Chemicals resources

A non-toxic health sector to ensure a safe and healthy planet for all: Health Care Without Harm supports the Global Framework on Chemicals, the successor agreement to the Strategic Approach to International Chemicals Management, and promotes the role that the health sector plays in safe chemicals management and the reduction of chemical hazards. Read our our submission supporting the new framework.

• Chemicals of concern to health and environment: This document combines a list of 200 chemicals from various authoritative lists and environmental conventions that are carcinogenic, toxic, mutagenic, and reproductive hazards. [English] [Spanish]
• Chemicals of concern for the health sector: Based on the report Chemicals of Concern to Health and Environment, it includes the list of chemicals used by the health care sector and/or included in health products. In addition, it includes case examples that demonstrate how hospitals have successfully substituted chemicals and chemicals in products with more sustainable alternatives. [English] [Spanish]
• Guide for the substitution of hazardous chemicals in health care (in Spanish): This guide provides tools and resources to implement a 6-step plan for the replacement of hazardous chemicals used in health care, as well as for the safe management of those chemicals that cannot yet be replaced.
• Priority Chemicals of Concern Reference: From antimicrobials to phthalates, and everything in between, learn which toxic chemicals are priorities to avoid, why they are dangerous, and alternative products and solutions.
• Safer Chemicals Guidance Document: Guidance includes a brief overview of each priority area in the health sector, along with a set of tools to reduce the use of hazardous chemicals and materials and improve the health and safety of patients, workers, visitors, and the community.

• Quick guide - Reducing PVC and DEHP in IV bags: Criteria, recommendations, and alternatives to PVC/DEHP products for IV bags, as well as links to case studies and references. [English] [Spanish]
• Quick guide - Reducing PVC and DEHP in medical products: Criteria, recommendations, and alternatives to PVC/DEHP in medical products, as well as links to case studies and references. [English] [Spanish]
• Guidelines for the procurement of safer medical devices: Resources for eliminating PVC/DEHP from medical devices
• Report on polyvinyl chloride (PVC) in health care: Summary of recent research about the human and environmental impacts of PVC from production to end-of-life, and provides a rationale for choosing alternatives.
• PVC/DEHP elimination goal: Elimination goal for safer medical products and devices

• Procurement criteria and safer alternatives for products used for routine hand hygiene [English] [Spanish] [Portuguese]

• Instrument disinfection: Evaluation of procedures, procurement criteria, and benefits of products used for safer high-level disinfection of instruments [English] [Spanish] [Portuguese]
• Surface disinfection: Procurement criteria for chemicals used to disinfect surfaces [English] [Spanish] [Portuguese]

• Disinfection tunnels factsheet: A document on the use of disinfection tunnels and disinfectant spraying of the general population. [English] [Spanish] [Portuguese]
• Antimicrobials in hospital furnishings - Do they help combat COVID-19?: No current high-quality evidence indicates that adding antimicrobial agents to the surfaces of products adds significant value beyond the array of the CDC's recommended procedures for preventing SARSCoV-2 transmission or health care-associated infections.

• Sustainable Procurement Index for Health (SPIH): This tool was jointly developed by Health Care Without Harm and the United Nations Development Program (UNDP) to help policy makers, manufacturers, suppliers, procurers, and health care facilities monitor greenhouse gas emissions, resource depletion, and toxic impacts from chemicals on human and environmental health, and human rights, labor rights and gender equality. 
• Sustainable procurement digest: A central resource for environmental criteria for health care goods (medical and non-medical) and services
• Sustainable procurement directory: Lists more than 120 sustainable products and services for health care organizations to consider and summarizes environmental criteria

• Lessons in Forging Global Change (2014): Article by Josh Karliner, Gary Cohen, and Peter Orris and published in Stanford Social  Innovation Review.A campaign to eliminate mercury thermometers and blood pressure devices that began 15 years ago at one Boston hospital blossomed into a worldwide movement that helped lead to an international treaty restricting the use of mercury. In this article three leaders of that movement discuss the campaign and the lessons they learned about how to create large-scale social change.
• Health Care Without Harm’s views on the Global Mercury Treaty: The treaty’s structures on coal-fired power plants and artisanal and small-scale gold mining (ASGM) —the two largest sources of mercury emissions—are relatively weak, creating a situation where overall global mercury pollution may continue to climb despite the global agreement.
• Cleanup, storage, and transport of mercury waste from healthcare facilities (2015):  The UNDP GEF project involved demonstrating best practices for the management of mercury waste and promoting mercury-free devices. As health facilities phase out mercury devices, proper methods of storage and transport are needed. This document is intended for project countries where national norms and guidelines for cleanup, storage, and transport of mercury waste do not exist at this time.

To scale up the replacement of mercury-based medical devices around the world, Health Care Without Harm has put together a guide that systematizes the basic steps in mercury substitution. Available in English, Chinese, Spanish and Portuguese.

• Compendium of resources curated by Health Care Without Harm Southeast Asia: This page brings together general information on the issue, model policies, and mercury-free alternatives for the health care sector.
• Developing national strategies for phasing out mercury-containing thermometers and sphygmomanometer in health care, including in the context of the Minamata Convention on Mercury: Exposure to elemental mercury in health care settings from spills or broken equipment, such as mercury-containing fever thermometers and sphygmomanometers (blood pressure devices), is a serious health problem for employees, patients and visitors as well as those tasked with repairing and cleaning up such broken equipment. It is also a problem that is entirely preventable through the careful choice and use of mercury-free alternatives. Many hospitals and health facilities, including those participating in WHO and Health Care Without Harm collaborative efforts to promote mercury-free health care, have already successfully switched to mercury-free thermometers and sphygmomanometers. A number of governments representing low-, middle- and high-income countries have also instituted policies for phasing out such devices in favour of accurate and affordable alternatives.

A two-year progress report: 2010 progress report on the global mercury-free health care initiative, this guide contains multiple examples of mercury-free healthcare from around the world. 

Health Care Without Harm has released a video meant to be part of training program for hospitals around the world aiming to eliminate mercury and safely manage and store mercury waste while governments search for a more permanent solution. The video is based on the UNDP-GEF Global Healthcare Waste Project mercury waste management guidelines and was produced with support from UNEP and the government of Norway.