Region Stockholm has agreed to phase-out lists for chemicals hazardous to the environment and the health of citizens, employees, and patients. The lists comprise chemicals and chemical products e.g., in healthcare, laboratories, dentistry, IT, cleaning, textiles, and allergy inducing fragrances or preservatives. With them, Region Stockholm prevents purchasing and procurement of chemicals and chemical products as well as articles and consumables containing toxic substances that fall within a large number of specified categories, such as: may cause cancer; and may cause inheritable genetic damage. The lists are mandatory for all chemical products procured by Region Stockholm. Since 2012 a significant proportion of hazardous chemicals have been phased out, especially from the healthcare sector. The healthcare sector saw a 90 percent reduction in the use of listed substances, decreasing volumes in weight from 1,100 kg to 115 kg. The phase-out lists serve as an inspiration for regions and countries around the world. Due to their impressive socioeconomic and environmental impact, holistic approach and their full respect for the Future Justice Principles, the Region Stockholm’s Phase-Out Lists for chemicals hazardous to the environment and human health of 2012-2016 and their revision 2017-2021 were recognized with the Future Policy Gold Award 2021 for Protecting from Hazardous Chemicals, awarded by the World Future Council, in partnership with the SAICM, UNEP, UNITAR, OECD, ILO and UNDP.
At a Glance
Region Stockholm has a strong focus on minimizing the environmental and health impacts from hazardous chemicals and pharmaceuticals.
One of the purposes of the phase out lists is to prove that legislation can be toughened up.
Chemical criteria have been used in all relevant procurements and since 2012 chemical criteria have been applied for example to medical devices, disinfection- and cleaning products, textiles, IT, and services. Region Stockholm phased out phthalates from most products, including medical devices, and allergy-causing perfumes or preservatives are banned.
Chemicals used in healthcare, public transport, and real estate can be harmful to both the environment and human health, impacting workers, consumers, and the general public. In recognition of these risks, Region Stockholm prepared a phase-out list of step-by-step reductions in the use of hazardous substances in chemical products and goods. As a result, since 2012 a significant proportion of hazardous chemicals have been phased out, especially from the healthcare sector. Based on Region Stockholm’s environmental review 2016, the healthcare sector saw a 90 percent reduction in the use of listed substances, decreasing volumes in weight from 1,135 to 115 kg. In total there are three separate phase-out lists: 1) Chemicals and Chemical Products, 2) Articles and Consumables, and 3) Chemical Products in Laboratory Activity. Selected criteria are used for adding substances to the lists and further dividing them into those categorized for phasing out and those for reduction. The phase-out list for Chemicals and Chemical Products is used in all units, except laboratory units, for the phasing out of existing substances and in procurement and purchasing. The phase-out list for Articles and Consumables is used by all Region Stockholm units in procurement and purchasing. The phase-out list for Chemical Products in Laboratory Activity is used by laboratory units for the phasing out of existing substances in their operations and in procurement and purchasing. Region Stockholm units concerned with dentistry use all three phase-out sub-lists. These lists are publicly available and provide a level playing field for all companies. They ensure transparent communication with clear objectives to be achieved every five years. In addition, there is political commitment and support for the phase-out lists at the highest regional level. The uniqueness of phase-out lists is that the environmental requirements are most often higher than those set out by the EU chemical legislation Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH), as the lists may include substances that are not yet regulated. Indeed, in 2016, more than 90 individual and groups of substances on the phase-out lists were not yet on EU REACH’s candidate list. Additionally, the lists are updated every few years with higher requirements. They provide systematic procedures for district procurement units to monitor and comply with the Region’s environmental programme; the responsibility for implementing the chemical strategy within the environmental programme becomes clear to the procurement units. Currently the phase-out lists impact about 100 procurements that Region Stockholm launches per year.
Future-Just Policy Scorecard
Our “Best Policies” are those that meet the Future Just Lawmaking Principles and recognise the interconnected challenges we face today. The goal of principled policy work is to ensure that important universal standards of sustainability and equity, human rights and freedoms, and respect for the environment are taken into account. It also helps to increase policy coherence between different sectors.
Sustainable use of natural resources
Companies have to comply with the requirements of the phase-out lists and disclose information to Region Stockholm.
Strong focus on occupational health and safety, and consumer safety.
Phasing out and restricting hazardous chemicals is the main objective, which is beneficial for different sectors with a focus on healthcare.
Focuses on the phase out and restriction of chemicals identified by the regional (EU), national (Sweden) and NGO (ChemSec SIN list) lists of hazardous chemicals; regularly revised to strengthen the requirements for phase out.
The list includes more advanced requirements compared to the EU chemical legislation REACH.
Equity and poverty eradication
Reduces exposure to harmful chemicals of workers and patients (in particular in the health sector), people using public services (including school children), consumers, and the general public.
Operates using information from the regionally, nationally and globally recognized lists of hazardous chemicals, including NGOs (ChemSec SIN List) and related legislations.
Based on scientific data and approved chemical testing methods for product samples to ensure that the declared content(s) of the product is correct.
Public participation, access to information and justice
The lists are publicly available which allows consumers and other stakeholders the possibility to revise lists and provide comments to the new editions to ensure better protection from hazardous chemicals for all. Transparency achieved by the public availability of the phase-out lists of hazardous chemicals in chemical products and goods.
NGOs and the public can compare lists from different years and provide comments and suggestions for further revisions.
Suppliers, companies, and NGOs are consulted.
Good governance and human security
Non-compliance can result in termination of the contract with the company.
Region Stockholm commissions external evaluator(s) to monitor contractual agreements and test products.
Sets thresholds for hazardous chemicals in products regardless of whether they have been added intentionally or occur as a contaminant or residue from the manufacturing process.
Integration and interrelationship
Application of the polluter-pays principle and the right-to-know principle.
Linked to different suppliers and sectors.
Strong cooperation between municipal authorities.
Strong communication with suppliers and sectors as well as NGOs (ChemSec, Health Care Without Harm).
Common but differentiated responsibilities
Endeavour in bridging gaps in communicating the phase-out list to ensure the general public, including vulnerable groups, is fully aware of the benefits of the policy implementation.
Successfully communicates to companies the need to disclose more facts confirming the phase-out of hazardous chemicals from products.
Ensures that the policy implementation does not place burdens on the most vulnerable groups by applying a step-by-step approach to „must have“ products in healthcare sector.
The phase-out lists aim to define chemicals hazardous to the environment and human health and set the goal to phase out these substances through the procurement system. The lists are mandatory for all products procured by Region Stockholm. The lists are made up of both prohibited substances and phase-out substances. For prohibited substances, these include those used in healthcare and laboratory operations, properties, vehicles, vessels, and for the servicing of medical devices; for phase-out substances, these include those used in the same areas listed for prohibited substances with the addition of analyses kits within healthcare and laboratory operations. Region Stockholm has an environmental programme with clear goals on products, transport, energy, chemicals and pharmaceuticals, and the procurement of goods for the public sector. The programme is revised regularly and includes the City of Stockholm’s Chemicals Action Plan with the vision of “a non-toxic Stockholm” by 2030. Stockholm’s Chemicals Action Plan specifically states that “protecting children and adolescents from exposure to harmful substances should be prioritized”. Implementation measures include clearing out and avoiding hazardous substances in chemical products, articles, and construction materials that are used in the city, and working to persuade other actors to move in the same sustainable direction. Region Stockholm’s phase-out lists for chemicals hazardous to the environment and human health have been compiled under the environmental policy programme. Region Stockholm regularly revises its environmental programmes and reports while new programmes are in development. The environmental work within Region Stockholm is primarily governed by the environmental programme that contributes to achieving national and international goals as well as sustainable development. The programme for the period of 2017-2021 contained 15 goals and 24 indicators, in addition to which there are guidelines and basic requirements for environmental work. The environmental programme applied to all regionally funded activities and was followed up every year. The phase-out lists of environmentally and health hazardous chemicals in chemical products and in goods were developed as part of the environmental programme. The previous list was published for the period of 2007-2011; the last phase-out list was published in 2012 for the 2012-2016 programme. The two most recent phase-out lists were published in 2017 for the period of 2012-2021 as: 1) Phasing out list for environmentally and health hazardous chemicals in chemical products; and 2) Phasing out list for environmentally and health hazardous chemicals in goods.
The phase-out lists are a centrally required document used in Region Stockholm procurement process in Sweden. The purpose of this legally binding phase-out lists are to improve the protection of human health and the environment from the risks associated with toxic substances used in healthcare, laboratories, and dentistry by promoting the gradual reduction in the use of these hazardous chemicals. Every fifth year, the phase-out lists are updated with higher requirements. The lists help to protect the health of employees, patients, and citizens from toxic chemicals in combination with the procurement of chemicals, cosmetics, cleaning products and medical devices. The lists are based on chemicals included in the European Chemicals Agency’s (ECHA) List of Substances of Very High Concern, which is an online database developed by the Swedish Chemicals Agency and the REACH Regulation.
Methods of Implementation
The aim of the phase-out lists are to identify and compile a list of substances that are banned or are to be phased out using Region Stockholm’s procurement system. Environmental criteria are used in the tendering process. Companies participating in the procurement process receive the phase-out lists and must meet these criteria to participate in the tender. This applies to all companies and ensures equal conditions for all. Companies must meet the criteria for offering goods to Region Stockholm. Region Stockholm also uses chemical testing methods for product samples to ensure that the declared content(s) of the products is correct; otherwise, contracts with suppliers may be terminated. Region Stockholm commissions external evaluators to monitor contractual agreements and test products. For example, during the autumn of 2018 and spring of 2019, 81 suppliers were audited in 17 agreements related to products and services. The agreements included various healthcare products as well as heavy transport and moving services. The environmental programmes last for the duration of a five-year period. Two years before the end of the period specified in the programme, new objectives are developed. For example, in the version of the environment programme for the period of 2017-2021, the goal on chemicals states that: “in 2021, the volume of chemicals hazardous to the environment and human health used for the operation and maintenance of public transport services will have been reduced by thirty percent compared with [findings in] 2017”. Based on the latest information from Region Stockholm’s 2019 environmental review of goal 10, a high increase in the use of phase-out substances was observed. It has been concluded that it is the result of a higher number of subcontractors reporting their chemical usage/purchase. This means that more service suppliers better understand how to report, whereas before not many had reported their chemicals. Therefore, even though a sharp increase in substances from the phase-out lists was noted, a sharp increase in reporting was also found, which is a valuable engagement result. The programme also notes that an annual inventory and report will be conducted and that “the phase-out chemicals in question are defined in Region Stockholm’s phase-out lists of chemicals hazardous to the environment and human health”. The procurement criteria and the phase-out lists must be complied within all operations financed by Region Stockholm. In general, environmental work is regulated by Region Stockholm’s management process and the work is ensured, monitored, and checked at the Council level, using its budget and reporting through audits. Financial, social, and environmental impacts are considered before decisions are made. Environmental work of administrations and enterprises must be planned in each annual budget and operational and business plan, respectively. Region Stockholm has developed a new sustainability strategy for the upcoming five years (2022-2027) that also includes work on hazardous chemicals.
To reduce the environmental and health impacts of hazardous chemicals, Region Stockholm banned purchasing and procurement of Chemicals and Chemical Products as well as Articles and Consumables containing toxic substances that fall within a large number of specified categories, such as: very toxic and fatal by inhalation; very toxic and fatal in contact with skin; very toxic and fatal if swallowed; may cause cancer; and may cause inheritable genetic damage. Additionally, concrete chemicals are addressed in the procurements for Information Technology (IT) products, including phthalates and polyvinyl chloride free cables.In 2012, there were 122 individual and groups of substances listed in the phase-out lists. As knowledge about the harm of chemicals becomes increasingly available, more substances are added to different categories of the phase-out lists. For example, the following substances were newly added to the lists of 2017, in comparison to the list of 2012, for the following categories: fragrances, lead compounds, cadmium compounds and mercury compounds. Since 2012, chemical criteria have been applied to medical devices, disinfection and cleaning products, textiles, and IT products and services. Region Stockholm has phased out phthalates from most of the products procured, including medical devices and allergy-inducing perfumes or preservatives. In general, since 2012, a significant proportion of hazardous chemicals have been phased out, especially from the healthcare sector. Based on Region Stockholm’s 2016 environmental review, the healthcare sector saw a 90 percent reduction in the use of listed substances, decreasing the volumes in weight from 1,135 to 115 kg. In the Environmental Programme of 2017-2021, the phase-out list was updated into two separate lists: the phase-out list for chemicals hazardous to the environment and human health, and the phase-out list for chemicals hazardous to the environment and human health in products. Today, there are approximately 108 individual and groups of substances on these two lists. More than 90 substances, individual and groups that are on the phase-out lists, were not on EU REACH’s candidate list by the time the lists were developed in 2016. Currently it is estimated that the phase-out lists annually impact more than 100 procurements of Stockholm County. Stockholm’s regional procurement had 17 agreements in the periods between autumn 2018 and spring 2019; in total, 81 suppliers have been followed up in these two periods. From these, 71 suppliers complied with the overall sustainability-environmental requirements (e.g., phase-out chemicals), while 10 suppliers had one or more products that did not meet the requirements. The results demonstrate the importance of having an active dialogue with industry representatives prior to procurement to ensure that suppliers agree to the environmental requirements. In addition, it is important to resume work on monitoring the agreements every few years.
Potential as a Transferable Model
Region Stockholm phase-out lists are public and known to experts working in the field and can serve as an inspiration for other regions and counties in Sweden and elsewhere. In Sweden, the Region Stockholm coordinates similar work in other regions and cities, including Gothenburg and Upsala, two of the larger cities in Sweden. Region Stockholm also communicates the phase-out lists to suppliers and companies from other countries to facilitate their compliance. Furthermore, in 2020 the policy was presented at a global virtual training session organized by the NGO Health Care Without Harm: Sustainable procurement in health care.