The Healthcare Industry: Plastics, Emissions, Surgery & Sustainability

Key unaddressed issues of sustainability within healthcare include high volumes of waste plastic, and the use of anaesthetic gases with a high greenhouse gas potential.  This white paper explores the role of plastic in healthcare, offering alternative materials. Analysing waste management allows identification of recyclable plastics to reduce the open loop plastic waste.  The energy and waste intensive field of surgery is discussed, highlighting the contribution of anaesthetic gases to the carbon footprint of surgery, alongside the identification of low carbon alternatives. 

NHS England estimates that it is responsible for 4-5% of England’s carbon footprint. With current global consensus moving towards net-zero emissions, it is imperative that healthcare plays a significant role [1]. Reducing the carbon footprint of healthcare could play a vital role in meeting climate targets, with NHS England pledging to become one of the first net-zero healthcare providers by 2040 [2].

The versatile class of materials, plastics, have become an integral component of modern medicine. Plastics, in various forms, find extensive use within medical consumables [3]. Many plastic items used within a medical context are “single-use”, with estimations showing that only 5% of plastic waste used within the healthcare system of the United Kingdom is recycled[4]. In contrast, only 15% of medical waste is classed as being biohazardous, which requires incineration due to biosecurity concerns[4]. 

It is projected that while plastic use and waste disposal plays a substantial role within the carbon footprint of healthcare (< 30%) [2], one of the main contributors to healthcare emissions is the use of anaesthetic gases. Global estimates place the use of anaesthetic gases as being equivalent to one million cars being on the road [5]. Anaesthetic gases such as nitrous oxide and desflurane are the single biggest contributor to NHS England’s carbon footprint, accounting for ~40% of the total emissions [6]. These anaesthetic gases have a much higher CO₂e, for example desflurane has a CHG potential 2,540 times greater than carbon dioxide. However, finding alternatives or changing working practices   of anaesthetic gases is more complicated than reducing the use of plastics due to the regulatory framework around anaesthesia.

Medicine is made up of many divisions (Paediatrics, Neurology, etc.).  The field of surgery is one of the most energy, waste, and plastic intensive aspects of healthcare [6]. It is estimated that operating theatres consume 3-6 times more energy than other parts of a hospital [6]. E.g., the number of single-use plastic items for simple surgeries such as a tonsillectomy can require over 100 items of single-use plastics [7]. These include items such as gowns, hats, instruments, packaging, and drapes, all of which could be substituted for more sustainable, multi-use alternatives [7]. Furthermore, there is an increasing trend towards more sustainable practices within surgery, with the four surgical colleges of the UK publishing pledges outlining strategies to improve the environmental impact of surgery [6]. This paper discusses the common plastics used throughout surgery and healthcare, alongside their environmental impact with regards to their usage and possible solutions in-terms of alternatives and waste handling including a discussion focussing on surgery.

We will discuss the common types of plastics used within healthcare and possible alternatives including waste management. We will then consider the carbon footprint of surgery.