PROTECTIVE EQUIPMENT
Canadian project focusing on PPE reduction and re-use
Kent Waddington, Linda Varangu, and Mia Sarrazin of the Canadian Coalition for Green Health Care, discuss a project in Canada that sought to verify that hospital use of PPE and some medical single- use plastic (mSUP) materials could be successfully and safely managed by focusing on the preferred principles of a circular economy – reduction and re-use.
COVID-19 was first confirmed in Canada at the end of January 2020. With this came great urgency to respond in a way that embraced existing infection control and treatment protocols while battling a rapidly expanding and unfamiliar enemy, as well as an unprecedented demand for personal protective equipment (PPE). Early in the pandemic, Health Canada predicted an estimated 63,000 tonnes of plastic PPE would end up as waste, and ultimately in landfills. In November 2020, a project – ‘Towards
a Safe, Secure and Sustainable Reusable PPE System in Canadian Health Care’ – was initiated, with financial support from Environment and Climate Change Canada. It set out to demonstrate that hospital-use of PPE and some medical single-use plastic (mSUP) materials could be successfully and safely managed by focusing on the preferred principles of a circular economy: reduction and re-use. This would be achieved firstly by addressing opportunities to reduce, and then by choosing products that can be re-used. Only after these two avenues had been pursued to the maximum would recycling be undertaken – to as great an extent as possible. Government of Canada priorities to
move Canadians toward zero plastic waste by 2030 were key driving factors for this project. The federal government supports the development of a new, ambitious, legally-binding global agreement that takes a lifecycle approach to addressing plastic pollution and reducing microplastics in the environment. Other complementary government priorities include supporting a climate-resilient, sustainable, and low carbon health system, and moving toward circular economy practices within the Canadian economy.
Project steps Knowledge development steps included an environmental scan of the literature on PPE and mSUP activities within the country’s circular economy, followed
There is a global trend toward increasing use of disposable PPE and mSUP.
by one-on-one engagement with more than 75 representatives from a multitude of sectoral stakeholders, including PPE and mSUP users, specifiers, medical practitioners, waste management professionals, manufacturers, and reprocessors. Using information gathered from this phase, seven roundtables were developed incorporating four design scenarios – ‘throw away’, industrial recycling/disposable, prevention/reduce and redesign, and prolonged service/ reusable – which were created to assess participant support for specific elements of the circular economy. Key takeaways from these workshops included support for reduction, re-use, and recycling of PPE and mSUP, and participants’ surprise that re-use was a much cheaper alternative to recycling and disposal options. Further outreach to the healthcare
workforce occurred through surveys geared to understanding current practice, challenges, and opportunities, as they related to PPE and mSUP use in Canada’s health system. The individual PPE products
of interest in the project were gloves, gowns, medical grade surgical masks, reusable elastomeric respirators, goggles, and face shields.
Main observations In most instances, when purchasers or the healthcare workforce referred to PPE, they were describing disposable products, not reusables. This aligns with the global trend in healthcare toward increasing use of disposable PPE and mSUP. Dr. Andrea MacNeill, surgeon, Clinical associate professor in the Division of Surgery, and director of the Planetary Health Lab at the University of British Columbia, said: “Our health system has developed increasing reliance on single-use items, including disposable N95 respirators and gowns, creating more waste and other emissions. As we experienced in the early days of the pandemic, this is not sustainable. It’s a lot easier to scale up your re-use cycles, such as laundering gowns or replacing the filters in reusable respirators, than it is to actually manufacture more of something –
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