October 2017

Announcing CleanMed Europe 2018
HCWH Europe and Radboud university medical center are delighted to announce that CleanMed Europe 2018 will be held in Nijmegen, Netherlands from 10th–12th October 2018. We invite you to mark your calendars and save the date - for more information and to sign up for updates, please visit
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Safer Chemicals
Climate & Energy
Sustainable Food
Member Update
Other News
Safer Chemicals

HCWH Europe welcomes the European Parliament rejection of flawed EDC criteria 

On the 4th of October the European Parliament rejected the flawed criteria proposed by the European Commission on the definition of Endocrine Disrupting Chemicals (EDCs).

The European Commission was under a legal obligation to present such criteria on account of Article 5 (3) of the Biocidal Products Regulation (528/2012), and Article 80 (7) of the Pesticides Regulation (1107/2009). However, the text proposed by the European Commission – which was long overdue – is regarded by the majority of scientific experts (including the Endocrine Society) and most civil society organisations as totally inadequate.

The proposed criteria were not fit for purpose and would fail to identify EDCs that are currently causing harm. As they stand, the criteria will neither provide an adequate level of protection for the environment or for human health. HCWH Europe therefore welcomes the European Parliament’s resolution.

Today’s result is a victory for human and environmental health in the EU, which was threatened by the definition for EDCs proposed by the European Commission. With their vote, MEPs have today recognised that these criteria are deeply flawed - EDC criteria should stand up to scrutiny and comply with the precautionary principle – a fundamental principle of EU governing policies related to the environment, and health and food safety

- Philippe Vandendaele (Chemicals Policy Advisor, HCWH Europe) 

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Workshop | Can the Medical Devices Regulation be an engine for for substitution?

On the 6th of November HCWH Europe will be organising a workshop entitled Can the Medical Devices Regulation be an engine for substitution? kindly hosted by MEP Michèle Rivasi (Greens) in the European Parliament.

The main objective of this workshop is to look at how provisions included in the Medical Devices Regulation can be used to achieve the substitution of medical devices containing harmful chemicals with safer alternatives  - the agenda is available here.

Click here to register

The 7th Environment Action Program (7th EAP, which guides EU environmental policy until 2020) states that: “The Union will further develop and implement approaches to address combination effects of chemicals and safety concerns related to endocrine disruptors in all relevant Union legislation. In particular, the Union will develop harmonised hazard-based criteria for the identification of endocrine disruptors. The Union will also set out a comprehensive approach to minimising exposure to hazardous substances, including chemicals in products”. (OJEU: L 354/187)

HCWH Europe’s objective in engaging in the policy process is to help phase out endocrine disrupting chemicals (EDCs) and chemicals which are carcinogenic mutagenic or Reprotoxic (CMRs) - particularly phthalates - in medical devices if safer alternatives are available and technically feasible.

Annex I.II.10.4.1 of the Medical Devices Regulation is an open invitation to prioritise medical devices that are benign by design, i.e. devices that are eco-designed. Therefore, HCWH Europe seeks to ensure that Annex I.II.10.4.1 is properly and consistently implemented.

To address this during our workshop, we have invited a range of relevant stakeholders asking them whether they are fully aware of the potential of the provisions included in the Medical Devices Regulation and how they are going to avail of them...

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Climate & Energy

HCWH Europe releases position paper on the Energy Efficiency Directive


In 2012, according to the World Health Organization (WHO), 7 million deaths were related to indoor and outdoor air pollution, representing one eight of global deaths. Air pollution is the single largest environmental threat to human health, and energy production and energy use account for the majority of air pollution caused by human activity.

Reducing energy use lowers reliance on burning coal and other methods of generating electricity through fossil fuel combustion, thus reducing harmful emissions. Reducing these emissions directly benefits human health as fossil fuel emissions directly contribute to the burden of diseases such as cancers, strokes, respiratory diseases, and heart disease.

HCWH Europe has released its position paper on The Energy Effiiciency Directive, which includes recommendations for policy makers on how to combat this health threat and help the healthcare sector reduce the effects of its energy intensive activities whilst also improving energy efficiency. 

Whilst the Energy Efficiency Directive (EED) is only one of many legislative instruments that will determine whether the EU will meet its Paris Agreement commitments, it does, however, have significant impact upon all other EU climate and energy files. 

To accelerate the transition to a low carbon economy and therefore meet the Paris Agreement’s objective to achieve zero global emissions in the second half of the 21st century, the EU will have to significantly reduce the amount of energy consumed in every country.

In this position paper HCWH Europe supports the position of Climate Action Network (CAN) Europe, in particular its recommendations for amendments to the revision of the EED. The EC’s proposal to increase the targets of the EED is not ambitious enough nor is it compatible with the EU’s commitments under the Paris Agreement.

HCWH Europe calls on the European Parliament and Council of the EU to support these recommendations, and not to underestimate the importance that energy efficiency measures will have on the success of all the other climate and energy policies and legislative proposals. An ambitious legislative framework is necessary to guide the health sector to significantly improve the efficiency of its energy intensive activities. This will help to reduce the sector’s contribution to air pollution and, in doing so, protect the health of EU citizens and the environment.

Read the position paper here, and learn more about antimicrobial resistance in HCWH Europe's Climate & Energy resources section.

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Last chance to register for HCWH's Climate and Health Roundtable

Registration is still open for HCWH's Climate and Health roundtable: registration for this event - for hospitals and health systems only - has been extended until the 3rd of NovemberAcross two days in Bonn we will discuss how to enhance healthcare’s role as a climate leader, including how to measure and monitor healthcare's carbon footprint; please find the agenda here.

Register now
Whether you're able to attend or not, HCWH Europe invites hospitals and health systems to endorse the ‘Health Care Call to Action on Climate Change' which is being signed by healthcare leaders from all over the world whose organisations are committed to taking action to reduce their carbon footprint, build greater health system resiliency, and generate leadership from the health sector in protecting public and planetary health from climate change.

So far 66 hospitals and health systems from 25 countries representing over 7,000 hospitals and health centres, have endorsed this call - join us as we aim to forge a powerful, collective voice advocating for climate-smart healthcare.
Endorse the call to action

The 2017 Climate and Health Summit

The 2017 Climate and Health Summit will take place on Saturday the 11th of November, alongside the 23rd UNFCCC Conference of Parties (COP23) in Bonn, Germany.

The summit will focus - from a health perspective - on actions within cities and regions that will advance implementation of national targets under the Paris Agreement, as well as actions that help build momentum towards increasingly ambitious climate commitments.

The 2017 Climate and Health Summit will be an opportunity to promote investment in communities and health systems and to increase the global capacity to respond to climate change by increasing awareness of sustainable development in the context of climate change and health, and strengthening collaboration between health organisations and with other sectors.

This summit is hosted by the Global Climate and Health Alliance (GCHA) in collaboration with the WHO Regional Office for Europe and its European Center for Environment and Health in Bonn, Germany, and with the Health and Environment Alliance (HEAL). 

Health Care Without Harm is one of the Summit’s Partner Organisations, alongside:

With an extensive programme delivered by a variety of speakers from the WHO, and regional and city authorities across the world, this summit will feature dynamic plenary presentations to engage, influence, and encourage commitment to climate action.

Learn, discuss, and exchange new ideas on increasing climate ambition and implementing climate and health actions - join us in Bonn for The 2017 Climate and Health Summit.

Register now


HCWH Europe releases update to antimicrobial resistance position paper

Each year, antimicrobial-resistant infections cause 25,000 deaths in the European Union alone, generating annual costs of at least €1.5 billion, and a total of 700,000 deaths worldwide. Antimicrobial resistance (AMR) develops when microorganisms become resistant to the antimicrobial drugs used to treat them - this leads to treatments becoming ineffective, infections persisting, and an increased risk of infections spreading.
Today HCWH Europe has released an update to its position paper on AMR, which includes recommendations for policy makers on how to combat this health threat.
AMR is primarily caused by inappropriate use and overuse of antibiotics in humans and animals. Increasingly, however, evidence shows that pharmaceutical waste from excretion and disposal (including effluent from the pharmaceutical manufacturing process) is also a concern in the development of resistance. AMR currently poses one of the greatest threats to global public health, an important focus for stakeholders worldwide should be on finding strategies to improve production standards and minimise the release of antimicrobials into the environment throughout their life cycle (i.e. in their production, use, and disposal).

Within this updated position paper, HCWH Europe provides recommendations and urges the European Commission to work with international governments and regulators to establish evidence-based targets for maximum levels of antimicrobial API (Active Pharmaceutical Ingredient) discharge associated with the manufacture of pharmaceuticals. These targets should be enforced at an international level, regardless of products’ origins. The goal should be to manage the pharmaceutical waste stream and control API discharge associated with the manufacture of pharmaceutical products.

Read the position paper here, and learn more about antimicrobial resistance in HCWH Europe's AMR resources section.
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Study reveals worrying genetic effects of environmental exposure to pharmaceuticals

For some time now it has been known that medicines enter into the environment through human excretion via wastewater, animal excretion via runoff from agricultural areas, and discharges from aqua culture. Current wastewater treatment plants are unable to completely destroy or remove pharmaceuticals which means they can ultimately end up in surface water, drinking water, soil, and agricultural crops. As a result, humans and animals are constantly exposed to a cocktail of low concentrations of medication at all stages of development.

Recently, a U.S. research group has found that cell cultures exposed to low levels of psychopharmaceuticals (carbamazepine, fluoxetine, and venlafaxine) may alter autism-associated synaptic proteins. The lowest studied effect concentration of carbamazepine and the highest concentration of this drug found in Dutch drinking water are not far apart.

Imported food grown on soil treated with contaminated water and sewage sludge can also lead to exposure to these psychopharmaceuticals and other medicines, moreover, carbamazepine can accumulate in various organs, including the brain.

Because humans and animals share a large number of genes, comparative research into external influences on our genes in animals is useful. The Thomas research group observed that a cocktail of these three psychopharmaceuticals in the brain of young fish activates genes related to autism, Parkinson’s, and multiple sclerosis.

We still do not know what the impact of low dose exposure over a prolonged period is; it would therefore be prudent to apply the precautionary principle and minimise use of drugs where possible, reduce pharmaceutical pollution throughout the life cycle of medicines, and conduct further research, as called for in HCWH Europe’s Safer Pharma campaign...

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Sustainable Food

Online Community of Experts helps tackle food waste in Europe

A new digital network has been launched to encourage collaboration and bring together expertise from across Europe and beyond in a focussed response to the global issue of food waste. The Community of Experts (CoE) aims to help drive action at every level of the supply chain by empowering individuals, organisations and nations through the sharing of skills, knowledge and resources needed to act against food waste.

Find out more at:

Developed by the EU REFRESH Project in cooperation with the European Commission’s EU Platform on Food Losses and Food Waste (FLW), the new Community of Experts will help users share and access information and ideas to develop and deliver their own initiatives, wherever they are based.

With 120 experts and 80 resources online, the collaboration between REFRESH and members of the EU Platform on FLW has already proven to be a powerful convening force, bringing together authorities from many disciplines, and from the whole value chain. 

Commissioner Vytenis AndriukaitisEuropean Commissioner for Health and Food Safety said, “On this important day dedicated to celebrating food, I am pleased to announce that we have a new ally in the battle against food waste: the REFRESH Community of Experts.

Fighting food waste requires concrete action and innovation by all key players in the food value chain. This battle has to be underpinned by knowledge and research and facilitated by an appropriate policy environment. It is great to see the EU Platform on Food Losses and Food Waste join forces with REFRESH in establishing a new tool making expert advice, new resources and best practice in food waste prevention only a few clicks away!

Join the REFRESH Community today and help us all find solutions to prevent food waste and together ensure our speedy progress towards the Sustainable Development Goal 12.3 target of halving food waste by 2030.”


Sharing expertise from across the EU

The strength of the Community of Experts lies in its instructive role to inspire action by sharing examples that have proven successful in reducing food loss and waste. These will allow users to adopt, adapt and replicate best practice actions to suit their own programmes, and their own societal, cultural and economic situations. 

The Community of Experts has the support of REFRESH and its 26 research partners from 13 countries who bring a wealth of experience on the subject. The EU Platform on FLW brings together Member States, EU bodies, international organisations, and actors in the food value chain including consumer- and other non-governmental organisations, all committed to taking action to prevent food losses and waste...

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NGOs write to ENVI committee that waste should not be a renewable energy source

Health Care Without Harm Europe has co-signed a letter to the Environment, Public Health, and Food Safety (ENVI) Committee of the European Parliament calling for the exclusion of the biodegradable fraction of municipal waste as a source of renewable energy.

On 30th November 2016, the European Commission published a proposal for a revised Renewable Energy Directive that establishes a common framework for the promotion of energy from renewable sources. HCWH Europe is concerned about the proposal’s inclusion of “waste” as a source of renewable energy. With this criteria, Member States would be able to use different kinds of energy generation from waste including: landfill gas, incineration and other thermal treatments, as well as anaerobic digestion, to meet targets under this Directive. Some of these measures are inconsistent with EU waste policies under the Circular Economy Package, and inconsistent with the EU climate agenda. 

Zero Waste Europe provides recommendations on ways to improve the Renewable Energy proposal - you can read more about this issue on their website.

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Member Update

Environmental medicine - A first at Complutense University of Madrid

This month, Universidad Complutense de Madrid (UCM), in collaboration with HCWH Europe member Fundación Alborada, offered an optional course on environmental medicine for the first time to medical students. 

UCM is one of Spain’s largest universities with the highest number of students and is considered (by some rankings) the best national university for quality of studies and research. The course,“Change your behaviour or move to another planet” had an excellent response with 80 students signing up - mostly medical students - but also those from degree courses on Nursing, Human Nutrition, and Dietetics.

Topics covered in the session included:

  • Environmental pollutants and alternatives
  • Chronic exposure to low doses of chemicals
  • New environmental diseases
  • The role of civil society
  • The perspective of patients and doctors

Dr. Adela Pelayo - Director of the Department of Pathological Anatomy at UCM - is the coordinator of this course, alongside Dr. Pilar Muñoz-Calero - an expert in Environmental Medicine in Spain. During the course, clinical cases of patients suffering from consequences of exposure to harmful chemicals were presented and valued highly by students, who showed surprise at the relationship between some diseases and the environment, previously unknown to them.

Students also learned from other specialists such as Dr. Ceferino Maestu - Director of the Bioelectromagnetism Laboratory at the Universidad Politécnica de Madrid’s Biomedical Technology Center, and Mrs. Ruth Echeverría – Lead Biophysicist of the Endocrine Disruptors project at Fundación Alborada...

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Other News

New Lancet report reveals pollution causes nine million deaths per year worldwide


According to a ground-breaking new report in the leading medical journal The Lancet, pollution in the air, water, soil, and the workplace is linked to an estimated nine million deaths each year worldwide equivalent to one in six (16%) of all deaths. This death toll is three times more than the number of AIDS, tuberculosis, and malaria-related deaths combined, and 15 times greater than fatalities of wars and all other forms of violence. [Source: NPR] 

In the EU alone, pollution causes more than 400,000 deaths - representing 7.8% of all deaths. Most of these deaths are due to non-communicable diseases caused by pollution such as heart disease, stroke, lung cancer, and chronic obstructive pulmonary disease (COPD). In the European Union (as in other industrialised regions), air pollution is the most harmful source of pollution, responsible for more than 280,000 deaths.1

The Lancet report on Pollution and Health is the first to analyse all forms of pollution (air, water, soil, occupational) and its impact on human health, the economy, and society.

The European Union is at the forefront of tackling pollution both within its borders and globally. In addition to specific laws such as the REACH chemicals law or air quality standards, the EU’s Environmental Action Programme (EAP) has been an important driver for pollution control action. With its emphasis on tackling environmental threats to health, the 7th EAP includes important pollution control goals.

The Lancet Commission on Pollution and Health is a two-year project that has involved more than 40 international health and environmental authors, and provides new estimates on the effect of pollution on health and its economic costs. Using data from the Global Burden of Disease study, it examines outdoor and indoor air pollution, water, soil, and workplace pollution. 

This Lancet report was conceived to draw attention to pollution’s enormous impact, and to highlight that this fatal issue does not receive sufficient attention as well as showing that the issue of pollution is solvable.

The report highlights the need to tackle sources of pollution associated with the healthcare sector, such as greenhouse gas emissions from the use of fossil fuels, pharmaceutical pollution, as well as patients’ and healthcare worker’s exposure to chemicals used in health facilities...

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