From WXXI news I'm Jasmine Singer and this is Environmental Connections.

Today's environmental connection began right down the road at the University of Rochester's Medical Center.

Each time I've passed by the constant stream of smoke from their power plant, I've wondered what kind of environmental impact does the health care system have?

My guess is that it goes well beyond what's in one smokestack.

Between the U of R and Rochester Regional Health Medical Systems, over 45,000 Rochester are employed by the local health care systems.

They are, of course, major powerhouses in the local economy and people's daily routines.

But one of the lesser known consequences of these health care systems is the extent of their impact on the local environment.

So the question looms what are these organizations doing to reduce their carbon footprints, given their dominance over the economy in the area?

Today's episode of Environmental Connections focuses on the different steps that these health care systems are taking in a new world of hospital sustainability, and what work is still left to do.

Joining me in the studio today to unpack these ideas are doctor Mike Waller, director of sustainability at Rochester Regional Health, and Doctor Jane Van Dis, co-founder of OB GYNs for a Sustainable Future.

Welcome, Doctor Waller and Doctor Van Dis.

Thanks, Jasmine.

So thanks.

Good to be here.

So great to have both of you.

And it's great to have our remote guest today, Heidi Fritz, who is the health care director of greener by default.

Welcome, Heidi.

Thanks.

Great to be here.

Our guests are going to give us an inside look at how health care systems can address sustainability in their daily operations.

And I am so excited about this episode.

Doctor Waller as director of sustainability for Rochester Regional Health, could you start by talking about the biggest sources of carbon emissions at the medical center and strategies that Rochester Regional Health has implemented to cut those emissions?

Sure.

well, for those who are not quite as familiar, we try to to get our hands around the different types of emissions by dividing them into three different scopes.

We call them scopes one, two, and three.

Scope one are sources that are generated onsite, from your operation.

So that includes things like natural gas combustion.

tailpipe emissions from any kind of vehicles for, health care systems.

There's actually, quite a bit emissions that are generated from, waste anesthetic gases.

So anytime somebody goes under, anesthesia, those gases get vented to the atmosphere, and they're, thousands of times more potent than, than carbon dioxide.

So that's all in scope one.

scope two is basically the emissions from electricity.

And then scope three is everything else.

And, scope three that that includes all of the emissions from all the supplies that are purchased.

And so all of the emissions that come from the manufacturing, delivering those supplies to the hospitals, that, is typically the largest category of emissions, but it's also the most difficult to actually get an accurate number.

So there's a lot of groups that have tried to estimate, and they say it's about 75 to 80% of the total emissions for most health care systems.

It's also the most difficult to to get your hands on and actually try to try to, try to figure out ways to reduce it.

So we tend to just focus on scopes one and two, because we can more easily manage those.

The medical center doesn't have its own power plant, right?

not at any of our locations.

We don't have any onsite generation other than the generators that sometimes we have to use.

So does that make it easier to prioritize renewable energy and energy efficiency since you're not tied to running your own facility?

And I should also add, does it does it also help balance the financial and environmental incentives when you're making energy decisions?

I think really with any technology, there are solutions out there to make them more efficient and, to use renewables.

Even if you have, say, an onsite natural gas power plant or using some other fossil fuel.

You know, there are ways that you can buy carbon offsets to offset the emissions.

for example, but at the end of the day, you know, I think the the biggest challenge, least for my job, is how do we reduce our emissions in a cost effective manner that, our, our C-suite will accept.

And so that's where I spend most of my time focusing on is, you know, how can we actually save money?

Well, switching to renewables, which we've fortunately been pretty successful, at least in the time that I've been there.

Tell me, why brag a little?

Well, you know, I, I learned so when I started.

We have a new CEO now, but when I started, our former CEO, his name was, Eric Beaver.

He.

And my first day in the job, he said, Mike, nobody knows what health care sustainability is, so you're kind of going to have to make it up.

And then he said, I'm also still trying to convince people why I'm paying you.

And then he then he literally kicked me out of his office.

Okay.

So, you know, I kind of took from that.

you know, I really need to focus on the financial savings.

So pretty much when when people ask me, what do what do I do?

I tell them that I pretty much just save, money for the health system with an environmental flair to it.

So you have to speak their language.

Exactly.

And so, you know, depending on the audience, I'll either just start with the savings and I'll be like, oh, by the way, we're reducing our our environmental footprint.

Or, you know, if it's a group like this, we can talk about the environmental stuff.

And by the way, we're saving, you know, millions of dollars as well doing these things.

So I know that some health care facilities are also exploring ways to generate their own green energy, whether that's through solar panels or wind power or even geothermal heating systems.

Has Rochester Regional Health considered any of those approaches?

Yeah, so we have a goal.

By the end of this year that 100% of our electricity would come from renewables.

Oh my gosh, that's amazing.

Which my job is to to finish that.

And so at the end of this year I'm a little, a little nervous about.

Yeah, sure that we achieve it.

So we just said it in front of Jane van der still.

So you're going to be held accountable.

Well, we're we're actually doing pretty well.

So when we tallied it up, we're at about, 76%.

Wow.

So we we're we have some plans in place where we think we can, at the very least, have, projects under contract by the end of this year, to, to meet that goal.

So we, we, we plan to do that.

But we basically are doing it with, just a lot of solar and we do have some geothermal, but that really doesn't make a dent.

the, the renewables were able to achieve that pretty much just boils down to solar because it's the cheapest form.

we also, purchase a lot of hydropower as well.

That's awesome.

and, we really don't have much wind, but that's that's another potential option that's being explored.

So in researching for this episode, we found that the highest contribution to global warming from health care comes from the United States.

So let me share some stats.

Our health care contributes 10% of all U.S. greenhouse gas emissions.

over, over one fifth of the health care contributions to climate change globally.

And 71% of the carbon emissions in health care comes from the health care supply chain.

I want to talk about what that tells us about the most urgent changes that need to be made.

So to help us answer that, let's turn to Doctor Jane Van Dis.

Doctor vendors from where you sit.

What is the most significant source of emissions in health care?

Well, as Mike mentioned, and as your statistic outlined, somewhere between 70 and 80% of all emissions in health care come from those scope three emissions, which is the supply chain.

And so in a hospital or in a health care setting, there are obviously purchase managers in all sorts of departments, and they are in charge of supplying all the necessary elements to provide the health care that we do.

So, for instance, all of the pharmaceuticals and importantly, pharma contributes up to 4.5% of global greenhouse gas emissions and up to 25% of a hospital's emissions.

So all the little decisions that, a purchaser makes in the in deciding what types of medicines, what the vehicles for distributing those medicines are, whether or not they're using the metered dose inhalers, which, as Mike mentioned, those also contribute, their direct greenhouse gas emissions.

so there are all there are tiny, tiny purchasing decisions along that supply chain that add up to that 80%.

and I will say that importantly, I think, I hope we can talk about this at some point.

Jasmine is is also the waste stream because that, that also gets, lumped in with the supply chain in terms of the, the things that are purchased.

And then those things after they have had their use.

How how much emissions comes from their disposal.

Let's do that.

Let's talk about the waste created in the hospital.

My wife tells me that she remembers a time in the 90s when her campus health services would autoclave medical instruments.

Doctor van Des, can you talk to us about where waste comes from and whether reusing equipment could play a role in reducing both waste and emissions?

Yeah.

So it's it's great because you you can hit two, birds with one stone.

Not that I want to hit any birds in the bird.

Two birds, one birdseed free do birds.

Exactly.

And I should say at the outset, just that I want to make clear I am an Ob-Gyn practicing at York at the University of Rochester.

however, I also started an organization called ObGyn for Sustainable Future, and this is actually an interest group of health care without harm.

So health care without harm is a is a global organization that helps, that helps health care organizations, plans to decarbonize and to think about how they can become champions, for both decreasing their emissions, but also the pollution in their communities.

So nothing I say here today is as a representative of the of the University of Rochester.

However, I obviously practice in that setting.

So I have a lot of experience.

So back to your question about waste.

there are every there again, are tiny, tiny decisions that are made in every single clinical situation for which you might have the opportunity for choosing something that is reusable versus, single use.

And so a perfect example in my area of expertise is the speculum, which, for the women out there, they might not have fond memories of this device, which we used to, perform a pap smear screening for cervical cancer, etc..

But what's interesting is, is that actually the metal speculum, which, to your wife's point, do require, autoclave.

the metal speculum is actually have less emissions.

So there was a great study that was performed a couple of years ago.

And what they did was they looked at the carbon emissions of plastic speculum versus metal speculum over the course of the year.

And what they found is that the plastic speculum, when you include the the emissions associated with the the disposal of those plastic speculum was actually over four times high.

So four times the carbon emissions for the plastic versus the metal.

we see this as well in decisions about drapery.

when we use reusable drapery, for instance, in surgical procedures, there's no difference in infection rate.

But there's a huge difference in the emissions of single use plastic drapery, which is the norm across healthcare and reusable cloth drapery.

So again, tiny, tiny decisions, all of which when added up, account for that 80% of those emissions.

I want to go back to your mic because as you mentioned, that's not what you're specifically representing today.

You are Mic was asked to be on today's episode, and unfortunately they were not able to join us.

But they did email me this morning and asked me to share how deeply committed they are to making health care more sustainable.

They say they've been working on this for over 25 years.

They say that they focus on practical challenges beyond recycling things like reducing waste and saving energy and, as they say, supporting local food systems, which will get back to, so that is good to know.

But I'm very grateful that we can dig in a little bit more with our guests who were able to show up today.

And I want to ask you one more question before we go to Heidi.

Doctor van Des hospitals also rely on sustainable procurement.

So purchasing materials and equipment with environmental impact in mind.

So what should hospitals prioritize when making these decisions?

Well, actually I think that there is a false sense of, having a better device or a better thing when it is single use.

And I do think that given that, the plastics industry is 25% of GDP, the fossil fuel oil industry is 6% of GDP.

There's a way in which the, procurement and the and the selling to doctors to purchase managers, etc., that single use is better, has infiltrated all of health care in a very to very deleterious aims.

and it's interesting speaking, to Mike's point about cost sensitivity, it's been shown that actually reusable surgical instruments are 99 times lower cost than single use surgical instruments.

And yet if you talk to any surgeon, they'll probably tell you that they think that, that that it's cost less.

Right, because it's made of plastic.

So there's a way in which the advertising and the marketing and all of the sales representatives within the healthcare industry have pushed plastic push single use on us.

And I will say it's really interesting.

I know you've had, here in this studio, people from RIT and the University of Rochester who are measuring the amount of plastics in the waterways around Monroe County.

And we know that these plastics are having very deleterious health effects on our, unborn children in the in the womb.

I'm a I'm an obstetrician.

So those are the patients that I care for, but also children's health, adults health, etc.. And so there's all sorts of ways in which this plastic ecosystem of which the health care and hospital systems are a huge, generator, in fact, the health care is the largest generator of plastic waste in the United States, generating over 5 million tons of waste per year.

and then we in health care are also the biggest consumer of single use, plastic.

And importantly, Jasmine, as your your audience probably doesn't know, less than 5% of that plastic in health care is recycled.

So it is either going into the landfill which is making its way into the water, or it's getting incinerated in our red bags, which are our medical waste bags.

And then unfortunately, those, chemicals then are going up in the air.

Wow.

I mean, you know, that, for actual solutions, it it really just boils down to the age old mantra of reduce, reuse, recycle.

Yes.

And I, I get a lot of frustrated that so many people focus on that recycling piece when it, you know, you people come and try to say that they want to recycle everything and throw everything in our single stream bins, but it's such a small amount of the materials and such a small impact on the overall emissions reduction efforts that we're trying to achieve.

The best thing that any, health care professional can do is to reduce first.

So figure out what are the things they don't need to buy or use, and then stop buying them and then switch to reusable, if they can can find alternative, product for whatever item that they use on a daily basis.

And then after that figure out ways to, to recycle it.

Yeah, but but starting at the, at the beginning of just the reduction step is huge.

And the people, if there are any health care professionals, are listening, the people who have the most power and authority in this are the physicians and the nurses, because they're the ones that direct the items that they want to use.

And then after that, it's the purchasing team.

So there's a whole group of purchasing folks in the background for for all of the health care systems that are really the ones testing and deciding which products that we use, and they're the ones that talk to the vendors, and tell them what the, the nurses and the physicians want to use and want to see in their products.

And so those those are the teams that can really have an impact on this.

Having said that, I do think there are these regulatory bodies in some more of these policy bodies that do that do play a role as well.

So a perfect example is, for instance, I think for instance, that a lot of hospitals require the physicians and nurses to use the plastic bouffant caps when they're in the operating room, when in fact there has been shown to be no difference in infection using a cloth reusable scrub cap.

and so sometimes what you'll see is the health care system will say you have to use the single use, even though there's no data to support that the single use is better or that it prevents infection.

Okay.

Wow, you guys are blowing my mind.

I just want you to know that, like, not in a not in a great way, but I am so in, you know, happy to hear that there are efforts being done here.

It's just one of those stats that it it's overwhelming, to say the very least.

If you're just tuning in, join me in being overwhelmed and excited by our guests today.

I'm Jasmine Singer and you're listening to Environmental Connections.

Once a month we move even over a little bit and take over the mic for environmental connections.

And today we're being joined by doctor Mike Waller, the director of sustainability at Rochester Regional Health.

Doctor Jane Van Dis, co-founder of OB Gyn for a Sustainable Future, and Heidi Fritz, who is the health care director at greener by default.

Heidi, let's turn to you.

I want to talk about hospital food service because most people don't realize the enormous carbon footprint of institutional food systems, and the fact that a pretty substantial percentage of our hospital's emissions come from the cafeteria and food service.

So I'd love if you could talk a little bit about that.

What is the percentage and can you tell us more about what role food plays in a hospital's overall sustainability impact?

Absolutely.

Thank you.

Yes, I, I think it's important for people to realize that, obviously food does make up a huge amount of, all health care emissions.

I mean, it doesn't sound like a lot and a percentage, it makes up 10 to 12% of all health care emissions.

But, there's a great opportunity there to, cut emissions, more easily without a whole lot of upfront investments.

so what we do at green or by default, is that we work with institutional food service to help transition, menus, make menu changes that reduce those carbon and water footprints that meet sustainability and health goals.

I will also making it easy for, for patients to have freedom of choice.

But, we look at choosing plant based foods and putting that front and center on, on menus.

because we know that there's a huge impact, you know, one third of greenhouse gas emissions worldwide are food related.

and again, in health care, food makes up 10 to 12% of all of that.

but plant based foods are a great way to cut emissions because plant based meals have, on average, half of a, of the carbon footprint, of animal based meals.

and it really makes a difference to sustainability as well as other aspects of the quintuple aim of health care.

And New York City health and hospitals implemented plant based meals for inpatients, reducing food related carbon emissions by, I think, 36% in just one year.

What were the biggest takeaways from that initiative?

And more importantly for us here in Rochester, how replicable is it for other hospital systems?

Yeah, new York City Health and Hospitals did an amazing job, and we were able to partner with them on their initial pilot that they did a couple of years ago, to, introduce more plant based meals as the default on their menus.

So what that means is that, people are offered a plant based chef special, and, actually two different plant based chef specials.

And then if they don't want those, they're offered, other menu options, which include meat and dairy, as well.

But, basically what we found in that initial pilot was, there were about 60% of patients that were eligible for the plant based meals that decided to stick with that plant based default.

So just having that nudge as the preferred option, the first option that was listed, it's a healthy option.

It's a hearty it's full of protein, but 50% or 60% of patients, actually stuck with that default and were happy to eat a plant based meal.

so turns out, really, most people are flexitarian at heart and happy to eat plant based, when it's delicious.

But, the other, you know, the other piece of, what we found in New York City is that, they had a tremendous, cost savings potential as well.

Are you working with other cities to implement this?

How replicable is it?

Yes, we are, New York City Health and Hospitals was just one of the institutions that we worked with.

we're working with hospitals across the country as well as in Canada and the UK right now.

it's different with each hospital because every system may have a different menu style or different foods or service operation.

But, the strategies that we're using are really flexible and can apply to, any of those, types of food service operations.

So it is replicable.

we're using, some behavioral science strategies, and Influencing choice architecture, which is able to be used in any setting.

I was going to ask you, I mean, not to get too derailed here, but I wanted to know if there have been challenges in changing perceptions about plant based meals, because, you know, I'm in full disclosure, I'm a longtime vegan and I'm used to those things that people say as they're looking at you askew when you're trying to, you know, feed them some some tofu.

What have you encountered with your work?

Yeah, this is great.

I think that there's certainly challenges about changing perceptions in that, you know, really only about 10% of diners actually identify as vegetarian or vegan.

And so then people think, well, you know, if that's if that's all, why are we serving plant based foods, everyone?

So there's this fear that there's going to be some pushback.

but we're really not suggesting those menu changes.

Just be for the vegetarians and vegans.

we want to make plant based food appealing and accessible to all diners.

and what we found is that when it's framed well and when the food is delicious, you really don't see that pushback, especially because there's still choice.

There's still meat and dairy options available as well on the menu.

So that fear of pushback is one, one challenge to overcome.

I think the other one is really comfort foods.

There's often an emphasis on wanting to provide people with familiar comfort foods when they're in the hospital and they're recovering, but oftentimes that's translated on the menu to mean things that are just heavy, less healthy foods that are maybe high in fat and cholesterol.

And so we're really not doing anybody any good, with that.

and what we've found is that it's not so much those, you know, traditional standard American diet comfort foods.

It's really about the familiar flavor profiles and having culturally relevant dishes that offers comfort.

So I don't want to put you on the spot here, because I know that the focus of greener by default is that sort of plant based by default.

But I am curious if you have any insight into this in the UFC's commitment to sustainability that they send me this morning.

One of the things they mentioned was that they, focus on local food and sourcing food from nearby farms as part of their commitment to helping to address this issue.

They want to support local agriculture, which they say reduces the food supplies carbon footprint.

Can you speak a little bit about the local food and also, composting, if that's also part of what you do?

Yeah, sure.

In terms of local food, I mean, I think that's great.

It's always good to support local and sustainable food systems.

at the same time, we do know that, you know, the transport cost, for example, of food is in terms of carbon emissions is far less related to the, the amount of distance that food has to travel.

It's much more related to what that food actually is.

So, you know, there's a quite a difference in, the emissions of different types of proteins, for example, and things like beans and lentils and fruits and vegetables are much lower carbon emissions, no matter where you get them from.

And do you happen to know about whether composting is part of any hospital cafeterias commitments to sustainable?

And again, I'm probably putting you on the spot, but just, occurred to me no problem at all.

And yeah, there's certainly, you know, there's quite a bit of food waste in hospitals.

and that's for a variety of reasons.

And composting is certainly a great idea.

It's, it's not our area of expertise with green or by default, we don't specifically work on composting projects with hospitals, but we encourage them if they already have some such a program.

You know, we would certainly want to encourage them to continue that.

But ideally, I think as one of the other guests mentioned, you know, you want to go upstream and really prevent as much food waste as possible to begin with.

So you don't even get to the point of needing to compost it.

It's a really great point.

I can I can jump on the food waste thing, please, quickly, because we've done quite a few food waste audits at our hospitals and some of our other, administrative buildings.

And at least in the hospitals, the majority of the food waste actually comes from uneaten patient food.

it's it's like over 90% of the food waste.

And so a lot of hospitals do a really good job upstream trying to reduce, you know, turning that over, prepare and make too much food.

But we're required.

We are required to give food to patients and but they're not required to eat it.

And so as you as you can imagine, a lot folks in the hospital, you know, they don't feel like eating right.

and so those, you know, they'll be full trays and it's really difficult to, to capture that because you would have to have a separate, bin to put that food waste into and then bring it down to a separate, you know, separate place in the waste room.

And that logistics, that logistical effort in the hospital is pretty difficult.

So we actually do compost at some of our facilities.

and, you know, the it's it's a it's a challenge.

And so each facility is unique.

and it takes quite a bit of effort just to figure out that, that whole process.

And have you heard about greenery by default or just the idea of transforming the menus because of the the animal products and the relation to that when it comes to greenhouse gas emissions?

You know, I have not heard of greenery by default, and I'd love to connect afterwards.

but we've we've attempted, similar efforts.

And, I have to say I haven't been very successful in most locations.

but we, we have made a little bit of progress in a few, but, you know, trying to get people on board, for a lot of these different topics is, is the biggest challenge when you have an organization with over 20,000 people in it?

you know, there are there are a lot of people who are very pro environmental, everything.

and then there are a lot of people that are very anti environmental everything.

And so there's there's quite a wide gamut and depending on you know, there's, there's just a lot of politics internally to deal with.

but I would love to connect and hopefully make some progress in that space.

Oh wonderful.

Well that is Mike Waller, the director of sustainability at Rochester Regional Health.

You just heard from Heidi Fritz, health care director at greener by default.

And we're also joined today by Doctor Jane Van Dis, co-founder of OB Gyn for a sustainable future.

We're going to take a short break.

But if you're listening to environmental connections right now and and this is getting you going and you want to take part in our conversation, we'd love to hear from you.

If you're watching us on the live stream on YouTube, feel free to leave a comment there.

You can also call us at 844295825 5 or 5 852639994.

When we come back, we'll dig in a little bit more into what sustainability efforts can be done, should be done, aren't being done.

When it comes to the world of hospitals.

We'll be right back.

I'm Megan Mack.

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That's the theme of the February issue of the magazine.

We'll take your questions, your comments, and we'll talk with the team at city about what's on their radar when it comes to the wellness scene.

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Welcome back to Environmental Connections.

I'm Jasmine Singer, and if you're just joining us today, we're discussing hospital sustainability and the environmental impact of health care systems.

In the first half, we explored the major sources of carbon emissions in hospitals and ways to reduce medical waste, among many other topics.

I'm here today with Mike Waller and Doctor Jane Van Dis, and joining us remotely is Heidi Fritz from greener.

By default, let's turn to the policy side of sustainability in health care.

Doctor Waller, Rochester Regional Health has committed, as you mentioned, to, sourcing 100% of its electricity from renewable sources.

What challenges would hospitals face in making this shift?

you know, I think we're very fortunate in New York State.

We have a lot of incentives and policies that, allow to go for renewables, much more so than other states.

And so, you know, depending on where you're located, there could be a lot of, a lot of challenges just to make that financially work.

we, we so we have a lot of, policies and incentives to make something like solar work financially.

on the flip side, we also have some of the lowest rates in the country here in upstate New York, because when you when you think about how electricity flows in New York State, it pretty much just all flows downstate to New York City.

And it's all generated upstate.

And so because we're so close to the generation, we have some of the cheapest prices.

So that makes the renewable, projects more difficult to pencil.

But even even with these low prices and all the incentives that we have in New York State, it still makes financial sense.

And so but you know, other other parts in the country, it might, it might not be the case.

Doctor vendors turning to you, are there any promising policy changes or regulations on the horizon from where you sit that could help encourage hospitals to operate more sustainably?

Well, I think if you had asked this question before the previous election, the answer would be that there were a lot.

However, I think even in the last few weeks, we've seen information, about climate change and sustainability getting scrubbed from the federal websites.

So, you know, for instance, to Mike's point, I know that Nyserda, for instance, offered hospitals in New York state, to cover 75% of the salary for a hospital sustainability manager, for two years.

which is amazing, right.

so that's a huge, generous, incentive.

and so, you know, there are absolutely ways as, as Mike referred mentions, that policies can promote local, positive sustainability efforts.

you know, I think whenever we're talking about sustainability, one of the things that that Mike referenced, actually, I feel like Mike's a mike in Rochester regional is a perfect template is that two things have to happen.

Number one, you have to have champions in the C-suite.

You have to have executive, support for these types of programs.

And then secondly, you have to conduct, what he referred to as audits.

Right?

So you want to be able to measure where your emissions are coming from, because then you obviously can enact, specific, changes or policy changes or, or requirements for your purchasers so that you, you meet some goals that you set yourself.

Now, health Care without harm is the nonprofit side of, the work that I do.

But then they also have a for profit organization called Practice Green Health and practice green health helps hospitals and health care organizations across the country, perform these audits and really get down into the exact by lines and numbers in order to then create, you know, a goal for, as Mike showed, you know, 2025 or 2026, we want to reduce this waste or we want to increase the purchase of of renewables in this way.

So there are a lot of tools out there.

It's just a question really, of whether or not I think a hospital health care system wants to avail themselves of them, and whether or not they have a champion in their C-suite.

it's a really good point, Jane.

I mean, do you feel hopeful that we'll get there?

And you you are embedded in this day in and day out in what I see as a very, like, kind of in, in quite the dichotomy, because you work in the emergency room and you care deeply about these issues.

So where does that leave you and where does that leave us?

Yeah.

Well, I think on a local level, I, I recently was appointed and I'm now serving on the board of the, Genesee Finger Lakes Climate Accelerator.

And so that's a local nonprofit that helps to, join with other organizations and lobby in Albany and tell the public, I, I volunteer at the Brighton Farmer's Market as part of color Bright and Green.

I do think actually, the public can play a huge role in demanding that some of the largest employers in this area, Rochester Regional and York, start to make some of these changes.

you know, obviously working from the inside, I do everything I can, but I actually think the public can play a huge role here in, you know, asking their doctor when they go to the visit about, whether or not, you know, the metered dose inhaler that they're using has carbon emissions associated with it or not.

So I want the public to know that they actually can make a difference, too.

I love that feel emboldened.

If you're listening to this and feel emboldened to give us a call.

84429582555852639994.

If you're local or you can comment on our YouTube live stream.

Heidi turning back to you.

Food is as we were discussing, a major part of the sustainability conversation, but it's often overlooked in hospital policy discussions.

How can hospitals be encouraged to take food sustainability more seriously?

You know, one of the things that we found that's really helpful is to approach this from, doing a pilot project on a short term basis and just collecting some data, being able to, to, to show, impacts of that.

on the food sustainability in particular, you know, how do menu changes, impact the amount of carbon emissions that you have or the amount of food cost, etc., and then be able to take those results to leadership and have some great discussions about, you know, how could we implement this permanently?

What else do we need to do?

it's it's a little easier to get some buy in sometimes for a short term project.

And so I think that's one way to drive, decisions about long term policy.

Has anything surprised you?

I'd love to hear a story or two from what it's like to do the work you're doing.

Well, it's been really interesting.

We've been, working with, not only sustainability folks, but food service and nutrition folks, other dietitians.

I'm also a dietitian myself.

sometimes it's medical students and nurses that come to us and they think, you know, I really want to see more, plant based food, not just from a sustainability standpoint, but also just from a health standpoint.

and we're working with really, cross sector, cross divisional, teams to, bring this project to, health care food service.

So that's been a lot of fun.

And we there's a lot of creativity involved for the chefs and culinary fans involved.

And, and then, you know, opportunities to really showcase another area of sustainability that isn't often talked about.

Yeah.

And you started with New York City.

I mean, Mike, does that give you hope if like, you know, they were like, let's do it in New York City.

If they could do it there, don't you think we could do it in Rochester?

Just try and get a few more plant based by default when it comes to sustainability efforts.

Yeah.

I mean, you know, one of the biggest challenges that in health care we have with a lot of these issues that we try to tackle are all of the regulations that we have to to follow.

So hearing that they did in New York City, you know, we're under the same regulations for the most part.

so at least when that question comes up, you know, well, I will know the answer to that one.

Well, should sustainability efforts in health care be centralized at the hospital level, Mike, or should there be a broader governmental push to enforce green policies across the industry?

Yeah, that's a that's a that's a really good question.

I think that's that you kind of get into the philosophical debate and, and how we regulate health care organizations.

Right?

We're very heavily regulated, industry and for very good reasons.

but, you know, there's an argument to be made that we're too overly regulated that drives up cost.

And so trying to figure out the balance between that, actually, with our composting program, years ago, New York State came out with a rule that if you're a large food waste generator, you have to figure out, have it do something with it.

Besides, send it to the landfill.

and so restaurants and, schools and they originally included hospitals in that group as large generators of a food waste.

And so that's what actually drove our composting program to, to start.

And then when the law actually came to fruition and got passed, hospitals were not a part of it.

And so there's a there are a lot of industry groups that try to get hospitals to not be as regulated, as they are for lots of reasons, trying to find that balance.

I was a little bit disappointed because we had actually figured it out.

We were saving money.

it was something that was totally doable.

And then there wasn't a regulation for that particular, problem.

But, I, you know, with all that being said, it is challenging to figure out that that balance.

Well, if there were to be more regulatory oversight, it seems unlikely at this point that it would come from the federal government.

Is this an issue that the states are likely to get involved in?

I, I personally don't think so.

they not with hospitals.

I mean, at least with, some of the issues that have affected us in the past few years.

it doesn't seem that, hospitals usually get a pass on for all of the ones, the one that came out with styrofoam, which I really appreciated.

that made that was a really tough, tough thing to figure out.

but they banned styrofoam in New York State, and so it just became pretty easy to get rid of it.

And, and hospitals, we weren't exempt from that.

so hopefully, you know, I think as these regulations come out, they're not, too costly for the health care system.

So there won't be much pushback on it.

Something that I've seen is that, you know, one of the topics that I lecture both nationally and internationally on are the health effects of plastic exposure.

So not only the little pieces of plastic that are in our food and our air and our water, but also all of the endocrine disrupting chemicals contained within those plastics.

And so, for instance, I'll be going to Albany next month to talk about, PFAs, which is one of the chemicals in plastics.

And, you know, I do think that from a legislative or policy perspective, hopefully there could be a connection made between how these chemicals are impacting our health.

And that's absolutely the reason that I got into wanting to understand and study this was because I was seeing more and more of my patients sicker and sicker with hypertension, especially in pregnancy.

So I do think that if we can make a good argument to the legislators in Albany about why exposure to plastics and chemicals is deleterious to human health in New York State, then some of the types of policies that could come about, for instance, just in January 1st of this year, we saw that, PFAs, intentionally added to textiles is now illegal in New York state.

so there are little ways that we could push the industry, the health care industry, to think about the way in which they're plastic use.

Remember, health, U.S health care is the single largest purchaser of single use plastic in the United States.

So connecting the health effects of plastic to the fact that we purchased more single use plastic and we waste more single use plastic, hopefully, you know, maybe there could be a policy entry into that.

I'm seeing that more and more making the headlines, Jane.

And, you know, to me that's shifting a little bit.

Is this something because you've been touting this one for a long time.

Do you think this is shifting?

I do, I do, you know, for those listeners that might not know, I have a TikTok channel and I talk about plastics and health on my TikTok channel.

Well, what is it?

Tell our listeners?

It's it's at, it's at J van just JV and guys, and my largest video so far is a video about this study that came out of New Mexico where the researchers took the brains of decedents who had no, family members.

And he he spun the brains, and then he performed mass spectrometry on the brains and found that in some of the 60, some plus people, their brains were a half of percent plastic.

Now, a half a percent might not seem like very much, but we're not, you know, we were we did not evolve on this planet to have plastic embedded in all of our organs like it is now.

and so, you know, one of the things that happened in that video was I pointed out that, like, a lot of the plastic that's going into our bodies is coming through food packaging.

and, you know, when you look at those rotisserie chickens, under a heat lamp, the heat and the fat are actually accelerating the plastic into the food and then and then obviously into our brains as well.

And so people were up and they were up in arms about the rotisserie chicken.

but they were also up in arms about the idea that our brains are filled with plastic.

And could that be influencing our IQ or our rates of dementia?

And the and the answer is it's entirely possible, right?

Because, we have seen, IQ levels going down generation after generation and dementia rates going up so well.

Wow.

I grew up in the those fluorescent 1980s when we basically ate, you know, Nutrisystem, microwavable meals.

And.

That's right.

And I don't even know if we owned dishes because we just ate out of the plastic takeaway.

So as, as as our, medical doctor on the panel, am I going to die?

No, no, Devin.

Because actually, the more whole plant food that you eat, it actually helps your gut microbiome.

And it's thought that the the level of the gut microbiome is where your body has the potential to eliminate the plastics that you're ingesting.

so eating a whole plant based diet actually is the best thing you can do to limit the amount of plastics in your body.

Oh, so I have a question for you.

If you don't mind, please.

Years ago, there was a study that came out that that said, I think it came out of Australia that said, in Western countries we consume on average a credit card with plastic.

Yeah.

Every week.

And and when you dug into it, the majority of the plastic just came from water.

And so, you know, in Western countries, the, the wastewater treatment plants, they're not capable of cleaning out all those little microplastics from when we, like, wash our clothes, etc.. Yeah.

And so, you know, the majority that comes with comes from water.

But, shellfish and other things that we commonly consume, you know, if you microwave anything, you're getting a lot of plastic.

Yeah.

how I don't know if you saw that study I did.

How how accurate is that?

Yeah, it's interesting because I've actually seen people debate that study, and I think that right now the there needs to be a better study, because while there is evidence that there are huge amounts of plastic that we are consuming and exposed to every week, whether it's a credit card or a credit card's worth or not, I think is up for debate.

but I will say to your point, for instance, in health care, you have the opportunity to choose what types of scrubs that people throughout the hospital where, and recently our hospital chose to move to 100% polyester away from, cotton poly blend.

and so and then each of these scrubs, the top and the bottom come individually wrapped in plastic.

so here's a way in which a simple decision now will likely increase the amount of microplastics going into the waterways here in Monroe County.

but thank goodness, we have reached and the University of Rochester with that $7.3 million grant to study microplastics in our water.

but you're right, Mike.

actually, tires are actually a huge source of microplastics in the water as well.

Wow.

I thought Mike was going to say, am I going to die?

Oh, no one's going to die.

Oh, well, actually, my medical opinion is that we probably are at some point, but I'm not the doctor.

I want to talk about scale really quickly before we have to conclude some hospitals are implementing these changes.

But what would it take, Mike, to spread sustainability efforts across the entire health care sector?

Yeah, it's it's it's a challenge, right.

These are and sustainability science.

We say this these are global issues that have inherently local solutions.

Yeah.

And you know, like you mentioned earlier, finding champions to do this work is is challenging.

And, so I think, you know, having discussions like this, but also just trying to talk to as many people as we can and, and inform them, on how much power and that they actually have on these issues, whether it's just simple decisions that they make every day or if they go and talk to their manager or their coworkers or whoever it is, you know, if you get a large multitude of voices really asking and driving for these changes, they they will happen.

And so there are groups that kind of coalesce, all these, all these folks like practice green health, home health care without harm that, you know, are trying to bring all these, people together to go and do that at their respective health systems.

Heidi, turning to you, can sustainable changes be made to hospital diets that would not to increase costs, might even decrease them?

Absolutely.

And in fact, you know, if you look at some of the lower carbon protein choices, like beans and lentils and soy foods, those are far less expensive than, most animal these proteins.

And so we've seen in a lot of pilot projects, the ability to significantly reduce food costs on top of reducing emissions as well.

And I just want to say to thank you, doctor vendors, for your comment about, plant based eating and, not being helpful in terms of your overall health because I think this is really a win win when you're looking at the food that served in hospitals.

It's not just about the sustainability aspect, but, you know, we all we all need to eat more fruits, vegetables and, get more fiber in our in our diets no matter what.

And you say it's a win win because it's also, as you're saying, as Doctor Brandis is saying, one of the best choices that can be made for the planet.

That was Heidi Fritz, health care director for greener by default.

As we close really quickly, Mike, for listeners who are health care professionals or hospital administrators, what's one concrete step that they could take today to start to make their hospitals greener real quick?

I would say, again, it boils down to the age old mantra of, reduce, reuse, recycle.

So, you know, the biggest emissions generator is our supply chain in the health care system.

If you can figure out ways to reduce the amount of items that we purchase, the one of the best ways to do that is to switch to reusable items, that that hits all.

All three of those reduce, reuse, recycle.

They're also reprocessed items where a single use, but you can reprocess it, buy it back.

those are some of the the simplest concrete steps that all health care professionals can take in their, area of control.

That's Mike Waller, director of sustainability at Rochester Regional Health.

Doctor Jane van Der.

For the rest of us patients, visitors and the public, how can we help push for greener hospitals?

Well, I actually think you can have a conversation with your doctor about, what their, sustainability practices are.

in my area, obviously, I mentioned a reusable metal speculum versus the plastic one.

there are also opportunities, as Mike pointed out, to reduce waste.

they did an audit of emergency rooms, and they found that in the trash in 24 hours, there were over 200, unused items that had made their way in the trash.

So it is absolutely a culture change.

It's a culture change in the cafeteria, and it's a culture change, in the purchasing.

But it could also be a culture change in the conversation that you have with your doctor.

And that's where I think the public can really make a difference.

Doctor Waller, doctor vendors.

Heidi Fritz, thank you all so much for sharing your insights, for the incredible work you're doing for having this discussion with us.

As you said, it's not one that's hard enough, and I'm just so grateful that you're going there.

And thank you to Emily.

Eli, text Tucano and Marianne Sullivan for their help in producing today's episode.

That's it for today's episode of Environmental Connections.

I'm Jasmin Singer.

Until next time, thank you for making today's environmental connection.

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