HEALTHCARE & SUS TAINABI LT Y
Sustainability and single use
George I’ons discusses the impact of the single use on the environment and highlights some potential solutions to reduce the carbon footprint of disposable medical devices.
As the largest employer in Europe and one of the largest employers in the world, the National Health Service is a vast organisation which requires considerable volumes of goods and services to function. Consequently, the NHS is responsible for 4% of England’s total carbon footprint,1
with a significantly higher
percentage of plastic waste compared to other industries. The complexity of infection control means that only about 5% of this plastic waste is being recovered.2
In 2020,
for instance, the need to urgently control COVID-19 infection rates led to increased use of personal protective equipment (PPE), which tends to be made of plastic material and is intended for single-use only. By July, health and social care services in England were already set to surpass PPE distribution in the whole of 2019.3
This unavoidable
increase in plastic waste, exacerbated by the use of single-use face masks among the wider population, has raised greater awareness of the need to improve waste management in the medical industry.
The traditional method of medical
device disposal is incineration, which must increasingly become a last resort due to the environmental damage caused by the process. However, it must be noted that, where incineration cannot be avoided, there are strict European regulations limiting clinical waste emissions,4
and the UK will now need to set
its own limits. Additionally, there are innovative solutions available to contain impact to the environment, such as sophisticated filtering systems which can help to prevent toxic fumes from polluting the atmosphere.
Maintaining safety standards With approximately 90% of medical device waste consisting of disposable, single-use
In one UK take-back scheme, disposable and non-infectious PVC medical devices from over 30 participating hospitals, including oxygen masks, oxygen tubing and IV bags, are turned into products for the horticultural industry, such as tree ties.
APRIL 2021 products or components,5 the challenge
is to resolve the tension between infection control and sustainability. Limiting healthcare- associated infections (HCAIs) must remain a priority, with average HCAI rates at 7.1% in European countries6
and antimicrobial
resistance continuing to be a growing concern. As a consequence, there are strict regulatory requirements which demand single use for many invasive medical devices, as well as stringent measures to protect patients and healthcare workers from needlestick injuries associated with disposable sharps. However, the need to maintain strict safety standards may not be the only factor constraining manufacturers; sustainability measures must also be commercially viable. Disposable products may be a critical source of revenue, while reprocessing single-use devices for reuse can be costly or complex.
Complexities of sterilisation Apart from the cost, sterilising products for reuse comes with limitations. Firstly, sterilisation methods may not necessarily reduce environmental impact if cleaning processes consume higher levels of energy than manufacturing and disposing of single- use devices. Secondly, certain sterilants
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