Tossing out everything from plastic bandages and cotton swabs to hospital robes after a single use, the U.S. medical industry generates more than 2 million tons of waste per year, environmental advocates say. Some of that waste makes its way to incinerators and, when burned, releases dioxin, mercury and other toxins.

Is it ironic that the industry we trust to protect our health is releasing substances that may be tied to cancer, diabetes and other illnesses? Many health-care professionals think so.

In recent years, some have begun to think greener. Most efforts focus on reducing toxic waste from hospitals and medical offices as well as cutting back on water and energy use. But some doctors and health workers are also considering changes in their practices that could enhance environmental and patient health.

"There is an understanding between and among health professionals that the environment is playing a really important part in our health status," said Barbara Sattler, director of the Environmental Health Education Center at the University of Maryland School of Nursing. Many U.S. hospitals are seeking ways to make their daily operations more environmentally friendly. More than a fourth have joined Hospitals for a Healthy Environment, which recently changed its name to Practice Greenhealth, a government-supported movement to minimize medicine's environmental footprint.

The biggest problem: limiting toxins, such as mercury, that are released into the environment during

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disposal.

Mercury "is leaching into the environment, and we're ingesting some of that through fish and seafood," said Ravindra Gupta, an internist at Inova Fairfax and co-chairman of the Going Green Committee for the Inova Health System.

Hospitals throughout the country have responded in the past decade by eliminating mercury from many of their supplies, including thermometers and blood pressure cuffs.

Bridgeport Hospital is a member of Practice Greenhealth, as is St. Vincent's Medical Center in Bridgeport, and recently earned the 2008 Making Medicine Mercury Free Award from the group. It was one of 22 hospitals to be recognized this year.

St. Vincent's eliminated mercury in 2002, said Jim Gengo, director of environmental services at the hospital. The process of eliminating mercury took about seven years, said laboratory manager Patti Clark, who is responsible for the hospital's chemical hygiene and green initiative.

Bridgeport Hospital started "going green" about 10 years ago, said Clark, a member of the Connecticut Hospital Association's task force on helping hospitals become greener. It's been building momentum and not only targets toxins, but includes recycling equipment, using earth-friendly products and saving energy.

The biggest challenge, she said, is "finding a place to store all the tings we want to recycle."

St. Vincent's recently marked the second anniversary of its Go Green initiative. One of the hospital's first steps was using green cleaning products through the "Greening the Cleaning" initiative of the Deirdre Imus Environmental Center.

The hospital's most recent statistics — from 2006-2007 — reported a savings of more than $9,000 in chemical usage; increase in recyling of cans, plastic light bulbs and batteries and a switch to filmless X-rays for imaging.

A switch from cotton mopheads to microfiber, which can hold up to six times their weight in water, has resulted in a savings of about 152,748 gallons of water per year, said Gengo. Microfibers can be washed up to 500 times as opposed to cotton mops that can be washed eight to 10 times before being discarded. The hospital uses about 112,000 mopheads a year, Gengo said.

Going green permeates every aspect of the hospital, from encouraging employees to bring in mugs for their coffee to reduce the use of Styrofoam, to using green materials during any hospital construction.

"The biggest challenge [with going green]," said Gengo, "is getting everybody on board."

In the mid-1990s, there were more than 5,000 medical waste incinerators in the United States, said Stacy Malkan, a steering committee member of Health Care Without Harm, an international coalition working to reduce medical industry pollution. Today, there are fewer than 100.

"But we'd like to see the end of all medical waste incineration," Malkan said.

For many hospitals, autoclaving, or steam sterilization, has proved to be a good alternative: The waste is steam-sterilized, compressed, then sent to landfills.

But to be really effective, the effort to minimize the environmental impact of medical waste has to start with smart purchasing practices, Kilgore said.

"We are looking at what we're buying and changing over [to greener products] because that sends a message to manufacturers that this is what is important to us," Kilgore said. "We make sure we're dealing only with manufacturers that are as concerned about the environment as we are."

Thanks to advances in product development and manufacturing, "there are many kinds of cleaners, pesticides, nontoxic chemicals on the market today that meet medical standards," said Anna Gilmore Hall, executive director of Health Care Without Harm. "Infection control, for example, is just as effective with green cleaners as it is when you use Clorox."

On the construction side, there has been progress in establishing medically appropriate green standards. The Green Guide for Healthcare, released in 2004 by a coalition of environmental and medical advocacy groups, was the first to offer hospitals guidelines for building green facilities. Of all medical green efforts, "the greening of the built environment is what has really taken off," said Niyati Desai, associate director of the Teleosis Institute, a Berkley, Calif.-based environmental outreach group that offers classes on green practices to medical professionals. But for Teleosis and a still small group of medical professionals, green medicine can be even more.

"It goes beyond what light bulb you're using to how do we make our care more sustainable?" Desai said. "Sustainable medicine is about prevention, precaution and using the most invasive procedures only when necessary."

Teleosis warns against over-prescribing medications, which Desai said presents a pollution hazard because unused pharmaceuticals often find their way back into the environment.

"If everyone who comes in gets prescribed pharmaceuticals or is admitted for surgery, that is more invasive on the environment," she said. "How do we step back and reduce that reliance?"

"Going green is not just about recycling," Gupta said. "It's more a change in the way we work. It's a change in our environment. For example, one of the big pushes in new construction is to have more daylight in the [hospital] rooms ... to help patients feel more at peace, so they require less medication for sedation."

Some medical practitioners are catching this green spirit, promoting their practices as environmentally friendly.

Christopher Warner, a gynecologic laser surgeon and obstetrician, advertises a Georgetown office that he says is entirely free of toxins, down to the paint on the walls.

"Everything in the space is recycled," said his wife, Sharon Warner, who manages the practice, called the Washington Wellness Institute. Everything (even the carpet and wall panels) is made of natural and recycled materials.

"All the things we tell our kids to do — turn out the lights, close the door — our office does it for us automatically," Christopher Warner said. "Coming into the office, the air just feels that much cleaner; the environment is less toxic."

Newsroom@ctpost.com Eileen Fischer contributed to this story.