Promoting Environmental Health at Magee-Womens Hospital of UPMC

by Leslie Davis, President, Magee-Womens Hospital of UPMC; Vice President, Women's Services, UPMC

Each year, more than 10,000 babies are born in Magee-Womens Hospital of UPMC. Ranked among the top 12 hospitals in the nation for gynecological care, Magee-Womens Hospital of UPMC is a National Center of Excellence in Women's Health, one of the first recognized by the U.S. Department of Health and Human Services. As a world-class center for both women's health and comprehensive medical-surgical care, our goal is to ensure that parents and health professionals have access to the best information and resources to enable them to make good decisions about their health and the environment in which they live.

As a major hospital in Pennsylvania, Magee has a long history of providing excellent care for women and childbearing families. Increasingly aware of a growing body of evidence that environmental stressors affect the health of children and their parents, the staff at Magee-Womens Hospital has partnered with the Heinz Endowments and the Center for Environmental Oncology (CEO) to learn more about how to prevent environmentally related diseases. The science is alarming. A report by The Centers for Disease Control and Prevention (CDC) found heavy metals such as mercury and lead and a wide variety of plasticizers, flame retardants, and other toxic substances in both the breast milk of mothers and the umbilical cord blood of infants. Parents often have levels of toxic agents measured by the CDC that are much lower than those found in infants and children, who are particularly vulnerable to these substances.

Working under a grant from the Heinz Endowments, our staff began to look at ways to reduce exposures to toxic chemicals and other environmental risks. A multidisciplinary team was formed within the hospital and a two-fold plan was developed: 1.) the hospital itself would serve as a model of sustainable, green principles to promote efficiency and reduce its own use of toxic materials suspected of increasing health problems and 2.) environmental health education would be created for administrators, staff members and patients to improve public understanding on how to increase efficiency and reduce reliance on suspected toxic materials.

In 2006, Magee staff members attended the CleanMed Conference in Seattle, the premier conference for the "greening" of healthcare that serves as a national forum for state of the art practices in improving environmental operations of health care facilities. This year's CleanMed conference will be hosted in Pittsburgh on May 20–22 and will provide healthcare leaders with information on environmentally preferable health care products, waste reduction strategies and methods to retrofit and design "green" health care facilities and operations.

One of the first initiatives at Magee involved the removal of the toxic plastics, polyvinyl chloride (PVC) and diethylhexylphthalate (DEHP), from the neonatal intensive care unit. Low levels of these chemicals, which are found typically in plastic tubing, have been shown to disrupt hormones and create developmental problems particularly for baby boys. The nurses in the neonatal intensive care unit (NICU) found vendors who could provide plastic tubing that was free of these harmful substances, and we made the switch. Mercury, a chemical that can cause neurological problems in children, was removed from the hospital entirely. The vaccines that are given to our newborns to prevent previously lethal childhood illnesses like typhoid fever have been mercury free for the last 4 years.

Throughout the childbearing year, all families at Magee receive education on environmental stressors, their links to illness and how to avoid them. This education is tied to the prenatal calendar, baby care classes, and postpartum discharge instructions.

In 2007, Magee-Womens Hospital of UPMC in collaboration with the Heinz Endowments, convened and sponsored the Teresa Heinz Women's Environmental Health Conference in Pittsburgh. This event attracted and inspired 2,000 participants. Environmental experts who spoke at the conference ranged from biologist Dr. Sandra Steingraber to pesticide researcher Dr. Tyrone Hayes to CEO-UPCI Director, Dr. Devra Davis. All participants received a "toolkit" containing resources to help women learn how health and the environment are connected and about ways to protect their families and communities.

As Magee enters its third year of environmental stewardship and education, we are developing an exciting roster of activities. In partnership with the CEO-UPCI, Magee will be reaching out to the larger community to provide environmental health education programs, such as continuing medical education (CME) Lunch and Learns for health professionals and an environmental movie series. In addition, Magee will take the lead throughout the UPMC system to provide guidance and resources as each hospital develops its own community-based environmental education for the populations they serve. Educators at Magee will collaborate with a team of environmental health experts, including Physicians for Social Responsibility, to develop a Toolkit for Obstetricians. The Toolkit will serve as a teaching and clinical tool for reproductive health providers and will also provide educational tools for patients with the goal of preventing prenatal exposures to environmental stressors.

We are pleased to participate in this year's CleanMed 2008 (See sidebar), where UPMC is providing a number of expert speakers for the conference. Once again, we will be sharing "science and solutions" with other health care and environmental leaders to further our mission of providing the best possible care to women, their families and our most vulnerable and precious patients—the babies born each year at Magee-Womens Hospital of UPMC.