- On November 22, 2018
- November / December 2018
Single-use plastic in hospitals is in the crosshairs for the next generation of medical professionals.
The movement to ban the use of single-use plastic is gaining momentum. Plastic shopping bags, coffee cups, and food packaging have all been under public scrutiny resulting in significant social and governmental changes. The argument is simple. Plastic degrades very slowly; is expensive when used once; and production uses large quantities of water and results in unnecessary carbon dioxide emissions.
My daily social media newsfeed reminds me of the environmental devastation caused by plastic. We are bombarded with powerful images of the ocean filled with plastic, sea and bird life losing the battle between nature and man, and very occasionally a glimpse of committed people initiating positive changes and alternatives to single-use plastic. As young people, who are inheriting the planet, we must step up to become its caretakers.
After making a conscious effort to reduce waste in my own day-to-day life, I struggle with the quantity of single-use plastic discarded with little regard in hospitals. If every industry is making changes, why is the healthcare industry so slow to shift?
Patient safety is central to healthcare. The use of single-use devices has increased since awareness that some bacteria and proteins can remain on instruments after decontamination and sterilisation. Since first reported on surgical instruments in the 1950s, there is a potential risk of patients contracting variant Creutzfeldt?Jakob disease, as well as HIV, hepatitis B and hepatitis C. The use of single-use devices therefore eliminates this possible risk as they are guaranteed to be contaminant free.
However, there is growing scepticism towards the actual risk of contracting variant Creutzfeldt?Jakob disease as the cases are limited to certain procedures. At this stage, there is little known about the actual long-term safety of reusing anaesthetic and surgical items due to the long incubation period of prion?related diseases.
On the other hand, single-use devices are produced at lower costs to justify their disposal. This can result in lower quality equipment and risks patient safety through iatrogenic harm. In 2001, the United Kingdom Department of Health publically recommended the use of single-use devices for tonsillectomy procedures. The anaesthetic associations of Ireland and Great Britain followed suit by recommending the use of single-use laryngoscope blades because of the proximity of the blade to the tonsils. Later, the Department of Health recommendation was withdrawn following an increase in adverse events and at least one patient death.
An audit in a United Kingdom hospital anaesthetic department found that nearly half of all waste was potentially recyclable, and only 4% of sharps bin contents was true sharp waste. Efficient waste reduction is limited by lack of awareness, convenience, safety concerns, and regulations.
There is still little known about the Australian healthcare industry's waste production. The United Kingdom's National Health Service (NHS) produced 408,218 tonnes of waste in 2005-6. This was calculated to equal to 5.5 kilograms of waste per patient per day. This can be compared to Germany, which has a notable public commitment to waste reduction, and produces only 0.4 kilograms of waste per patient per day.
As a medical student, I usually find myself quietly backing up against a wall terrified to say or do something wrong. But soon enough, my peers and I will be inheriting the system. Our decisions will matter, and we therefore need to step up like our peers across other industries.
The medical profession has proven very slow to shift thus far. But given an escalating desire to save the environment, I hope this will spill over to the incoming generation of new doctors. If we do not make a call to action, we may not have the opportunity to have long and fulfilling careers like our predecessors.
Rebecca Burridge, final year medical student, University of Notre Dame Sydney. For a complete list of article references, please contact the editor – firstname.lastname@example.org