Environment, health & safety

Guide to choosing safer products and chemicals: Implications for nurses

ANA recognizes that nurses are at the forefront of addressing chemical exposures that impact human health and reforming chemical policy to create a safer environment. ANA’s 2006 House of Delegates resolution, Nursing Practice, Chemical Exposure and Right-to-Know, states that “[ANA] endorses efforts to ensure that nurses have full access to information and the right-to-know about the potentially hazardous chemicals to which nurses, other healthcare workers, patients, and communities in general are exposed.”

Most people do not realize that they may be exposed to hundreds of chemicals daily. The Environmental Protection Agency’s (EPA) Toxic Substances Control Act (TSCA) Chemical Substance Inventory lists approximately 83,000 chemicals. Cosmetics, food additives, flavorings, cleaners, pesticides, plastics, flame retardants, pharmaceuticals, personal care products, and other items can contain chemicals injurious to the environment or human health, or both. Many chemicals are linked to cancer, reproductive issues, developmental or neurologic disorders, and other health issues.

Safety testing is sometimes done after the chemical has been introduced onto the market or not at all. In 1976, the EPA grandfathered existing chemicals in use under the TSCA. This meant that the manufacturers of the 62,000 chemicals in use in 1976 that began the TSCA Chemical Substances Inventory were not required to produce certain product safety information. It is often difficult to receive an entire list of ingredients for chemical products due to proprietary information. Manufacturers are responsible for creating their own Material Safety Data Sheets, enabling potentially harmful chemicals to escape notice by labeling them as an inert ingredient or flavoring, or by omitting them altogether, under the guise of confidential business information.

The main artery that delivers toxins into the environment is the healthcare industry, thus creating the need for the development of chemical policy for health care and miscellaneous companies, manufacturers, purchasers, suppliers, contractors, and vendors who work with health care. Inadequate laws regulating chemicals and their use, ill-defined or unknown health effects stemming from chemical exposure, and the dependency of health care on toxic chemicals for pest control, cleaning, and treatments compound this problem.

Nurses may be unaware of the dangers of the chemicals they work with and may not know that safer alternatives exist. Health Care Without Harm (HCWH), an international coalition of organizations working with the healthcare industry to reduce health care’s environmental footprint, has released the Guide to Choosing Safer Products and Chemicals (Guide) to assist with this issue. The Guide is an overview of and a blueprint for basic chemical policy to be used in healthcare facilities and systems. It emphasizes that healthcare institutions have an “ethical responsibility to use products containing chemicals that pose less risk to human health.”

The Guide defines a comprehensive chemicals policy program as aggregate actions of an institution in removing commercial chemicals that harm humans or the environment, including those that have not been evaluated for this toxicity; moving responsibility to manufacturers and suppliers to test and monitor chemicals’ safety; assuring consumers have all data needed regarding individual components of products; and determining that products be least harmful from cradle to grave. Precaution, least harmful substitution options, green product design, manufacturer responsibility, full disclosure on all product components, increased accountability, worker involvement, and consideration of whether or not the product in question is even needed are principles, per the Guide, to govern a comprehensive chemicals policy program.

The Guide is useful for nurses, as it identifies health implications from toxins that healthcare professionals are exposed to. Current standards and regulations frequently do not adequately provide enough information or protection for the worker exposed to hazardous chemicals. Nurses are encouraged to join health and safety committees in their facility. Nurses can take the lead in finding safer alternatives for toxic chemicals used in their workplace, thereby reducing occupational exposure, while assuring that the alternative is as effective as the more toxic chemical.

The Guide is an excellent tool to assist nurses to establish comprehensive chemicals policy programs in their workplaces. See the entire guide at www.noharm.org/us/chemicalpolicy/guide.

ANA is a nurse member organization of HCWH. Nurses are an integral part of HCWH. Together ANA, HCWH, and other groups can collaborate on initiatives that help nurses protect themselves and the environment.


Holly Carpenter is senior staff specialist for the Center for Occupational and Environmental Health at ANA.

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