Indiscriminate use of natural resources and increased output of noxious end products during manufacturing processes is threatening the very existence of our planet. Most would agree that positive change is necessary, but few are clear on how to accomplish that. Physicians are looked upon as leaders in society, and we should set the example. A good start would be making our offices eco-friendly.
The Environmental Health Committee of the BCMA worked with the Canadian Medical Association during the August 2007 meeting of General Council to promote various environmental improvement projects. One of these initiatives was to develop a list of steps that physicians can follow to decrease our impact on the environment or reduce the eco-footprint (land required to accommodate the waste and neutralize the carbon dioxide) in our offices. The health industry consumes gigantic amounts of energy and generates enormous waste. The eco-footprint of some health institutions is up to 37 times their size! These 10 steps were developed for doctors’ offices, but we hope you will adapt them to reduce your eco-footprint at home and elsewhere.
Step 1. Reduce energy use
• Use energy-efficient equipment such as those certified by the Energy Star program
• Turn down the thermostat at night and on weekends.
• Set your air conditioner 2 degrees higher, and your furnace 2 degrees lower.
• Use energy-efficient lightbulbs or fluorescent lights, and avoid using halogen lamps.
• Turn off computers and other electronic equipment when not in use.
• Ensure the windows and exterior doors are sealed.
• Use motion sensors or timed lighting for unoccupied rooms.
• Use natural light as much as possible.
Step 2. Encourage eco-transportation
• Locate your office close to public transit. Educate your patients and staff about their options.
• Provide bicycle storage and change rooms.
• Encourage teleconferencing and e-conferencing.
Step 3. Switch to eco-purchasing
• Purchase environmentally friendly paper with high post-consumer content and chlorine-free bleach.
• Purchase environmentally friendly medical equipment.
• Use certified environmental products such as those approved by EcoLogo, Green Seal, and Forest Stewardship Council.
Step 4. Use less paper
• Reuse paper printed on one side, provided confidential information is not released.
• Set your printer to double-sided printing.
• Receive journals and other publications via e-mail rather than paper.
• Refuse unnecessary packaging from pharmaceutical companies.
• Contact the Canadian Direct Marketing Association (416 391-2362) to request junk mail be stopped.
Step 5. Reuse and recycle
• Use cloth gowns.
• Stock reusable equipment, rather than disposable, such as specula.
• Recycle paper, glass, plastic, and aluminum and keep recycling bins in areas where these materials are used.
Step 6. Eliminate mercury-containing equipment
• Replace mercury thermometers and sphygmomanometers with non-mercury alternatives.
• Dispose of mercury products safely.
Step 7. Reduce toxic cleaning and sterilizing alternatives
• Use non-glutaraldehyde sterilizers or steam autoclaves.
Step 8. Employ water-saving strategies
• Fix leaks.
• Install restrictors (aerators) on taps.
• Reduce the use of bottled water and water coolers and install filters on tap water.
Step 9. Use eco-building materials
• Consider less-toxic materials such as cork, hardwood, or linoleum rather than carpet.
• Use low-volatile organic compound (VOC) paint.
• Use hardwood furniture instead of particleboard or plywood, which can emit formaldehyde.
Step 10. Use green landscaping
• Plant drought-resistant foliage.
• Use rooftop plants to reduce the heat island effect.
• Use integrated pesticide management strategies.
—Susan Germain, MD
—Ray Copes, MD
—Bakul I. Dalal, MD
Environmental Health Committee
1. Germain S. The Ecological Footprint of Lions Gate Hospital. Hosp Quart. 2001/2002;61-6.
2. Hancock T. Energy, Health and Healthcare. Hosp Quart. 2001/2002;62-4.
3. Hancock T. Doing Less Harm: Assessing and Reducing the Environmental Impact of Canada’s Health Care System. 2001. Canadian Coalition for Green Health Care, Ontario. Available at www.greenhealthcare.ca.
4. Green Guide for Healthcare. Best Practices for Creating High Performance Healing Environments. V2.2 January 2007. 468 page pdf document available at www.gghc.org.
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
- Only the first three authors are listed, followed by "et al."
- There is no period after the journal name.
- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org