives

A good first step before selecting an electronics recycling company that meets your needs and protects human health and the environment includes seeking suppliers who are e-Stewards. E-Stewards are certified by a set of criteria developed by the Basel Action Network to identify electronic recyclers who properly handle hazardous electronic components, based on national and international laws. This certification list (found at http://www.e-stewards.org/local_estewards.html) can serve as verification that the recycler does not ship hazardous electronic waste to landfills, to developing (non-OECD) countries, or to prison operations in the US, as well as has adequate facility closure insurance or coverage.

Whether contracting with a recycler or an asset disposition firm, it is crucial to ask detailed questions about their services, recycling facilities, worker safety policies, HIPAA and RCRA compliance services and other factors in order to make an informed decision.

Acknowledgement

The Premier Safety Institute wishes to thank Health Care Without Harm and Practice Greenhealth for their assistance with development of this Web site module.

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