“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
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
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.
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
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.
# # #
Contact: Leah Russell