Waste generated by the health care industry has been cited as a major source of toxic pollution, including mercury and dioxins, which poses a serious threat to public health. The purpose of this study was to investigate pollution prevention activities of health care facilities in Oregon related to environmentally preferable purchasing practices, recycling, mercury reduction efforts, and written policy. Surveys were sent to 57 hospitals in Oregon, 24 facilities responded (42.1 %). Results indicate that the following environmentally-preferable purchasing practices are being implemented: purchasing reduced hazardous material (92%); using recycled packaging (75%); and, using products made from recycled content material (83%). Other practices, such as the purchasing of cadmium-free red bags (25%), supplies shipped in reusable shipping containers (34%), and using minimal packaging (46%) are being implemented in a few hospitals. None of the hospitals are purchasing chlorine-free office paper. The majority of participating Oregon hospitals are recycling paper (96%), cardboard (96%), clear glass (67%), linens (87.5%), batteries (67%) and X-ray film (83%). Fewer hospitals are recycling plastics: #1 PET and #6 polystyrene (37.5%), #2 HDPE (42%), #5 polypropylene (33%). Fewer hospitals are also composting food (46%), computers and equipment (42%), fluorescent lamps (21%) and solvents/fixers (29%). Major barriers to recycling in hospitals include lack of established markets for some materials, limited space to collect the materials, and low employee participation. The majority of participating hospitals are reducing the purchasing of mercury containing products, replacing mercury blood pressure units and gauges, replacing lab and housekeeping chemicals, and pharmaceuticals. Fewer than 50% of then participating hospitals are replacing switches, recycling batteries and conducting an inventory of mercury sources. Few hospitals are checking drains and pipes for mercury contamination (13%), recycling fluorescent lamps (21%) and requiring vendors to disclose mercury content below 1% (17%). While most hospitals no longer purchase new mercury-containing devices, the cost associated with disposal of mercury as a hazardous waste is a major barrier to elimination. Hospitals located in urban areas in Oregon are more likely to implement pollution prevention strategies than rural hospitals. Nearly all Oregon hospitals lack a corporate policy on pollution prevention/source reduction, or written goals on waste volume reduction or waste toxicity reduction efforts. The few hospitals (8%) that have put policies in place have done so voluntarily, and with the full support from upper-level management. Based on theses findings recommendations include the following: 1) Establish a "Green Team" of hospital staff from diverse departments. This group can then strategize about courses of action for the facility with input from all responsible sectors. 2) Conduct a waste audit. This establishes a baseline of existing hospital waste and will help determine how to shape a waste minimization program and pollution prevention plan. 3) Pollution prevention education should be a top priority for all departments within each hospital including purchasing, nursing, housekeeping and top management. Many health care professionals are not aware of the link between the products and practices they choose and the environmental consequences of these choices. 4) Rural hospitals can join pollution prevention email list serves such as the Oregon Health Care Without Harm list (HCWHoregon-health.org) or the H2E list serve (www.h2e-online.org) to share, learn and identify practical strategies for pollution prevention and waste minimization. 5) Approach and involve upper level management to work with hospital "green teams" to develop and implement a hospital policy on pollution prevention. / Graduation date: 2003