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Growth in Medical Waste Poses Threat to Public Health

In the age of COVID-19, a team of researchers is developing a plan to turn single-use medical devices into a safe supply chain of reuse and reinvention

“Take, make, waste.” That, regrettably, is the unsustainable pattern seen across many industries.

One industry that may surprise you is health care. The current structure of the health care supply chain is not conducive to reducing greenhouse gas emissions, making the United States responsible for a disproportionate share of the world’s medical waste.

Consider a simple blood pressure cuff: These medical devices can easily be reused with proper cleaning, yet many are manufactured as a single-use disposable product.

But what if the United States could transform its linear health care economy into a circular economy that is “restorative and regenerative by design”?

A team of researchers across disciplines and institutions are mapping a route toward a more sustainable future for medical devices. Their research, recently published in the December issue of Health Affairs, reveals the barriers to achieving this goal and proposes policy and market-driven solutions to transform the health care supply chain in the United States.

Leading the work for the University of Pittsburgh is Melissa Bilec, associate professor of civil and environmental engineering in the Swanson School of Engineering. The first and corresponding author is Andrea MacNeill, clinical associate professor of surgery at the University of British Columbia, and the senior author is Jodi Sherman, associate professor of anesthesiology and epidemiology at Yale University.

“We’ve started to believe that single-use is required to reduce infection, but there is an overreliance on that model,” Bilec said. “When you look at this issue from a broader perspective, the manufacturing and disposal of these single-use devices is contributing to environmental and public health issues.”

One of those environmental impacts is climate change, which negatively influences human health and has been shown to disproportionately affect marginalized communities. 

The health sector is responsible for 4.6 percent of global greenhouse gas emissions, and the United States contributes to more than a quarter of that total. The result, the researchers found, is up to 614,000 disability-adjusted life-years (DALYs) lost annually.

“A circular economy aims to maximize material value and minimize waste by employing cycles of reuse, reprocessing, repair, recycling, and other strategies to extend the longevity of a product,” Bilec explained. “Though this concept faces barriers globally among consumers, manufacturers and regulatory structures, we focused our research on the United States.”

The article cites perceptions regarding infection prevention, behaviors of device consumers and manufacturers, and regulatory structures that encourage the proliferation of disposable medical devices as barriers to achieving a circular economy. 

Innovation in a time of crisis

The reaction to the current COVID-19 pandemic is an extreme example of the amount of waste that can accumulate in this industry. The one-time use of plastic and disposable personal protective equipment (PPE) has skyrocketed during the coronavirus pandemic with facial coverings, shields, and gloves being used – and often disposed of incorrectly – by the general public. Think of the discarded PPE you have undoubtedly seen in grocery store parking lots or other public environments.

While safe and sustainable medical waste management concerns have been amplified in 2020, the COVID-19 pandemic has also revealed the impact of reuse and reinvention in the health care sector. 

“In this past year, manufacturers in the automotive industry jumped into the medical device sector to produce ventilators. Makers across the world recycled scraps of fabric to create invaluable face coverings. Faculty and students in the Swanson School repurposed equipment to produce sanitizer for local hospitals,” Bilec said. 

“These are all examples of how everyday people applied innovation in a time of crisis to benefit public health. If we steer this innovation toward establishing a circular economy, we can begin to reduce the negative environmental impact in this industry.”

The group has been working in the sustainable health care space for several years, but due to perceived responsibility gaps in U.S. funding agencies, it remains difficult to get financial backing. They continue to forge ahead because they believe that improvements in the healthcare sector are critical in our sustainability progress.

Bilec was a co-author of the medical device study, as were Aman Khanuja, Robert Lagasse and Saed Alizamir of Yale University, Harriet Hopf of the University of Utah, Matthew J. Eckelman of Northeastern University, Lyndon Hernandez of the Medical College of Wisconsin, Forbes McGain of the University of Melbourne, Kari Simonsen of the University of Nebraska, Cassandra Thiel of New York University, and Steven Young of the University of Waterloo.

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Contact: Leah Russell