The estimated disposable plastic associated with each COVID-19 RT-PCR test performed is 822 grams - including necessary PPE. This speaks to a sustainability goal shared by healthcare and life science alike - reducing biohazardous waste. Clinicians and researchers point to achievable steps to take now and achievements to strive for. Life science should listen in.
Eco-health
For many years hospitals and clinical labs have recognized their own responsibility in eco-health, a term that refers to the interplay between human health and the environment. Tania Morin, a medical student at McGill University who is part of the Inspire Sustainability initiative to green healthcare outlined this concept for me last Earth Day.
Chemical and biological waste management is a strong focus in eco-health according to an Environmental International paper calling for a new scientific framework to meet long-term eco-health research needs. Chemical pollution is implicated in infectious disease emergence. Pollution contributes to biodiversity decline via food chain impacts. In turn, such biodiversity losses risk the dilution effect. While the effect is unproven, it has been observed that pathogen transmission is lowered when there is a larger number of poor-quality reservoir species. Whereas disease transmission increases when there is a smaller population of high-quality reservoir species. Chemical pollution can also drive pathogen evolution through mutation. Another long lamented issue is that antibiotics and disinfectants that enter wastewater raise risks for increased resistance in pathogenic microbes. Further, pollution-related immune toxicity in humans and animals opens a backdoor for increasing pathogen prevalence. Not to mention the fact that waste disposal accounts for 25% of healthcare expenditure in non-pandemic times.
With so many balls in the air, biomedical researchers have examined COVID-19 pandemic-related pollution and drawn a few conclusions that are also relevant to life science lab work.
Increase sorting for biohazardous waste
Given eco-health concerns, and the limits of material science to validate more eco-friendly chemicals and devices for biomedical work, numerous sustainability studies looked awkwardly in the mirror at conventional healthcare facility disposal.
Single-use plastic contributes to incineration and landfilling waste streams. One report estimated that each COVID-19 RT-PCR test generated 37 g of plastic waste. Another included required PPE for the staff running these tests which bumped up that number to 822 grams. As of October 2021, The CDC reports a total of 597,258,741 RT-PCR and Isothermal amplification-based tests have been taken in the United States alone. Let’s ballpark that to 491 million kilograms or 541 tons of single-use plastic from COVID-19 tests. And that’s a drop in the giant bucket of global biomedical waste - which increased from 200 tons each day to 29,000 tons each day.
Here comes the key take-away.
Biohazardous waste can be reduced without sacrificing health and safety. The majority is incinerated because it’s cost-effective. Unfortunately, high-temperature waste-to-energy incineration services with gas emission controls are not widely available. Working with what is available - sustainability researchers have called for sorting out non-hazardous waste from biomedical streams as an achievable step for developing countries with huge potential to reduce incineration and landfill pollution and costs.
Sorting may be an uncommon practice for healthcare waste in developing countries, but it’s a critical lesson for all life science labs. Even high-tech lab facilities have some potential to improve sorting non-contaminated materials from biohazardous waste collections. This can be accomplished by improving end-user awareness so non-contaminated waste never enters the biohazard stream. It can be done with a single stream waste service that sterilizes then sorts recyclable plastics out of a mixed collection. Triumvirate Red 2 Green is a valuable service available on the East Coast in the United States. Some hospitals in the U.K. are using the Sterimelt machine from Thermal Compaction Group which was shortlisted for the Lord Carter innovation award at the Hospital Innovation Exhibition in London to safely process biohazardous plastic waste into marketable blocks of plastic on site. Infection control and preventing lab contamination are always paramount but they don’t need to be in conflict with sustainability.
Barriers
We still need to be realistic. Material science is an extremely challenging field. Every material must be validated for each use case. There is no pretending that we have a biodegradable plastic suitable for extracting nucleic acids and growing cell lines. Medical-grade lab plastics do have an environmentally friendlier advantage over consumer-grade plastics because they are not supposed to leach. In that sense once segregated by type and decontaminated, biomedical plastics are a better recyclate.
There is also no pretending that there is a downstream market for all theoretically recyclable materials today. Recycling biohazardous waste with a guaranteed downstream market for collected materials is a premium service. Sterilization and segregation are additional process burdens. Higher volumes drive down costs but the big barrier is the limited appetite of the market for re-usable items manufactured from recycled resins.
Biohazardous recycling is not perfect. It can be the best option. Simple actions like not adding non-contaminated waste to a biohazardous collection are always powerful.
Eco-friendly healthcare champions
To end on a lighter note, I’m delighted to share news reported in Forbes about an innovative solution from a pair of University of California Irvine M.D.s that was recognized by the World Health Organization 2021 Compendium of Innovative Medical Devices for COVID-19. Their non-profit Recyclablu donates face masks to homeless communities in Los Angelos and is working to send donations to India.
The material source? Surgical sterilization blue wrap, or what we might recognize as autoclave wrap. It is composed of three layers of cloth and polypropylene making it tricky to recycle. Typically it is landfilled. Healthcare generates enormous volumes of the stuff. Rarely blue wrap is recycled by hospitals with services like New Hampshire’s Circular Blu.
Cheers to Recyclablu! The WHO recognized that diverting medical waste from landfills and remanufacturing the material into masks that are donated supports the dignity of the human person. How true it is!