RECYCLING & SUSTAINABILITY
many other materials. If you look at it from a holistic perspective, plastic is, in many instances, less damaging to the environment when compared with other potential materials.”
Denkstatt,2
Studies by Franklin Associates1 which modelled the
and
substitution of plastic with alternative materials (such as paper, steel, aluminium and glass), suggest that a move away from plastics may come at an even higher net environmental cost. A Trucost study, published in 2016,3 built on this research, found that replacing plastics in consumer products and packaging with a mix of alternative materials that provide the same function would increase environmental costs from $139 billion to $533 bn annually. The study concluded that this is because strong, lightweight plastics help us ‘do more with less material, which provides environmental benefits throughout the lifecycle of plastic products and packaging’.
Some argue that hospitals should be looking to move to reusable products where possible, and reduce their reliance on single-use plastics. The 2017 Annual Report of the Chief Medical Officer, ‘Health Impacts of All Pollution – what do we know?’4
stated: “Global economics
now make it cheaper to manufacture single-use items within healthcare rather than carefully assess where multi-use items re-sterilised would be equally safe, cheaper, and cause less pollution through landfill and/or incineration. Further, there can be a clinical inertia - or comfort - in using single-use, due to the perceived benefits, but this can go beyond necessity.
“There is sometimes good evidence to invoke the precautionary principle and promote, if not require, the use of single- use items (Prion disease outbreaks where the long-term risk is initially unknown). When good research, however, establishes the true risk, then we should not perpetuate a culture of single-use inappropriately and universally. “From a health and pollution
perspective, the adoption of every single- use item should be considered, not the default. The overuse of disposable equipment has a downside, being disproportionately polluting. This may impact on human health, for example via plastic (or metal) incineration and landfill. That said, it must also be acknowledged that there can be an economic argument for switching to and maintaining single- use. This argument can be increasingly persuasive in areas, as in times of resource constraint.”
“Often it is safer and cheaper to choose a single-use plastic option,” commented Darby Booth. “It isn’t practical to use glass for syringes, for example – you certainly wouldn’t want to take a syringe apart,
144 Health Estate Journal October 2019
remove the needle, and reprocess it; the risks to staff and patients are simply too high.”
“As a business we offer single-use and reusable plastics,” added Janine Farmer. “We encourage the use of reusable plastics where clinically appropriate. For example, there has been a trend towards using disposable plastic instrument trays in recent years, but hospitals should be moving to reusable trays in theatres. “All healthcare manufacturers should follow an environmental plan and help hospitals evaluate the options.” Janine Farmer added that the quality of plastic is particularly important when reprocessing products. “Our reusable products are guaranteed for a minimum of 1000 decontamination cycles, which is very high,” she commented. “As autoclave technology advances, decontamination units are adopting more plastic items.”
Reducing and recycling packaging According to figures cited by the Healthcare Plastics Recycling Council, 85% of hospital waste generated is non-hazardous, while around 30% of theatre waste is plastic - mainly from packaging.5
The potential for plastics
recycling in hospitals is significant, but this requires careful management, and sorting plastics can prove a challenge. “Any plastic waste that has come into contact with bodily fluids is considered a biohazard. These products need to be
Plastics represented nearly 70% of all recyclable materials analysed during the pilot study. With over 20,000 pounds of plastics collected, the pilot case study facilitated a better understanding of plastics in the medical waste stream, and
disposed of in a yellow bag and sent to landfill – they cannot be recycled,” Darby Booth explained. “In addition, disposables may the only safe option in many instances.”
Reducing the carbon footprint Nevertheless, there are still ways to reduce their footprint, starting with how they are packaged. Sometimes, packaging can be excessive - an instrument might be packaged and then placed in yet another package. Analysis of hospital packaging is the first step towards delivering improvement, and there have been some high-profile projects underway, aimed at increasing the recycling of plastics in healthcare. Stanford Healthcare, in the US, partnered with the Healthcare Plastics Recycling Council in 2012 to conduct a pilot study documenting the following: n Recyclable material type, volume, and flow through target departments in the hospital.
n Clinical recycling process, including lessons learned and process recommendations.
n The process of establishing a recycling programme within the clinical setting.
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