Why Health Care Needs Sustainable Waste Stream Management

doi:10.1001/amajethics.2022.915

AMA Journal of Ethics

2022

DOI: 10.1001/amajethics.2022.915

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Why Health Care Needs Sustainable Waste Stream Management

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2024

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Cited by 2 publications

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Global Medical Supply Inequities

Sunilkumar,

Hicks,

Suresh

2024

Undergraduate Journal of Public Health

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The global issue of medical supply inequity exists as some countries have excess medical supplies, which leads to large amounts of medical supply waste resulting in both economical and environmental harm. However, many countries face the opposite issue and instead have a shortage of necessary, life-saving medical supplies. The duality of the issue is a harsh and widespread reality throughout the world. For example, the United States generates about 4.7 million pounds of medical waste yearly (Zygourakis et al., 2015; Thiel et al., 2020). In contrast, India, especially during the COVID-19 epidemic, faced a massive shortage of essential equipment like N-95 respirators, face shields, as well as ventilators. To reduce the worldwide inequities that arise due to the imbalance of medical supplies, Blueprints for Pangaea (B4P), a medical surplus recovery organization was founded. B4P, headquartered at the University of Michigan in Ann Arbor, redistributes unused medical supplies to places in need both locally and internationally, effectively reducing medical supply inequities one shipment at a time. This paper aims to explore the key components and global dynamics contributing to medical waste and to consider B4P as a potential model for addressing this problem.

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Global Medical Supply Inequities

Sunilkumar,

Hicks,

Suresh

2024

Undergraduate Journal of Public Health

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Environmental Impact of Overtreatment of Distal Radius Buckle Fractures

Zainab,

Sandefur,

Peterman

et al. 2024

JAAOS Glob Res Rev

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Introduction: Pediatric buckle fractures are common. Current literature supports a single provider visit with education and removable wrist brace/bandage, without additional follow-up visits. Potential overtreatment through casting and follow-up visits may impose a substantial environmental burden through waste generated from casts and vehicular CO2 emission. This study seeks to estimate the national environmental impact of buckle fracture overtreatment through geospatial analysis extrapolated from a review of buckle fracture treatment at our institution. Methods: A retrospective chart review was performed to determine incidence and treatment of buckle fractures at our institution between 2018 and 2022. All radiographs were reviewed to confirm appropriateness for inclusion. Data were collected for treatment, follow-up frequency, cast utilization, and patient home ZIP code. Buckle fracture incidence was computed using the total pediatric population served by our institution, derived from United States (US) Census data. Treatment was assumed to occur at the office of the nearest orthopedic surgeon, identified through the National Provider Identifier Registry. For cast waste estimation, we collected and weighed discarded short-arm casts from our institution and used the number of patients treated in a cast to estimate total waste. CO2 emissions were estimated to be 411 g of CO2 per mile, and mileage was calculated for round-trip distance to the nearest orthopedic surgeon and multiplied by the estimated number of unnecessary visits. Travel for the initial visit was not considered overtreatment and was not included. Results: Annually, the United States sees an estimated 66,495 buckle fractures, with 62.5% overtreated with casting. The average short-arm cast weighed 0.498 lbs ± 0.133. When additional visits occurred, there were an average of 1.2 additional visits. Each year, overtreatment of pediatric buckle fractures in the United States generates an estimated 9.4 tons of cast waste and 405.4 tons of CO2. Conclusion: Overtreatment of buckle fractures has a significant measurable environmental impact.

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Why Health Care Needs Sustainable Waste Stream Management

Cited by 2 publications

References 11 publications

Global Medical Supply Inequities

Global Medical Supply Inequities

Environmental Impact of Overtreatment of Distal Radius Buckle Fractures

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