Intended for healthcare professionals


Talking trash

BMJ 2016; 355 doi: (Published 17 November 2016) Cite this as: BMJ 2016;355:i5996
  1. Courtland K Keteyian, medical director1,
  2. Marschall S Runge, vice president for medical affairs2,
  3. Sudhakar G Reddy, coordinator3,
  4. Brahmajee K Nallamothu, professor4
  1. 1Prevention and Community Health and Jackson Health Network, Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201, USA
  2. 2University of Michigan Health System, Ann Arbor, MI, USA
  3. 3Office of Campus Sustainability, University of Michigan, Ann Arbor, USA
  4. 4Center for Health Analytics and Medical Prediction (M-CHAMP), Department of Internal Medicine, University of Michigan, Ann Arbor, USA
  1. Correspondence to: C K Keteyian courtland.keteyian{at}

Five steps to a greener future for healthcare organisations

The health of the environment is critical to the health of populations. Healthcare, however, is not known for environmental sustainability. In addition to concerns about energy and fresh water consumption, landfill waste poses a particular challenge. Hospitals in the US produce over 13 kg of waste every day for each staffed bed.1 The UK NHS generates 1% of all domestic waste in the UK2 and discards over 63 000 metric tons of waste each year.3 Landfill waste adversely affects human health4 5 and accelerates climate change by releasing greenhouse gases, including methane and carbon dioxide, during decomposition.6 Despite their critical role in managing healthcare resources, clinicians are rarely engaged or poorly trained in efforts to minimise hospital waste.

The prevailing view that most hospital waste needs special handling is incorrect. All hospital waste falls into one of several categories—hazardous items including cleaning agents and chemotherapeutics; regulated medical waste, which is …

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