Anyone trying to live sustainably will easily discover how challenging it can be to remove plastics from their lives. That’s only in homes and the everyday workplace. Eliminating single-use plastic use in healthcare and hospitals is an even more challenging issue.
We have to reduce our reliance on these finite and polluting materials in our institutions, workplaces and homes. In some places, this is harder to do than in others. Reducing plastic use in the medical industry poses a very particular set of problems.
Many are now familiar with the harm single-use plastic does, both in terms of global warming and environmental pollution. But it is also important to recognise why medical institutions use plastic. It is cheap, durable and – especially important in a healthcare or hospital setting – can provide a sterile environment or be sterilized easily.
Medical practitioners can easily and safely dispose of single-use items contaminated with hazardous waste. Manufacturers modify certain medical plastics with coatings that make them particularly resistant to microbes. To have this discussion, we must recognize that single-use plastics offer a clean and efficient way to facilitate health and hygiene in medical environments4.
But at what cost? The piles of single-use plastics are beginning to concern the medical professionals and others in the industry who are surrounded by them daily. And researchers are yet to fully determine the harm of plastics, particularly microplastics, to human health.
We know that certain types of plastics like polyvinyl chloride (PVC) contain toxic chemicals5. So while these can be germ resistant and easy to sanitize, they do also bring risks.
But even without taking direct health risks into account, there is damage done by single-use plastics. Its contribution to environmental and climate crises is significant. There is also a recognition that the use of single-use plastic in healthcare and hospitals could conflict with a medical practitioner's oath: primum non nocere (first do no harm).
Hospitals produce more than 5 million tons of waste each year – that is 29 pounds of waste per bed per day. An estimated 25% of the waste generated by a hospital is plastic1.
When trying to reduce single-use packaging and plastic in a medical setting, there are issues to consider which do not usually apply in other areas. One issue, of course, is the safety of both staff and patients. Whatever replaces single-use plastic must offer the same provision for the health and safety of staff and patients.
Operating rooms are a particular area to consider. An operating room produces more than 30% of a facility’s waste and two-thirds of its regulated medical waste. Regulated medical waste is one of the most challenging areas to manage when thinking about single-use plastic use in healthcare and hospitals.
Single-use plastics increased within the industry in part due to alarm over HIV and AIDS. This was one of the drivers that helped to fuel the use of single-use devices and excessive plastic packaging within the healthcare sector. Concern over spreading disease and contamination is still a major challenge within the field.
Sustainability policies, at the national level, within health boards, and individual practices and hospitals can have a big impact on the reduction of single-use plastics. These policies can help more medical facilities practice greenhealth safely.
Hospitals that contributed data as part of 2019 Environmental Excellence Awards submissions together saved an impressive $68 million on sustainability initiatives in 2018. They did this while reducing more than 309 million kBtus of energy and diverting 146,750 tons of waste from the landfill. They also avoided 183,360 metric tons of carbon emissions through mitigation projects.
Reducing single-use plastic use contributes to more sustainable functioning of the healthcare system. So what can we do? One step that industry practitioners can take is to utilize practical and safe alternatives to single-use plastics. This means choosing reusable items where possible.
Medical personnel can reuse tools like surgical basins and sterilisation wraps. And doing so can reduce waste from a practice or hospital by several tonnes per year. Some hospitals are experimenting with replacing blue wrap (a commonly used polypropylene sheeting) with reusable sterilisation containers that practitioners can clean, just like the instruments they contain.
The FDA approved EnviroPouch is an alternative to the single-use sterilization pouches commonly used. And NewGen Surgical, a medical device company has developed several sustainable medical products. Including a skin stapler made with 69% plant-based material.
This product results in a 67% reduction in energy used during the production process. And eliminates more than 500 pounds of plastic waste for every 10,000 skin staplers used. They've also developed a sustainable needle counter box. This eliminates 93% of the plastic waste associated with a product used in nearly every operating room procedure.
Already, it is also possible for those in the medical field to choose single-use plastics that are not as damaging for the environment for certain applications. Polycare, for example, offers reduced plastic use trash bags for different waste streams, and a range of 100% compostable products made from plant starches from sustainable feedstocks. The manufacturer can make items such as caddy liners for food waste, patient carrier bags, nappy bags and aprons from this 100% compostable material.
Right now, practitioners should be looking for more sustainable alternatives to single-use plastics for a range of common applications. While decision-makers within the medical field can also reduce single-use plastic use by creating a responsible culture among staff.
Disposable personal protective equipment and a range of other items are essential in certain settings, of course. But there are times when it is easy for staff to overuse these items. Good education and training can help all healthcare facilities meet their environmental and sustainability goals.
The field of bioplastics and eco-friendly plastics offers a range of exciting possibilities. Bioplastics could potentially help reduce the impact of single-use plastics in healthcare and hospitals considerably in the coming years2. As inventors continue to refine and improve compostable plastics made from sustainable feedstocks, they will likely find an increasing number of applications within the field.
Polyhydroxyalkanoates (PHAs) are bioplastics that have potential in a variety of areas, including in biomedical/medical fields3. PLAs and PCAs are also useful materials for a range of biomedical/medical applications.
While there are ways to reduce single-use plastic in hospitals, it is unlikely that the healthcare field will be able to eliminate them any time soon. This means that for the foreseeable future, we'll not only have to find alternatives. We also need to look at ways to mitigate the impact of necessary plastic waste. Though many practices and hospitals are making great strides towards sustainability, they won't ever be true 'zero waste' due to the biohazard component.
In the past, many hospitals simply jumbled all the different waste streams together. They collected the waste from reception-area trash to operating-room waste and burned them in incinerators. This is still common practice in many developing countries.
But medical waste incineration is a leading source of dioxin, mercury, lead and other dangerous pollutants. This option carries a heavy environmental impact that involves a threat to human health. Despite these dangers, many governments, public health agencies, international organizations and transnational corporations continue to promote incineration technologies as waste management "solutions."
Fortunately, it is possible to effectively treat and disinfect medical waste in other ways. The non-profit Health Care Without Harm is collaborating with health care systems, NGOs, governments and international agencies such as the World Health Organization. Their main task is to research and promote environmentally sound and healthy alternatives.
And by separating the waste stream more effectively, it also becomes possible to recycle a much higher proportion of the single-use plastic that passes through each medical establishment. Single-use plastic items that do not come into contact with patients are not biohazards, and practitioners can recycle them.
Some hospitals already sort their recycling. But the challenge is finding a recycler prepared to take materials from a single site. Often, aggregating plastic waste from several locations can make it more attractive to recyclers.
The Healthcare Plastics Recycling Council offers a toolkit that is a great resource for hospitals and practices. It is available for those who want to find a recycling network to join.
Researchers believe that the world's healthcare industry represents around 4% of global greenhouse gas emissions. If the industry were a country, it would be the fifth-largest emitter on the planet. But by reducing single-use plastic use, and mitigating the impact of the waste generated, hospitals and practices can concentrate on being more sustainable and eco-friendly.
|Lee, Byeong-Kyu & Ellenbecker, Michael & Moure-Eraso, Rafael. (2002). Analyses of the recycling potential of medical plastic wastes. Waste management (New York, N.Y.). 22. 461-70. 10.1016/S0956-053X(02)00006-5.|
|NEW ADVANCEMENTS OF BIOPLASTICS IN MEDICAL APPLICATIONS, Kulsoom Bano, Reetika Pandey, Jamal-e-Fatima and Roohi, Protein Research Laboratory, Department of Bioengineering, Integral University, Lucknow - 226026, Uttar Pradesh, India.|
|Keshavarz, T. and Roy, I. 2010. Polyhydroxyalkanoates: bioplastics with a green agenda. Current Opinion in Microbiology. 13 (3), pp. 321-326. doi:10.1016/j.mib.2010.02.006|
|North EJ, Halden RU. Plastics and environmental health: the road ahead. Rev Environ Health. 2013;28(1):1‐8. doi:10.1515/reveh-2012-0030|
|Plastics and Health Risks. Rolf U. Halden, Center for Environmental Biotechnology, The Biodesign Institute at Arizona State, University, Tempe, Arizona 85287-5701|