SUS TAINABL E HEALTHCARE
Challenges of delivering sustainable solutions
Dan Sullivan points out that reliance on disposable PPE has been exacerbated by COVID-19, but says it is symptomatic of a deeper misperception of sustainable options.
By July of 2020, 2.3 billion items of single- use PPE had been distributed to health and social care services in England, the same number consumed in the whole of 2019.1
Global shortages in the face of the surge in demand following the COVID-19 pandemic saw the disposable PPE industry rocket in value from $800m to $166bn as governments raced to secure enough resources.2
There were several unfortunate environmental consequences to this change in the market. First was the amount of PPE that had to be sourced from as far afield as Turkey, China and Korea. Such a long supply chain was not only vulnerable to disruption, it brought with it soaring CO2
emissions
from air freight and shipping. In some cases, this led to the inevitable situation of PPE reaching the UK market and being rejected as sub-standard, much to the frustration of the policy-makers responsible for awarding the contract.3 All NHS Trusts are striving to meet the
2042 deadline for becoming carbon neutral. However, the current situation means that an average NHS Trust disposes of 72,0004 items of disposable PPE every day. With 223 Trusts in the UK at the moment, it is no wonder that the NHS accounts for 5% of the UK’s carbon footprint. A single-use gown is disposed of either by being placed in landfill or by being incinerated. Neither option is ideal for the environment; an average gown takes 450 years to decompose based on products made of similar materials,5
and
that is assuming none of the plastic makes its way into the oceans as microplastic
The UK Textiles Association estimates that switching from disposable gowns to reusable would save the UK £1.2 billion annually, and a research study published by the Association of Perioperative Registered Nurses calculated the switch would reduce carbon emissions from the PPE life-cycle by 66%.
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pellets or is simply tossed away through accident or negligence. One Hong Kong beach for example, found 70 face masks within 100m of each other.6
Incineration offers a slightly
cleaner option thanks to the air-scrubbing technology that reduces the emissions produced by the incineration process. However, the COVID-19 pandemic saw the incineration industry in crisis, unable to meet the strain on their services and relying on the relaxing of regulations to enable the sheer volume of infectious waste to be put through municipal and mobile incinerators.7 There appears to have been a global consensus that disposable PPE was bad, but not as bad as a PPE shortage in the midst of a pandemic. This was a reasonable calculation, but the danger now is that the demand for disposable PPE becomes driven by convenience rather than necessity. The ubiquitous use of single-use PPE has led to a perception by some that disposable PPE is safer – the idea that a soiled item is immediately destroyed seems more reassuring than donning an apron that has already been in repeated use in infectious conditions. There is also the trend of what
JANUARY 2022
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