Environmental impact of personal protective equipment distributed for use by health and social care services in England in the first six months of the COVID-19 pandemic

Rizan, Chantelle; Reed, Malcolm; Bhutta, Mahmood F.

doi:10.1177/01410768211001583

Cited by 117 publications

(99 citation statements)

References 10 publications

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“…2020 ), and single-use medical devices and products used during hysterectomy ( Unger et al. 2017 ); and d ) items used in, but not specific to, surgery, such as personal protective equipment (masks, gloves, aprons, gowns, and face shields; Rizan et al. 2021 ), surgical face masks ( Allison et al.…”

Section: Resultsmentioning

confidence: 99%

“…2008 ), and service provision over a designated period (anesthetic equipment, McGain et al. 2017 ; personal protective equipment, Rizan et al. 2021 ; and reprocessed medical devices, Unger and Landis 2016 ) or to support a designated number of hospital beds or patient days of care (sharps containers, Grimmond and Reiner 2012 ; McPherson et al.…”

Section: Resultsmentioning

confidence: 99%

“…HG, Horton General NHS Trust, United Kingdom; JRH, John Radcliffe Hospital, United Kingdom. References: (1) McGain et al 2010 ; (2) McGain et al 2017 ; (3) McGain et al 2012 ; (4) Allison et al 2020 ; (5) Lee et al 2021 ; (6) Schmutz et al 2020 ; (7) Davis et al 2018 ; (8) Liang 2019 ; (9) Eckelman et al 2012 ; (10) Sherman et al 2018 ; (11) Leiden et al 2020 ; (12) Grimmond and Reiner 2012 ; (13) McPherson et al 2019 ; (14) Donahue et al 2020 ; (15) Ison and Miller 2000 ; (16) Vozzola et al 2018 ; (17) Vozzola et al 2020 ; (18) Carre 2008 ; (19) Van den Berghe and Zimmer 2011 ; (20) Rizan et al 2021 ; (21) Ibbotson et al 2013 ; (22) Mikusinska 2012 .…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-eight studies assessed environmental impact contributions from equipment used in surgical settings, including a) general surgical items, such as gowns (Carre 2008;Van den Berghe and Zimmer 2011;, drapes (Vozzola et al 2018), scrubs (Mikusinska 2012), scissors (Ibbotson et al 2013), suction receptacles (Ison and Miller 2000), deep vein thrombosis (DVT) compression sleeves, pulse oximeters, LigaSure devices, harmonic scalpels, endoscopic trocars, arthroscopic shavers, scissor tips (Unger and Landis 2016); b) anesthetic equipment, such as anesthetic drug trays (McGain et al 2010), laryngeal mask airways (LMA; Eckelman et al 2012;Liang 2019), laryngoscope blades and handles (Sherman et al 2018), central venous catheter insertion kits (McGain et al 2012), and anesthetic equipment at two hospitals (McGain et al 2017); c) items specific to particular procedures or specialties, such as titanium alloy knee implants (Lyons et al 2021), custom packs used to deliver newborns (Campion et al 2015), ureteroscopes (Davis et al 2018), spinal fusion instrument sets (Leiden et al 2020), and single-use medical devices and products used during hysterectomy (Unger et al 2017); and d) items used in, but not specific to, surgery, such as personal protective equipment (masks, gloves, aprons, gowns, and face shields; Rizan et al 2021), surgical face masks (Allison et al 2020;Lee et al 2021;Schmutz et al 2020), medical gloves (Weisz et al 2020), urinary catheters (Stripple et al 2008), sharps containers (Grimmond and Reiner 2012;McPherson et al 2019), and vaginal specula (Donahue et al 2020).…”

Section: Equipment and Materialsmentioning

confidence: 99%

“…In contrast, eight other studies aligned their functional unit with the lifespan of the reusable item (e.g., maintenance of 40 airways using either 1 reusable LMA or 40 singleuse LMAs in Eckelman et al 2012). Other functional units employed included: per item (disposable custom packs, Campion et al 2015;knee implants, Lyons et al 2021), per kilogram (medical gloves, Weisz et al 2020), per procedure (Unger et al 2017), per kilogram of collected bodily fluid (suction receptacles, Ison and Miller 2000), use over a designated period (surgical masks, Allison et al 2020;Schmutz et al 2020;urinary catheters, Stripple et al 2008), and service provision over a designated period (anesthetic equipment, McGain et al 2017; personal protective equipment, Rizan et al 2021;and reprocessed medical devices, Unger and Landis 2016) or to support a designated number of hospital beds or patient days of care (sharps containers, Grimmond and Reiner 2012;McPherson et al 2019). Study system boundaries were set as cradle-to-grave in all studies, except in Weisz et al (2020), where a cradle-to-manufacturer-gate analysis was undertaken.…”

Section: Equipment and Materialsmentioning

confidence: 99%

See 4 more Smart Citations

Operating in a Climate Crisis: A State-of-the-Science Review of Life Cycle Assessment within Surgical and Anesthetic Care

Drew

Christie

Tyedmers

et al. 2021

Environ Health Perspect

103

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BACKGROUND: Both human health and the health systems we depend on are increasingly threatened by a range of environmental crises, including climate change. Paradoxically, health care provision is a significant driver of environmental pollution, with surgical and anesthetic services among the most resource-intensive components of the health system. OBJECTIVES: This analysis aimed to summarize the state of life cycle assessment (LCA) practice as applied to surgical and anesthetic care via review of extant literature assessing environmental impacts of related services, procedures, equipment, and pharmaceuticals. METHODS: A state-of-the-science review was undertaken following a registered protocol and a standardized, LCA-specific reporting framework. Three bibliographic databases (Scopus ® , PubMed, and Embase ® ) and the gray literature were searched. Inclusion criteria were applied, eligible entries critically appraised, and key methodological data and results extracted. RESULTS: From 1,316 identified records, 44 studies were eligible for inclusion. The annual climate impact of operating surgical suites ranged between 3,200,000 and 5,200,000 kg CO 2 e. The climate impact of individual surgical procedures varied considerably, with estimates ranging from 6 to 1,007 kg CO 2 e. Anesthetic gases; single-use equipment; and heating, ventilation, and air conditioning system operation were the main emissions hot spots identified among operating room-and procedure-specific analyses. Single-use equipment used in surgical settings was generally more harmful than equivalent reusable items across a range of environmental parameters. Life cycle inventories have been assembled and associated climate impacts calculated for three anesthetic gases (2-85 kg CO 2 e=MAC-h) and 20 injectable anesthetic drugs (0:01-3:0 kg CO 2 e=gAPI). DISCUSSION: Despite the recent proliferation of surgical and anesthesiology-related LCAs, extant studies address a miniscule fraction of the numerous services, procedures, and products available today. Methodological heterogeneity, external validity, and a lack of background life cycle inventory data related to many essential surgical and anesthetic inputs are key limitations of the current evidence base. This review provides an indication of the spectrum of environmental impacts associated with surgical and anesthetic care at various scales.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Equipment and Materialsmentioning

confidence: 99%

Section: Equipment and Materialsmentioning

confidence: 99%

See 3 more Smart Citations

Operating in a Climate Crisis: A State-of-the-Science Review of Life Cycle Assessment within Surgical and Anesthetic Care

Drew

Christie

Tyedmers

et al. 2021

Environ Health Perspect

103

View full text Add to dashboard Cite

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Environmental Impacts of Personal Protective Clothing Used to Combat COVID‐ 19

Uddin

Afroj

Hasan

et al. 2021

Advanced Sustainable Systems

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Personal protective clothing is critical to shield users from highly infectious diseases including COVID‐19. Such clothing is predominantly single‐use, made of plastic‐based synthetic fibers such as polypropylene and polyester, low cost and able to provide protection against pathogens. However, the environmental impacts of synthetic fiber‐based clothing are significant and well‐documented. Despite growing environmental concerns with single‐use plastic‐based protective clothing, the recent COVID‐19 pandemic has seen a significant increase in their use, which could result in a further surge of oceanic plastic pollution, adding to the mass of plastic waste that already threatens marine life. In this review, the nature of the raw materials involved in the production of such clothing, as well as manufacturing techniques and the personal protective equipment supply chain are briefly discussed. The environmental impacts at critical points in the protective clothing value chain are identified from production to consumption, focusing on water use, chemical pollution, CO 2 emissions, and waste. On the basis of these environmental impacts, the need for fundamental changes in the business model is outlined, including increased usage of reusable protective clothing, addressing supply chain “bottlenecks”, establishing better waste management, and the use of sustainable materials and processes without associated environmental problems.

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Micro‐bacterial assessment of disposable gowns with a focus on green endoscopy in gastrointestinal endoscopy procedures: A Japanese pilot study for healthcare waste reduction

Naito,

Nakamura,

Muramatsu

et al. 2024

DEN Open

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ObjectiveThis study aimed to implement green endoscopy through the microbiological assessment of gowning techniques during endoscopy to reduce carbon emissions and separate medical waste.MethodsTwenty‐five patients who performed esophagogastroduodenoscopy from March to May 2024 were included in this study. Four sections of the isolation gowns (anterior, posterior, right, and left) were cut into 2 cm2 after endoscopy, and the rate of microbial contamination was examined using the stamp method.ResultsThe endoscopic examination time was 8 min (6−12), and endoscopy was performed by 10 expert endoscopists, six endoscopists, and nine residents. The overall isolation gown contamination rate was 56%, with 25%, 20.8%, 20.8%, and 33.3% in the front, back, as well as right and left arms, respectively. The rates of isolation gown contamination rates in the expert endoscopists, endoscopists, and residents groups were 30%, 50%, and 77.8%, respectively, with a higher rate in the residents group. Regardless of the physician's performance, bacterial detection was consistently higher in the left arm (42.9% vs. 40% vs. 25%; p = 0.093). The detected bacteria comprised 58% Gram‐positive and 42% Gram‐negative organisms, including those from tap water used for endoscopy bacteria and obtained from the participant's skin or mouth. No pathogenic organisms were detected.ConclusionsThe bacteria detected in disposable gowns after gastrointestinal endoscopy were non‐pathogenic. Thus, our findings suggest that changing all personal protective equipment of respective endoscopes might not be essential. We advocate for green endoscopy to achieve sustainable development goals and reduce medical waste.

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Environmental impact of personal protective equipment distributed for use by health and social care services in England in the first six months of the COVID-19 pandemic

Cited by 117 publications

References 10 publications

Operating in a Climate Crisis: A State-of-the-Science Review of Life Cycle Assessment within Surgical and Anesthetic Care

Operating in a Climate Crisis: A State-of-the-Science Review of Life Cycle Assessment within Surgical and Anesthetic Care

Environmental Impacts of Personal Protective Clothing Used to Combat COVID‐ 19

Micro‐bacterial assessment of disposable gowns with a focus on green endoscopy in gastrointestinal endoscopy procedures: A Japanese pilot study for healthcare waste reduction

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