Activities for Environmental Sustainability in Community Pharmacies and Universities

009 pharmacies often work long hours with the habit of eating different kinds of cold cuts, which leads to weight gain, generating values of body mass index (BMI) in these workers which is an indicator of obesity. In addition, stress and physical difficulties like problems with back or foot pain with standing a majority of the day affect to staff health. Therefore, efforts should be ensuring the health of staff pharmacy could provide health and have health as well.

pharmacies often work long hours with the habit of eating different kinds of cold cuts, which leads to weight gain, generating values of body mass index (BMI) in these workers which is an indicator of obesity. In addition, stress and physical difficulties like problems with back or foot pain with standing a majority of the day affect to staff health. Therefore, efforts should be ensuring the health of staff pharmacy could provide health and have health as well.
These ideas come from various successful programs in the world. For example, the University of Maryland in the United States [4], which since 2010 has purchased at least 200 million kWh of wind power annually, remaining the nation's #1 purchaser of wind power among all colleges and universities. Other example is the University of Oxford in the UK by Biocultural Variation Unit and obesity [5], that offer the Summer Program in Obesity, Diabetes and Nutrition Research Training (SPORT) is a 10-week research internship for medical students only. The Program offers an intensive summer research experience and mentorship to successful applicants, as well as a stipend.
On the other hand, health campaigns focused on smoking cessation have substantially increased in recent years, however it continues to remain a health concern, including pharmacies, there are workers who continue to smoke [6][7][8].
It also requires efforts to change these behaviors. Because of this, it is necessary to have clear rules expressed in documents (as being forbidden to leave out of the pharmacy "to smoke a cigarette"). It should take into account the rules that are in other institutions, even posted on their Web pages as the Massachusetts Institute of Technology (MIT) [9].
Another key to achieving social sustainability in community pharmacies element is linked to the friends and families of workers of Pharmacy, and should be involved in creating programs of physical and mental health for them, with the respective diffusion as the case of health and wellness program at the University of Toronto [10].
What specific measures are required to raise at the community pharmacy to improve sustainability?

Introduction
Sustainability could be considered a buzzword of current health care practice but finally it need develop activities having sustainability as goal [1]. In this way, activities which are developed daily by pharmacists in community pharmacies as dispensing, pharmacotherapy follow up, pharmacovigilance, storage and administrative activities requires efforts to ensure the sustainability of the services.

Environmental sustainability
Community pharmacies are not currently using efficient practices to promote sustainability. For example, papers are used for daily printed documents; however unnecessary paper being printed that is not being utilized. This type of behavior is explained by the absence of standard operating procedures focused on wasteful use of paper within the pharmacy. Another issue is that the computers aren't turned off at the end of the day. These are preventable situations to generate environmental sustainability in pharmacies. These behaviors allow efficient reduction of our carbon footprint. Universities and Schools of Pharmacy have the potential to educate student pharmacists and contribute to research on effective practices that focus on environmental sustainability practice in community pharmacies [2].
Even the US Environmental Protection Agency (EPA) on its website show a ranking of universities that use sustainable sources (for example: air, water, electricity) as in the case of the University of Pennsylvania which uses air resources to generate kilowatts for daily activities [3]. This kind of strategies can be implemented as well in community pharmacies.
There are also proposed global rankings from other institutions, such as the case of the UI Green Metric World University Ranking, which leads the University of Nottingham. Review of different strategies in described in ranking can be used for implementation in community setting.

Join international campaigns such as "Meat Free Monday" (http://www.meatfreemondays.com):
International health campaigns should be a great strategy of community pharmacy, so that people can make reference to community pharmacy health. For example, the UN, through its UN Food and Agriculture Organization (FAO) issued the report's La larga sombra del Ganado [11], which determined that 18% of all greenhouse gases worldwide come from industry livestock. This exceeds even all means of transport in the world, and puts the livestock as the main culprit of global warming. In one meatless day, each person reduces its carbon footprint by 12%. In another report entitled Confronting climate change through the ganadería [12], it is clear that the current government measures are not enough; with current country pledges to reduce emissions of these gases, it will not be achieved more than a third of the necessary measures to prevent an increase of 2° C global temperature by the end of 2020 reductions. Community pharmacies can promote this kind of initiative for improve health of their patients and contribute with sustainability.

Conclusion
Community pharmacy together with universities has a crucial place in society and the range of influence is very large. Health sustainability is within reach. It requires taking the decision to start and continue working for benefit of population and ecosystems.