CONCORD — Dartmouth-Hitchcock Medical Center, which discards eight tons of trash a day, is working with hospitals across the country to reduce the environmental impact of operating rooms.

The Lebanon hospital recently joined the Greening the Operating Room Initiative being organized by Practice Greenhealth, a networking organization for health care institutions.

The goal is to collect data on how hospitals are saving money while reducing waste, energy and workers' exposure to hazardous chemicals.

Practice Greenhealth estimates that operating rooms produce 20 to 30 percent of a hospital's waste.

John Leigh, manager of waste and recycling programs at Dartmouth-Hitchcock, didn't have an exact figure for his hospital, but said operating room waste makes up a significant portion of the roughly eight tons of trash the hospital generates each day.

The challenge is finding ways to reduce waste while protecting patients, he said.

"Infection prevention and patient safety are always going to trump other considerations," Leigh said.

Joining the national initiative will allow Dartmouth-Hitchcock to quickly learn what other hospitals are doing to tackle the problem as well as share what it has done to "go green," including reprocessing single-use devices, recycling medical plastics and installing LED lighting.

As medical supplies and equipment get more complex, the materials they're made of get harder to recycle, he said, and much of it is designed to be used only once.

The hospital has focused on doing a more thorough job of segregating medical waste — which is more costly to dispose of properly — from ordinary trash and has invested in reusable cases for sterilizing equipment rather than disposable wrapping material.

The wrapping material itself can be recycled, but the hospital doesn't generate enough of it on its own to make selling it economically feasible, he said.

Another major challenge has been dealing with infectious waste such as bloody gauze. The hospital has a process to sterilize such waste so it can be put in a landfill, but also has a new system that Leigh described as a large cylinder on wheels with a suction that could be rolled up to an operating table.

Blood or other fluids could then be suctioned directly into the cylinder and then transferred to a wastewater treatment system.

As part of the new initiative, Leigh said he hopes to reach other players such as physicians and medical equipment suppliers to get them on board.

"Folks like me and a handful of the nursing corps being into this is not going to be adequate for more of the long term and fundamental change we're looking for, especially up the supply chain," he said.

"Many of the things I've been talking about are what we consider downstream activities. It's the upstream stuff that's really going to have much more bang for the buck environmentally."

The national initiative was announced last spring.

As new hospitals join, they will begin sharing information and putting together a set of best practices.

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