In a world increasingly aware of the delicate balance between human health and the environment, one sector stands at the intersection of both: healthcare. Hospitals, clinics, and health facilities provide life-saving services, but they also produce hazardous waste, consume large volumes of water and energy, and generate emissions that, if unmanaged, can harm the very people they’re meant to protect.

This is where environmental auditing comes in. Let’s walk through why it matters, what to look for, and how compliance or non-compliance presents itself during a health facility environmental audit. Find more posts on environmental audit here.

Why Conduct an Environmental Audit in Health Facilities?

An environmental audit in a health facility is not just a legal requirement, it’s a health and safety necessity.

Key Objectives:

• Ensure compliance with environmental laws and regulations.
• Identify environmental risks—such as improper disposal of medical waste.
• Promote sustainable practices—like energy and water efficiency.
• Protect the community and environment from contamination and pollution.
• Support accreditation and certification under EMS frameworks like ISO 14001.

According to the World Health Organization (WHO), healthcare activities worldwide generate millions of tons of waste annually, 15% of which is hazardous, infectious, toxic, or radioactive. [WHO, 2018]

What to Look for When Auditing a Health Facility

Environmental auditing involves examining systems, processes, behaviors, and compliance documents. Here’s what a thorough audit should cover:

1. Legal & Regulatory Compliance

Ask:

• Does the facility have a valid Environmental Impact Assessment (EIA) license?
• Are there up-to-date waste disposal permits, effluent discharge licenses, or air emission certificates?
• Is the facility complying with national environmental laws (e.g., EMCA in Kenya) and public health regulations?

Compliance Looks Like:

• All relevant environmental permits are up-to-date and displayed.
• Clear understanding among staff of legal requirements.

Non-Compliance Warning Signs:

• Expired licenses.
• No documentation of environmental approvals.
• Facility unaware of environmental obligations.

2. Medical Waste Management

This is priority number one in health facility audits.

Look for:

• Segregation of waste: sharps, infectious, general, chemical, pharmaceutical.
• Use of color-coded bins and proper labeling.
• Secure storage areas for hazardous waste.
• Contracts with licensed waste handler companies.

Compliance Looks Like:

• Bins in each ward or lab clearly labeled and color-coded.
• Storage rooms are locked, ventilated, and away from public access.
• Waste tracking logs are kept and up to date.

Non-Compliance Warning Signs:

• Mixing infectious and general waste.
• Overflowing bins or exposed sharps.
• No evidence of proper disposal methods.

3. Water Use & Sanitation

Water is critical in health facilities for hygiene, cleaning, labs, and patient care.

Key audit items:

• Source and quality of water supply (municipal, borehole, rainwater).
• Presence of water meters and consumption monitoring.
• Water-saving features (e.g., low-flow taps).
• Sanitation standards in toilets and wards.

Compliance Looks Like:

• Clean water available at all points.
• Regular water quality testing records.
• Water usage records available for review.

Non-Compliance Warning Signs:

• Rusty or broken taps.
• Water leaks or stagnant pools.
• No conservation measures in place.

4. Chemical and Hazardous Substance Handling

Hospitals use a range of chemicals from disinfectants to chemotherapy drugs.

Check:

• Storage: Are chemicals labeled and stored in ventilated areas?
• Use: Are Material Safety Data Sheets (MSDS) available and accessible?
• Disposal: Is there a proper system for expired or unused chemicals?

Compliance Looks Like:

• Locked chemical storage with MSDS posted on walls.
• Staff trained on handling chemicals and PPE use.

Non-Compliance Warning Signs:

• Open containers or expired chemicals on shelves.
• No training records or emergency response kits.

5. Energy Use and Air Quality

Health facilities run 24/7, consuming significant electricity and fuel.

Audit areas include:

• Use of energy-efficient lighting and appliances.
• Functional ventilation and HVAC systems.
• Measures for indoor air quality control, especially in isolation rooms or labs.

Compliance Looks Like:

• Energy audits conducted regularly.
• Air filters changed on schedule.
• Use of solar power or energy-saving bulbs.

Non-Compliance Warning Signs:

• Poor air circulation in wards.
• High electricity bills with no tracking or efficiency plan.

6. Environmental Emergency Preparedness

Hospitals should be prepared for chemical spills, fires, or disease outbreaks.

Audit for:

• Presence of spill kits, fire extinguishers, and evacuation plans.
• Training records for environmental and emergency response.

Compliance Looks Like:

• Monthly drills conducted.
• Staff know what to do in case of an emergency.

Non-Compliance Warning Signs:

• Fire extinguishers not serviced.
• No written emergency plans or visible exit signs.

7. Staff Awareness & Documentation

Environmental management isn’t just about systems, it’s about people.

Check for:

• Existence of an environmental policy.
• Training records on waste handling, PPE use, chemical safety.
• Availability of environmental audit reports and corrective action plans (CAPs).

Compliance Looks Like:

• Policy posted on staff boards.
• Staff can explain basic environmental procedures.

Non-Compliance Warning Signs:

• No environmental training conducted.
• Audit reports not available or followed up.

How Do You Know If a Health Facility Is Compliant?

A compliant facility will:

• Meet all environmental and health legal requirements.
• Keep comprehensive records and documentation.
• Maintain cleanliness and hygiene in all areas.
• Continuously improve based on audits and feedback.

A non-compliant facility will:

• Have poor waste management practices.
• Operate without key permits.
• Lack awareness of environmental risks and responsibilities.

The Bigger Picture: Benefits of Environmental Auditing

• Reduced Environmental Footprint: Less waste, less pollution.
• Safer Health Environment: Protects patients, staff, and the community.
• Cost Savings: Efficient use of water and energy.
• Better Reputation & Compliance: Improved trust and reduced legal risks.

“Environmental audits are not just about compliance, they are about continuous improvement and sustainability.”
— Kenya National Environment Management Authority (NEMA)

Final Thoughts

Health facilities save lives, but they must also protect the environment in the process. An environmental audit shines a light on where things stand and where improvements are needed.

As environmental auditors, our job is not to punish but to guide facilities toward sustainability, safety, and excellence. And as health facility managers, embracing the audit process can lead to a cleaner, more efficient, and more respected institution.

Ready to Begin Your Audit?

Start with a comprehensive checklist and walk through each department with intention and a keen eye. You’re not just ticking boxes, you’re protecting lives and the planet.