As often as I have railed against the proliferation of plastic materials in our lives, I have always made an exception about medical products and devices. For one thing, as someone with absolutely no medical expertise, I feel totally unqualified to comment on the judgment of medical professionals about devices and practices that save people’s lives.

This summer, the issue came home, when my deteriorating eyesight and advanced cataracts finally made corrective surgery necessary. Plunged into more intensive doctoring than I have ever experienced, I couldn’t help observing how ubiquitous plastic materials are in this realm, from the furnishings of the examining room to diagnostic devices— many with disposable single use parts—to supplies like IV tubes, plastic gloves, tapes and syringes, right down to the implanted lenses that now, miraculously, enable me to see better than I have since childhood.

There’s no doubt that plastic materials have revolutionized medical practice in terms of hygiene, safety and cost. Single-use plastic items help preserve a sterile environment and avoid the spread of pathogens. Plastic has been important to the development of innovative devices like replacement joints and more comfortable prosthetics, and has enhanced safety through tamper-proof packaging, shatter-proof devices and impermeable plastic coatings for essential supplies like biohazard bags that protect the people who handle contaminated materials.

But there is also no doubt that all this plastic has created a tremendous waste problem. By one estimate, U.S. hospitals produce more than five million tons of waste per year, about 29 pounds per patient per day. The waste stream includes infectious items such as bandages and gloves, hazardous chemical and radioactive waste, as well as general waste, a category that includes paper and single-use plastics.

The World Health Organization has estimated that roughly 80 percent of hospital waste falls into this general waste category; about 55 percent of it is plastic, and only about 20 percent of that plastic is recycled. The COVID pandemic and the subsequent global campaign for immunization increased the plastic waste stream by creating even greater demand for disposable gloves, syringes and PPE.

Delving a bit, I’ve gotten a glimpse at the extraordinary complexity of sustainability in the medical industry. For example, energy use is another huge challenge. According to the U.S. Department of Energy’s 2021 Energy Star technical guidance for benchmarking a range of building types, U.S. hospitals are among the country’s most energy-intensive buildings, ranking just behind fast-food restaurants and supermarkets.

Exposure to disinfectants like benzalkonium chloride (BAC), widely used in hospital settings, can be a hazard for health workers, and hospital wastewater can contain high levels of BAC and pharmaceuticals, contributing to pollution of soil and water in surrounding communities. And much of the plastic used in hospitals is polyvinyl chloride (PVC), which is commonly used in flooring and walls but is also used in many disposable medical devices. PVC off-gasses toxic chlorine-based compounds that are harmful to human health and the environment.

Learn more at:

Health Care Without Harm

noharm-uscanada.org/issues/us-canada/waste-management

Practice Greenhealth

practicegreenhealth.org/

U.S. energy-use intensity by property type

portfoliomanager.energystar.gov/pdf/reference/US%20National%20Median%20Table.pdf

The industry is finding ways to address these challenges without compromising patient health and safety. One group involved globally is Healthcare Without Harm, a nonprofit working to reduce the industry’s environmental footprint and create climate-resilient healthcare systems. It is transforming the medical supply chain through meticulously researched procurement guidelines for medical facilities, with detailed approvals in 10 key product categories that can transition from disposable to reusable with no risk to patient health or safety. The group’s Healthcare Climate Challenge has secured the commitment of more than 300 health institutions representing more than 22,000 hospitals in 40 countries, an engagement in effective climate action, including the decarbonization of their operations.

An affiliated network, Practice Greenhealth, operates in the U.S. and Canada, working with more than 1,400 hospitals and health networks including the U.S. Veterans Administration, the Army’s MedCom facilities and Kaiser Permanente. In addition to the complicated problem of medical waste and single-use plastics, Practice Greenhealth advises on energy efficiency and renewable energy, healthy buildings and building materials, and reduction of chemical exposure in medical facilities and in the surrounding community. It also tackles healthier meals and support for community food systems, sustainable procurement and reduction of harmful chemicals and excessive packaging, greening healthcare-related transportation for both patients and staff, and reducing water consumption.

This monumental effort is driven less by consumer demand and more by the ethics of the medical profession, embodied in the phrase “do no harm.” The prospect of containing healthcare costs through energy efficiency, the transition to renewable energy sources, and the strategic reuse of materials and supplies where it is safe and appropriate also matters. I was encouraged to find such a strong commitment to sustainability, with an emphasis on leadership that goes beyond compliance and recognizes that access to healthcare, climate resilience and environmental justice are closely intertwined.