Where the health is the sustainability?

SUSTAINABILITY IN HEALTHCARE IN A COVID POSITIVE WORLD

“PPE”. It’s bewildering to think that only a couple of years ago the acronym for Personal Protective Equipment would scarcely be used, let alone understood, outside of a science lab or a construction site. Now in our COVID positive world, tracking down a person who has managed to avoid using single-use PPE, whether it be a mask or a face shield, is a task akin to finding a needle in a haystack. Attempts to reduce the spread of COVID by avoiding the shared handling of goods have resulted in an increase in the consumption of single-use plastic items. But while the pandemic may have sent you and I back to using disposable coffee cups and leaving our reusable containers at home, hospitals and medical facilities have seen dramatic increases in their plastic waste production with the increased demand for single-use PPE, causing an environmental nightmare. Infection prevention is of course paramount, but surely there are ways to reduce plastic waste while preventing contamination? Environmentalists and innovators everywhere are fronting up to the challenge of preserving sustainable practices in a pandemic-stricken world.


Waste production in healthcare has increased dramatically since the beginning of the pandemic. After finally having reached the top of political agendas across the globe, the implementation of many plastic-reduction policies were stopped dead in their tracks alongside the emergence of COVID-19 (Patrício Silva et al., 2020). The coronavirus was taking lives and livelihoods and the only thing on anyone’s mind was how to stop the spread of the virus. With a ticking clock and uncertainty surrounding the virus’ ability to persist on surfaces of different materials, single-use PPE was an attractive solution to stop the spread of COVID-19. Single-use PPE boasts sterility and disposability, so fresh items are guaranteed to be virus-free and can be quickly discarded once contaminated. Due to the highly infectious nature of the coronavirus, medical staff are obliged to discard and re-don single-use masks, gloves, gowns and visors between patients to avoid spreading infection throughout the hospital. This effort to prevent disease leads to multiple discarded sets of PPE for each staff member on each shift. While risk of infection may be adequately disposed of along with single-use equipment, the environmental impact of such volumes of plastic waste is not out of sight or out of mind (Ammendolia et al., 2021).


There is great interest in sustainability in healthcare, particularly in this time of increased PPE necessity. While human health and infection prevention have justifiably been prioritised in confronting the coronavirus, there has been a corresponding demand for the consideration of reusable and recyclable PPE in healthcare. This demand stems not only from a desire to reduce plastic waste for environmental reasons, but also emerges out of necessity in the face of world-wide shortages of single-use PPE (Rowan & Laffey, 2021). The disposal of plastic waste such as single-use PPE can have major environmental ramifications, leaching harmful chemicals into the environment and allowing microplastics to make their way into the food chain. Reusable protective equipment seems an obvious choice for resource preservation and waste reduction, but the process of decontaminating PPE has proved to be a bigger challenge than one might anticipate. With myriad great minds supercharged by pandemic-scale pressure and the desperation associated with diminishing resources, COVID-19 has resulted in the development of some very impressive innovations in the realm of waste reduction.


Difficult times though call for ingenious innovations, and one dedicated team has managed to pair sustainability with infection prevention in a ground-breaking device. The ‘ventilation hood’, produced in Melbourne by hospital-based researchers and engineers, was designed to provide ventilation of infectious airborne particles produced by patients with respiratory illnesses. The hoods hang over a hospital patient’s bed, covering the upper body area so that the patient’s upper body is in a kind of igloo. The hood’s primary purpose is to protect healthcare workers from exposure to infectious airborne particles such as those produced by patients with COVID-19. The hood is transparent and mobile, consisting of a metal frame, a HEPA filter/extraction fan unit, and a clear plastic cover to defend against droplets and airborne particles. The hood looks similar to a pram hood and while the frame and fan/filter can easily be reused between patients, the reusability of the quintessential plastic cover would have posed a problem to which single-use plastic could have easily presented a solution. Despite this, the team opted for a reusable plastic cover made of PVC which is not only washable on-site in an industrial washing machine but is also a recyclable plastic.


Nurse researcher Sam Bates was involved in the development and testing of the hood at a Melbourne hospital and celebrated its success in the sphere of sustainability, saying that the hood has “absolutely made an impact on reducing single-use waste disposal”. As far as sustainability is concerned, the healthcare arena is a daunting one to tackle because of strict infection control principles and regulatory guidelines. Sam reiterates though that healthcare workers are genuinely concerned about environmental issues and are willing to collaborate to make reusable options work. “Unfortunately, single-use has become the foremost way of thinking in healthcare. We need to change that approach and instead explore reusable options as the first and preferred approach.”


It is heartening to see that even in the face of a global pandemic, environmentally conscious innovations are being prioritised in the healthcare environment. With the issue of single-use plastics an ever-growing concern around the world, new and innovative approaches to waste reduction are paving the way to a brighter future for people and the environment. The combination of inspired minds taking on sustainability challenges and pandemic-scale pressure has the potential to yield many more incredible innovations.

Ammendolia, J., Saturno, J., Brooks, A. L., Jacobs, S., & Jambeck, J. R. (2021). An emerging source of plastic pollution: Environmental presence of plastic personal protective equipment (PPE) debris related to COVID-19 in a metropolitan city [Article]. Environmental Pollution, 269. https://doi.org/10.1016/j.envpol.2020.116160


Patrício Silva, A. L., Prata, J. C., Walker, T. R., Campos, D., Duarte, A. C., Soares, A. M. V. M., Barcelò, D., & Rocha-Santos, T. (2020). Rethinking and optimising plastic waste management under COVID-19 pandemic: Policy solutions based on redesign and reduction of single-use plastics and personal protective equipment. Science of The Total Environment, 742, 140565.


Rowan, N. J., & Laffey, J. G. (2021). Unlocking the surge in demand for personal and protective equipment (PPE) and improvised face coverings arising from coronavirus disease (COVID-19) pandemic – Implications for efficacy, re-use and sustainable waste management [Review Article]. Science of The Total Environment, 752. https://doi.org/10.1016/j.scitotenv.2020.142259


Written by Cait O'Shea