PROTECTIVE EQUIPMENT
Domestic Net Zero Sustainable Packaging
Domestic Net Zero Material Converter
Recycle
Domestic Net Zero
Manufacturing Reuse Repurpose Repair
Domestic Supply of Raw Materials
critical supplies. Mackenzie Health President and CEO,
Compost ZEV for Distribution Green Purchasing
Resilient, Sustainable, Low-Carbon Green Hospital
User An idealised circular economy system with a focus on reusable PPE gowns.
and it creates less pollution.” In the US health system, an estimated 85% of PPE gowns were disposable in 2020, while more reusables were worn in Europe and Canada. Key Canadian healthcare leaders are starting to buck the disposables trend, and many actions were undertaken by members of the healthcare workforce during the pandemic that supported reusables for safety, security, and sustainability reasons.
Safety Most purpose-made reusables used in healthcare have been shown to be safe. “The idea of the safety of single-use disposable consumables has been very successfully perpetuated by industry, such that the entire landscape has shifted, making it easier for hospitals to be reliant on single-use disposables when in fact there are no data to back up that claim of improved safety from an infection prevention and control perspective,” said Dr. MacNeill.
Health Canada provides standards
for the material integrity of gowns, the protection that they provide, and safe use of reusable PPE. CSA Group has a series of standards dealing with infection prevention and control, and specifically with decontamination, disinfection, and sterilisation, through CSA Z314, Canadian Medical Device Reprocessing. The evidence for gown safety is further supported by the fact many large Canadian hospitals and health systems have safely deployed reusable isolation and surgical gowns, elastomeric
20 Health Estate Journal May 2023
respirators, a variety of clinical products like rigid sterilisation containers (to replace plastic ‘blue wrap’), laryngoscope blades and handles, and anaesthesia breathing circuits. Increased domestic manufacturing of PPE will help provide greater assurance that reusable PPE meets strict Canadian medical device standards, as some imported products during the pandemic were found not to meet them.
Security The pandemic is believed to have helped reverse some of the disposable trend in Canada, particularly in locations where hospital laundry service was accessible to clean and sterilise reusable PPE, such as gowns, and medical device reprocessing capabilities or localised sterilisation were available for reusable elastomeric respirators. In the case of Mackenzie Health, reduced availability of disposable PPE contributed to the Ontario health authority’s decision to use reusable PPE to increase security and access to these
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The environmental benefits of utilising reusable gowns include reduced use of fossil plastics, and decreased
healthcare-generated plastic waste
Altaf Stationwala, said: “During the early days of the pandemic when PPE supply was at risk, Mackenzie Health leadership was laser focused on procuring PPE and other supplies we needed to ensure our staff and physicians were safe. The reusable isolation gown solution that Ecotex provided at the most challenging time in healthcare for basic supplies of commodities was fundamental to delivering patient care. Not only was the initial supply timely, but it also immediately introduced a predictable supply of product for the foreseeable future. The fact that it also reduced our environmental footprint was an added benefit.” It is important to support domestic
manufacturers striving to develop and refine safe, high-quality PPE, which can provide security in the supply chain. New domestic development of PPE during the pandemic includes Canadian companies developing isolation gowns, plant-based medical masks, and healthcare-specific reusable elastomeric respirators to replace disposable N95s. ‘Homegrown’ PPE solutions mean less reliance on the unstable global supply chain and its unpredictable price swings, increased access to local supplies – such as raw materials, and enhanced local/on-site reprocessing and disinfection – all of which support improved resilience of Canada’s healthcare system.
Sustainability Sustainability encompasses financial, social, and environmental aspects. A reusable PPE system supports all three of these dimensions. With respect to cost savings, BC GreenCare estimates the per use price for a reusable gown is approximately nine times cheaper than that of a disposable one, resulting in $2 m in savings over a six-month period, as well as nearly $50,000 in avoided waste disposal costs. Similarly, Toronto’s University Health Network claims a 60% saving after switching to reusable gowns. Reduced costs for reusable elastomeric respirators have been made by users too. Social benefits also accrue from
increased use of reusable PPE, including support for local jobs, and growth in regional manufacturing companies (enhanced research and development/ innovation and new job creation/ opportunities), safe domestic workforces, and growth in both on-site and off-site cooperative and commercial laundries and medical device reprocessing facilities. This is in contrast to the offshore manufacture of PPE, where some facilities were identified as using forced labour.
Reduced use of fossil plastics The environmental benefits of utilising reusable gowns include reduced use
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