PROTECTIVE EQUIPMENT


of fossil plastics, decreased healthcare- generated plastic waste, and lower overall greenhouse gas emissions. One study that evaluated a number of science-based lifecycle studies reported that reusable surgical gowns and drapes demonstrated substantial sustainability benefits over the same disposable product in natural resource energy (200% to 300%), water (250% to 330%), carbon footprint (200% to 300%), volatile organics, solid wastes (750%), and instrument recovery. All these sustainability benefits exist even in comparison with the required cleaning and sterilisation of the reusable PPE, and support a more robust circular economy, and enhanced planetary health.


Key findings An optimal reusable PPE gown system within the context of a circular economy was envisioned by the project team. Various components need to be in place to ensure a circular economy, including at the hospital, followed by the user and various re-use (cleaning/sterilising, repair, and repurpose) and recycling/composting options, sourcing of domestic raw materials, the converter, packaging plant, manufacturer, and distributor. All of these will have minimised their use of fossil plastic and energy. What drives these activities is healthcare ‘green’ purchasing, resulting in a safe, secure, and sustainable reusable PPE system that provides maximum benefit on many levels of the health system. While no reusable gown made of domestically grown plant-based fibres exists yet, there’s no need to wait for it to emerge to start reaping the many benefits of a reusable PPE system now.


Numerous opportunities A circular economy approach for PPE gowns is just one of many opportunities for hospitals to engage in reduction and re-use practices to curtail the use of single-use plastics. Others include virtual care, which cuts down on the use of PPE and transportation emissions; optimising the use of gloves according to infection prevention and control guidelines – resulting in a reduction of glove use with enhanced hand hygiene practices; asking patients with scheduled admissions to bring in their own garment bags; requesting removal of unneeded items in pre-packed trays for surgeries; encouraging manufacturers to replace fossil plastic with plant-based plastics as a raw material for reusable products and packaging; cleaning and sterilising purpose-built reusables (PPE isolation and surgical gowns, elastomeric respirators, goggles and face shields, underpads and bibs, sharps containers, and clinical products like anaesthesia breathing circuits) within appropriate supporting infrastructure; employing patch kits like CleanPatch for damaged patient touch


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surfaces such as vinyl/polyurethane mattresses; sharing products with other hospitals when they are no longer required, and repurposing spent surgical gowns as PPE for non-sterile clinical applications, or using them to make smaller reusable PPE, such as shoe covers used in surgery. PPE use is expected to increase


several-fold over the next five years, particularly after COVID-19 caused pent- up demand for surgeries. Hospitals can lead by purchasing safe, secure, and sustainable reusables, which will save the Canadian healthcare system money, help protect the environment by reducing consumption of fossil plastics and waste generated, cut down on climate emissions, create domestic jobs to build thriving communities, and help establish a resilient health system. For more information on this project, visit https://greenhealthcare.ca/ppe-msup/


n This article, titled ‘COVID-19 and PPE Waste: A catalyst for a reusable personal protective equipment health system’, first appeared in the Autumn 2022 issue of Canadian Healthcare Facilities, the magazine of the Canadian Healthcare Engineering Society. HEJ thanks the authors, CHES, and the magazine’s publisher, MediaEdge, for allowing its re-publication here.


Kent Waddington is the Communications director at the Canadian Coalition for Green Health Care. Linda Varangu is the Coalition’s senior advisor on Climate Change, and the lead on the ‘Towards a Safe, Secure and Sustainable Reusable PPE System in Canadian Health Care’ project. Mia Sarrazin is the Coalition’s bilingual Environmental Healthcare coordinator.


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