Medical and Health Care Systems

Health care delivery in the U.S. has certainly become a "high-tech" industry sector. Whether in the dental office, the clinic, the physician's office, or the hospital, equipment is sophisticated and evolving. And some of the older equipment uses exceedingly high amounts of water, usually for cooling. Technologies designed to replace the traditional "once-through" cooling are making their way into some of this equipment.

Moreover, the health care industry sees the benefit of the "GOING GREEN" and has developed the Green Guide for Health Care, which addresses wateruse within the industry's facilities.

Here we have gathered some important documentation that relates to water use in the Medical and Health Care Systems:

Reports on Steam Sterilizer Water Savings

Steam sterilizers, a subcategory of autoclaves, are utilized in three major applications: hospitals, pharmaceutical manufacturing, and research institutions. They are used to disinfect (1) surgical instruments in hospitals and (2) instruments and apparatus used in the research and manufacture of products where sterilization is essential. The purpose of sterilization is to destroy all living microorganisms, which include spores, viruses, and bacteria, including those that cause infection or disease (pathogens). Although other types of sterilizers exist, including dry heat, ethylene oxide, and radiation, steam sterilizers are by a large margin the most widely used form of sterilization. Sterilizers present a major opportunity for water efficiency because water is used in these units when they are both in operation and when they are at idle. Three documents provide valuable information:

  1. This report documents water savings achieved with the installation of equipment (the Water-Mizer™) that eliminates the need for tempering water on Steam Sterilizers. This field study was conducted in a Denver hospital and encompassed three sterilizers, two with retrofits and one as a control. NOTE: Go to Appendix G (the last page in the report) for derivation of the savings data.
    - Sterilizer Savings Report (PDF) (8.3MB) (If file does not automatically download, right click on the link and select "Save Target As..." from the drop-down menu.)
  2. This analysis, completed in 2004, examines the Water-Mizer™ and other technologies designed to reduce water consumption in steam sterilizers. The analysis is included within the larger Year One study report on California Potential Best Management Practices (PBMPs) and, as such, presents an assessment of the total water savings potential of statewide retrofit of existing water-wasting sterilizers. (Readers may, at their option, extrapolate the water savings potential data for California to their own geographic area of interest through use of a population metric.)
    - PBMP-Year One-Chapter VI-Sterilizer Savings Assessment
  3. A study of water savings on sterilizer retrofits was performed for the University of Washington by John Leaden of the UW and Roger Van Gelder, consultant to Seattle Public Utilities. For further information, Roger can be reached at:

Reports on X-Ray Film Process Retrofit Water Savings

Large-scale X-ray film processing (developing) with current technologies uses large amounts of water to rinse chemicals from the film and to cool the processing equipment. X-ray film processing in medical applications represents a significant opportunity for new technologies to reduce or eliminate water use. One of those technologies is the application of water recycling to the process equipment. However, the use of film processors in the medical sector is gradually declining, as new digital imaging technology for radiography becomes cost-effective and gains presence in the market. Digital technology will eventually provide better images at lower cost than X-ray films. In the meanwhile, there is one piece of equipment that can yield significant water savings when applied to the typical film processor.

Green Building for the Health Care Industry

Sponsored by the Hospitals for a Healthy Environment (H2E), the Green Guide for Health Care (GGHC) offers a first (but very small) avenue into water use efficiency for health care facilities. Unfortunately, the GGHC (which uses the LEED formula for much of its construction) is almost a carbon copy of LEED criteria, in which water use efficiency is almost totally absent. (Of course, this is to be expected when no recognized water efficiency professional sits on the GGHC Steering Committee. Maybe its time for water efficiency practitioners to become involved and contribute!)

Check out the GGHC website and Version 2.1 of the GGHC Practices Guide:
- GGHC Guidelines-Version 2.1

Retrofit of 15 Skilled Nursing Facilities

In the late 1990s, the Upper San Gabriel Valley Water District retrofitted and replaced plumbing fixtures in 15 different skilled nursing facilities in their service area. This summary provides data on water savings achieved:
- Skilled Nursing Facility Retrofit Program.pdf

Other Information on Water Use Efficiency

View this presentation by H2O Applied Technologies on the topic of water efficiency in hospitals:
- H2O Technologies-Hospital Water Efficiency

View this presentation by Leann Gustafson of East Bay Municipal Utility District on water efficiency in hospitals:
- Water Efficiency in Hospitals-EBMUD