When it comes to recycling medical plastics, hospital nurses are on the front lines: Their engagement is critical to a successful “green transition” in the healthcare sector. That was one of the key takeaways from a recent workshop at the Danish Technological Institute exploring recycling programs in medical facilities.

Medical device manufacturers, nurses and representatives from hospitals, the Danish Environmental Protection Agency, the Danish Medicines Agency and the PVCMed Alliance attended the workshop on Nov. 25, 2019, in Copenhagen, which focused on PVC, the most widely used plastic in hospitals. Stressing that the commitment of medical professionals is “crucial to the green transition of healthcare,” Mette Skriver Revsbech, a nurse at Copenhagen University Hospital, explained to attendees how much plastic waste is generated after just five surgical procedures. That realization motivated her co-workers to take part in a project to collect and repurpose 2,000 used oxygen masks, said Revsbech.

Tobias Johnsen of the PVCMed Alliance reinforced that message by discussing examples of recycling projects initiated in healthcare settings in Australia, New Zealand, South Africa, Guatemala and the United Kingdom, where it was “striking” that nurses were at the forefront.

One program in Australia is illustrative of what can be achieved. As reported in PlasticsToday in February 2019, the PVC Recycling in Hospitals program, developed by the Vinyl Council of Australia and sponsored by medical device OEM Baxter Healthcare, began in 2009 with a single healthcare provider and has since grown to more than 140 hospitals across Australia and New Zealand. It provides recycling bins and training material for staff. Nurses separate three PVC products—IV fluid bags, oxygen tubing and oxygen masks, none of which have been contaminated with bodily fluids or drugs, an important distinction as potentially contaminated materials must not enter the recycling stream. This possibility has stymied recycling efforts in medical facilities in the past; however, it should be noted that a vast amount of medical plastic waste, notably packaging, does not come in contact with patients.

Making worthwhile products from the recyclate is also a key tool for engaging medical personnel, who already have intense professional lives, in recycling initiatives. At the workshop, attendees were shown one example—school shoes donated to South African children living in deep poverty that were made from recycled medical plastics. It takes only 20 IV bags to make a pair of those shoes, according to workshop participants.

Efficient sorting of plastic waste also was a key discussion point. Attendees learned that In the capital region of Denmark, the plastic is collected at the hospital without further sorting, which is done outside the facility because of space considerations.

The PVCMed Alliance proposed a more low-cost solution, whereby sorting takes place in the respective hospital departments. Every hospital could use its own granulator that simply crushes the plastic. Sufficiently large quantities of recyclate can then be sold to a recycler. Such a practice poses no particular risk of infection, said the organization, which represents the PVC medical industry chain. Hospital waste is handled exclusively by professional nurses who know which patients could pose a risk. The experiences from Copenhagen University Hospital and around the world show that mis-sorting is extremely rare, according to PVCMed Alliance.

To simplify sorting and recycling efforts, it’s important to begin at the beginning and design products with recycling in mind, noted Annette Bitz from Danish medical device OEM Ambu. She presented a new design manual at the workshop, which makes the case that, as much as possible, a single type of polymer should be specified for the fabrication of a medical device. Plastics expert Peter Sommer-Larsen from the Danish Technological Institute cited the example of oxygen masks, which consist of soft and hard parts. They can be made either in PVC of varying softnesses, or two different types of polymers. Choosing the latter option makes recycling impossible, partly because of the plastics’ different melting points, stressed Sommer-Larsen. Considering the product's entire lifecycle at the design stage can lead to a more sustainable outcome when the device has fulfilled its primary purpose.

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