Opinion

Jul 21, 2023

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After my column last week urging the health-care sector to consider the environmental costs of medical care, many readers wrote to ask why I didn’t address the “elephant in the room.” As Bob from Oregon wrote, “Every time I go to the hospital, I see plastic everywhere. Everything’s wrapped in plastic, and then it’s all thrown away. Why aren’t we calling for the health-care industry to reduce their plastics use?”

Bob is right. Every day, U.S. health-care facilities generate 14,000 tons of waste. One patient being hospitalized results in nearly 34 pounds of waste every day. Of that waste, up to 25 percent is plastic.

Plastics are ubiquitous in health care today, but it wasn’t always that way. Several decades ago, medical supplies were commonly made of metal, cloth and glass. Now, it’s hard to find items that aren’t made of plastics or wrapped in them.

The reasons behind that change were justifiable: Busy clinicians prioritize efficiency, and it’s convenient to open a package and find a procedure kit that’s new, sterile and ready to use. Economics played a major role, too, as it’s often cheaper to purchase disposable plastics than to run reusable items through sterilization procedures.

But as I discussed before, it should be a major concern to the health-care industry that medical care itself is perpetuating the climate crisis. The pollution the sector causes harms not only the planet but also the health of our patients.

Some hospital leaders are showing that cutting single-use plastic use is possible. One bright spot is the switch from disposable plastic gowns to those that can be laundered and reused 75 to 100 times. One study found reusable gowns reduced solid-waste generation by 84 percent and cut greenhouse gas emissions by 66 percent. Another found that these gowns are clinically superior to disposable ones; they are less likely to break and tear and increase infection protection for the wearer.

Many hospitals are making this switch. UCLA Health was using 2.6 million disposable isolation gowns every year, generating more than 230 tons of landfill waste. By switching to reusable ones, it dramatically reduced waste and saved an estimated $450,000 annually.

As an added bonus, because the UCLA system altered its practice before the pandemic, it did not experience the cost surge of single-use gowns during the height of covid-19 fueled by the global supply-chain disruption and the nationwide run on protective equipment. UCLA hospitals also avoided the critical shortage of gowns faced by other health-care facilities.

The Virginia-based Carilion Clinic similarly avoided shortages by stopping its dependence on single-use gowns. Over the first three years after the switch in 2011, it eliminated nearly 515,000 pounds of waste and saved more than $850,000. Another set of Virginia hospitals, the Inova Health System, partnered with a sports apparel company to design and produce custom reusable gowns that are reportedly better fitting, more comfortable temperature-wise and easier to put on and take off.

If such changes are better for the environment and reduce costs without negative impacts on patient care, what’s preventing more widespread adoption? One reason is the misconception that reverting to reusable materials will incur more costs or result in greater inefficiencies. Providers and administrators from institutions that have successfully implemented changes should widely share their stories and best practices.

Another reason is that incentives are not aligned in favor of the change. Here’s where regulatory agencies can nudge the health-care sector. The Food and Drug Administration can help motivate manufacturers to switch to reusable materials, and the Centers for Medicare and Medicaid Services can be more aggressive in pushing hospitals to meet sustainability goals.

There are many single-use plastic products that don’t have an affordable and clinically comparable reusable alternative. Research should focus on designing resilient materials that can be disinfected and reused like metal and glass instruments.

As the smoke from the Canadian wildfires has recently reminded us, there is a close tie between the environment and human health. The health-care sector needs to do more to decrease its impact on worsening the environment — and, in so doing, help safeguard our patients’ well-being.

Do you know of specific innovations in the health-care sector that are helping to reduce their impact on the environment? I’d love to hear from you. Please keep sending me your comments and questions.