Decontamination
Pointing to a slide (see Table 1), Paul said PPE demand data from early October 2022 showed that just a 15% reduction in the use of the examination gloves across the health and social care sector across England would bring a £24 m saving, and a 27,000-tonne carbon reduction. His team has been piloting a new dispenser – from which the user simply pulls the glove out, cuff first, from the bottom of the unit, puts it on, and then pulls out the next one. He said: “The dispenser only dispenses one glove at a time – rather than five dropping onto the floor, and the user then putting four of them in the bin.” Paul added the indications were that such a dispenser could reduce waste by about 10%, equating to a year-on-year financial saving of another £16 m. He added: “In fact the 15% figure is probably higher, because Great Ormond Street achieved that 33% reduction before the pandemic, and there is probably a lot more glove wearing now. “So, that’s a 27,000-tonne potential carbon
reduction via the Glove MOOC, and an 18,000 tonne saving from the dispenser.” Turning to the team’s ‘other achievements’, he said: “We have identified a reusable Type IIR mask – which is currently being piloted in an acute setting at the Royal Devon & Exeter Hospital, and we’re also looking at doing a community pilot – because community settings don’t readily have access to compliant laundries. We’re thus going to the laundry to try and make it compliant. “This doesn’t, however, entail thousands of pounds’ worth of capital investment, but rather it’s about their processes, and making sure that they have got a quality management system in place. They have all the infrastructure and equipment, but we need to make sure they can be compliant with HTM 01-04, so we can ensure that these masks are laundered safely. They’re not allowed to be laundered at home, because they are classed as medical devices.” Paul said the team was also working with
Bollé on developing reusable eye protection, with the eyewear specialist designing and making a product specifically for health and care. He
Product TIIR
Aprons Visors
All users
Pre-COVID All
All users Pre-COVID
Reduction (%)
80% 80% 80% 80% 80%
Just a 15% reduction in the use of the examination gloves across the health and social care sector across England would bring a £24 m saving, and a 27,000-tonne carbon reduction.
explained: “We have seen four prototypes so far, and they look like cycling glasses. Designed to last at least two years, they’re scratch and fog- resistant, but we are currently looking at how we clean and decontaminate them safely. “At the moment, we know people use wet wipes – some of which are harsher than others – to clean eye protection, and that some are damaging the seals that are incorporated for the aerosol-generating procedures.” He explained that the aim is to pilot
renewable eye protection using Ozone and UVC: “We will choose two sites, installing an Ozone cabinet on one, and UVC on the other. We can then start to put them into a pilot to demonstrate that they’re safe, and to get some user feedback.” Paul pointed out that the goal is to ‘reduce’,
‘re-use’, and ‘recycle’. Masks can be made into blackout blinds, mattresses for homeless
Plastic
reduction (Tonnes)
5184 1620 3264 541 80
Waste saving (£)
£1,555,200 £486,000 £979,200 £162,240 £24,000
Carbon
reduction (Tonnes)
11,520 3,600 9,792 833 24
Table 1. Carbon, waste, and cost-saving benefits of reusable masks, visors, and aprons. 62
www.clinicalservicesjournal.com I September 2023
people, or shredded and made into other materials.
“Looking at re-use, and in terms of the Type IIR masks we currently use, you could save 5,184 tonnes of plastic going into waste, and – working on a £300 / tonne disposal cost – also save over £1.5 m, while simultaneously reducing carbon by 11,500 tonnes,” he commented. Paul added that plastic aprons also create a
lot of waste: “Our key message is that if you do need to wear an apron, please wear a reusable one. They are available; they can be laundered through the same process and can be used up to 75 times. If we went over to reusables, reducing the number of aprons used by 80%, this would save nearly 10,000 tonnes of carbon, 3,264 tonnes of waste, and again, circa £1 m saved, year-on-year,” he commented. Professor Bu’Hussain Hayee, Professor of
Gastroenterology at King’s College London (KCL), also gave a call to action at the CSC Autumn Study Day. He explained that endoscopy is the third highest generator of waste in healthcare. There are a number of reasons for this: endoscopy involves a high throughput of cases; it has multiple non-renewable waste streams; it requires resource-heavy decontamination processes; and it involves numerous hospital visits for patients and relatives. Each endoscopy generates 2.1kg of disposable
waste (46L volume) and most of this waste goes to landfill (64%). Biohazardous waste accounts for around 28%, while only 9% of
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