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A fact sheet published by the American Chemistry Council, a plastic trade group, says: “Single-use plastics are the cleanest, most efficient way,” to facilitate health and hygiene in hospitals.
But those working to make hospitals more sustainable say plastics have been overused.
In a survey of 332 hospitals that has not yet been published, Practice Greenhealth looked at common single-use plastic items in operating rooms that had been successfully replaced by reusable items. Tools like surgical basins and sterilization wraps could be reused and would reduce waste by several tons per year. Depending on where they cut back, hospitals could also save thousands of dollars a year, Practice Greenhealth says.
Recycling nightmare
“It worked for a while when China took it,” says Janet Howard, the director of engagement at Practice Greenhealth, of medical plastic waste. But now, she says of hospital recycling efforts, “We’re going backwards.”
In 2018, China announced it would no longer buy two-thirds of the world’s waste. That's leaving facilities little choice but to toss their commingled plastic waste into landfills or incinerators. PVC that ends up in incinerators can release toxic chemicals.
“There are still certainly different types of plastics that could be recovered that aren’t being recovered today for a number of reasons,” says Kim Holmes, the vice president of sustainability at the Plastics Industry Association.
“There are items used in patient care that don’t come in contact with patients so they’re not biohazards, and those could be recycled,” she adds, referencing things like packaging and storage containers.
In hospitals that do attempt to sort their plastic for recycling, Holmes says producing enough material to be attractive to a recycler is a challenge for any one single hospital and more effective when trash is aggregated from a number of locations. The Healthcare Plastics Recycling Council offers a toolkit for hospitals looking for a recycling network to join.
The ‘ick factor’
One of the most common plastic items thrown out of operating rooms is “blue wrap,” a sheet of polypropylene that covers sterilized tools that is removed and discarded before surgeries.
Its single-use nature removes what Howard called the ick factor, but it also leaves a small mountain of trash behind.
“It’s like after a holiday when you have that pile of wrapping paper on the floor,” she says. “That’s blue wrap in the operating room every day.”
Some hospitals, she says, are experimenting with replacing the blue wrap with reusable sterilization containers that can be made clean just like the instruments they contain.
Another profuse item in medical facilities is the sterilization pouch—a small, sealable pouch used to keep sterilized equipment free of germs.
It was a desire to ensure their tools were free of pathogens that led two sibling dentists, David and James Stoddard, to create a pouch of tightly woven fabric to house their sterilized dentist tools. Their company, EnviroPouch, was created in 1993 and purchased by Barbara Knight in 2001.
The Centers for Disease Control outlines strict standards for sanitizing medical instruments, and the pouches that contain them must be registered with the Federal Drug Administration, which EnviroPouch is.
Knight says the product she sells is more effective than plastic pouches because it forms a thicker barrier around sharp tools. Each pouch eliminates roughly 200 single-use plastic pouches, she says.
“The fabric weave makes it a very torturous path for a sharp [a medical term for any instrument with a sharp edge] to penetrate,” she says, as opposed to the film in a plastic pouch.
Knight says the dentists who created the pouch were inspired by the story of Kimberly Ann Bergalis, a woman who died in 1991 after being one of six American patients infected with HIV at the dentist.
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