Sustainable Health IT: A Plan for Healthcare-Generated e-Waste?

As American and world health care systems move towards increased reliance on health information technology, there’s a corresponding need arising for responsible, sustainable and safe methods of managing the growing tide of e-waste that inevitably follows. Paying attention to the twilight period of IT’s life cycle also provide opportunities for innovation. While Global 1000 companies such as GE churn out high value, yet toxin-rich hardware, innovators such as Redemtech find responsible ways of recycling such equipment.

A new paper in the online journal Environmental Health Perspectives, meanwhile, spells out the growing health concerns from e-waste, specifically around the potent neurotoxicants often associated.

The primary producers of e-waste are the US and China (each produce around 2.5 million tons per year), the EU (9 million tons). While high tech recycling plants produce little environmental or associated human dangers, large scale primitive recycling practices release vast amounts of toxins. Such recycling occurs primarily in China, India, Nigeria and Vietnam, with smaller operations in Morroco, Senegal, Peru, South Africa and Uganda. This produces a noxious flow of neurotixns from the developed to less developed world, with the possible exception of China who are both large producers of waste, and large contaminators through unsustainable recycling practices.

Menu of Menace

The primary pollutants of concerns released from e-waste include the following:

Lead from monitors and old circuit boards is a potent, well studied neurotoxin. Children aged 1-6 who live in communities engaging in primitive e-waste recycling have blood lead levels 50% higher on average than neighboring communities. Poisoned children face a number of developmental challenges.

Mercury is found in tiny amounts in monitors, circuit boards, cell phone and various types of lamp bulbs. But when combined in mass recycling sites, the amounts released can reach troublesome levels. Inorganic mercury is transformed into organic mercury, which then accumulates in the food chain, with fish being the primary source of exposure in humans. While mercury toxicity has developmental effects in children, little research has looked at the effects of e-waste on children’s blood levels.

Cadmium from batteries and chips results in substantially increased exposure among children living nearby, though the precise health effects are not known. Numerous studies have linked higher cadmium levels to increased neurological deficits in children.

Hexavalent hromium is a metal coating used to prevent corrosion in many components. While a known human carcinogen, effects on children from environmental exposure is unclear.

A veritable salad of other chemicals including PBDE flame retardants, PCBs and polycyclic aromatic hydrocarbons round out the rogues lists. Some of these are the result not only of the components being recycled, but also the process: Using heat that creates toxic smoke, for example.

Challenges of e-Waste

In addition to the large amounts, and currently dubious business model for competitively addressing the problem, several other challenges exist. These include the fact that e-waste enters the waste stream as a completely mixed source of toxicants that varies in toxicity, may contaminate for long periods of time and through multiple media: air pollution, water contamination and the food stream, for example. Further conflating the challenge: A general lack of scholarship regarding the true extent of the hazard, how much harm it is causing and how best to mitigate that harm.

First Do No Harm

Will the irony that health information technology meant to save lives in the developed world might end up poisoning children elsewhere compel resourceful social innovators to develop large scale sustainability efforts to manage health care related e-waste?

Should health IT plans on the organizational, as well as state and national level also be tied to sustainable management practices over the complete lifecycle of the technologies?

Should “meaningful use” also be linked to “responsible reuse & recycling?”