HCWH's co-founder Gary Cohen is a recipient of the prestigious Skoll Award. This video, chronicling the evolution of HCWH's work, premiered at the 2009 Skoll World Forum. enlarge video
PVC, Health and the Environment
PVC plastic, also known as PVC, is widely used in medical devices. It can be harmful to patients, the environment and public health. As a result there is a growing move away from PVC in medical devices and other products including building materials. PVC uses toxic chemicals and causes pollution during its production, use and disposal.
Manufacturing PVC requires large amounts of chlorine. Making chlorine is very energy intensive and some factories use mercury or asbestos. The next stage is to make EDC, and then vinyl chloride, the building block of PVC. These processes generate highly toxic dioxin, one of the most persistent organic pollutants known to science. Both vinyl chloride and dioxin are proven human carcinogens.
The use phase of PVC is the one that poses the greatest direct risk to hospital patients.
In its pure form, PVC is stiff and brittle. It can only be made into consumer products by the addition of modifying chemicals, many of which are hazardous. The most common additive in PVC medical devices is a softener — or plasticizer — called DEHP. DEHP is one of a group of chemicals called phthalates, which are being increasingly restricted because of their toxic effects.
DEHP can leach out from products like IV tubing, directly into the body of the patient. Medical associations and government agencies in several countries now acknowledge that there are risks, especially to the most vulnerable patients, and advocate replacing PVC and DEHP-containing products with alternatives.
A growing number of hospitals, health systems, communities and manufacturers around the world are reducing PVC and DEHP. While these efforts are primarily taking place in Europe, the US and Japan, there are also incipient initiatives in developing countries that point to an escalating trend in the Global South.
PVC is rarely recycled, instead it usually ends up being incinerated or landfilled. Whenever waste containing chlorine is burned, dioxin is produced. In the USA in the 1990s, medical waste incinerators produced 40% of the entire country's atmospheric dioxin. Today the USA uses non-burn technology for most of its medical waste. The World Health Organisation recommends PVC medical waste not be burned and
India prohibits it.
To learn more about environmentally sound ways of disposing of medical waste, see our medical waste page. Go to our resources page for more in depth information and links to other sites.
- Aggregate Exposures to Phthalates in Humans: HCWH 2002 Report (pdf)
- DEHP Exposures During the Medical Care of Infants (pdf)
- Dioxin, PVC and Health Care (pdf)
- Health Care Institutions Moving Away from PVC/DEHP (pdf)
List compiled by Health Care Without Harm
- Neonatal Exposure to DEHP and Opportunities for Prevention (pdf)
- Pediatric Hospitals: Take the NICU No Harm survey! Find out more about PVC-Free Building Materials (pdf)
- Summary of FDA Safety Assessment on DEHP (pdf)
- Summary of the 2002 Report of the Health Canada Expert Advisory Panel on DEHP in Medical Devices (pdf)
- Use of DEHP-Containing Medical Products and Urinary Levels of MEHP in NICU Infants (pdf)
2005 Harvard study
- Weight of the Evidence on DEHP (pdf)
- Why Health Care is Moving Away from PVC (pdf)