HEALTHCARE & SUS TAINABI LT Y
may have toxic properties that harm the environment as well as people handling them. Lastly, some methods may not be suitable for all device types. For instance, for many devices, sterilisation with ethylene oxide is the only effective method that does not damage the device during the sterilisation process; in the United States, 50% of all sterile medical devices are sterilised with ethylene oxide. However, since this method releases harmful emissions, the US Food and Drug Administration is now encouraging the development of new methods or technologies to reduce dependence on ethylene oxide.7
Resistance to reuse
The acceptance of reprocessing single-use devices in the US, where the practice began in the 1970s,8
is not reflected in the UK
and Europe. The hazards of reprocessing have led the UK’s Medicines and Healthcare products Regulatory Agency to discourage the reprocessing and reuse of single- use products.9
In the European Union,
the Medical Device Regulation (MDR), which will come into force in May 2021, introduces strict reprocessing guidelines and places full product liability on the reprocessor. The safety and performance of reprocessed devices must be equivalent to the original device, in compliance with the MDR.10
been contentious,11
These new requirements have and the complexity
of compliance may discourage many manufacturers from choosing this route.
Recycling device materials Rather than reusing a medical device in its entirety, the device materials can be reprocessed and used for a different purpose. Polyvinyl chloride (PVC) – the most widely used plastic for medical devices, with a share of about 40% – can be recycled
several times without losing its critical properties.12
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.13 The collected and recycled PVC in the UK equates more than 550,000 oxygen masks, saving the NHS significant costs in waste disposal. Such schemes could be implemented on a much wider scale. Ongoing research and innovation could create increasingly efficient recycling options in the future. Emerging technologies for chemical recycling can be used for plastics that are difficult or uneconomic to recycle mechanically. One example of chemical recycling is depolymerisation, a reaction which breaks up a polymer into its original monomers, which can then be used, separately or together with virgin monomer, to make new virgin-grade polymers.14
This
is an important step towards a circular economy, keeping useful plastic materials in circulation rather than disposing of them unsustainably.
Sustainable design
Plastic usage and recycling possibilities should be factored in right from the initial stages of medical device design. There may be opportunities to reduce the use of plastic in the packaging of a device, as well as the device itself. Reducing the number of components in packaging or devices not only decreases plastic use, but may also simplify the manufacturing process, assembly of the final product, and recycling at the end of the product life cycle. For disposable products, manufacturers can strive to avoid materials that have a damaging impact on the environment during disposal and incineration. For instance, bio-degradable
polymers can contaminate a recycling stream and emit methane when incinerated, and methane has a carbon emissions impact that is twenty-five times greater than CO2
.
Improving manufacturing efficiency Energy use and environmental impact must be assessed across the whole life cycle of a product. Manufacturing processes contribute to the overall footprint of a product and making changes in this area may be less complex than making changes to the product itself. Measures such as improving energy efficiency or reducing water use also lead to immediate cost savings, making sustainability more commercially attractive. Owen Mumford has adopted onsite changes to ensure all energy is coming from clean, renewable sources, and are also investigating a wide range of materials and additives which can reduce the energy required to process into final product. For instance, using bio-based monomers made from natural sources such as wood pulp or sugar cane can offset the carbon emitted during processing. Logistics and modes of transport must also be planned for at the very beginning of the design process, so that energy efficient choices can be made, especially if there is a need for controlled temperature.15
Strengthening manufacturing efficiency and productivity often produces automatic sustainability benefits. Implementing ‘lean’ manufacturing methodologies to optimise inventory management or reduce overproduction is likely to decrease energy use. Similarly, new technologies designed to streamline manufacturing processes may also reduce waste. Taking a holistic view of how raw materials and production methods are being used across different products may reveal opportunities to streamline both resources and processes, enabling greater task agility across production lines.
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