|
By Jason Gale
Just steps from the
operating theaters at Melbourne’s Footscray
Hospital, a storeroom holds a quiet rebellion
against medical waste. Stacked
neatly on wire racks are bundles of surgical
gowns and drapes — some wrapped in pale blue
disposable plastic, others in washable fabric
that’s made to last.
The difference
seems small, but to critical-care doctor and
anesthesiologist Forbes
McGain, the latter pile signals a hospital
daring to push back against the tide of
single-use items pervasive in healthcare.
It’s not the only
part of the hospital where change is visible.
Next door, the decontamination room hums with
activity. Staff in navy scrubs and hair covers
rinse trays, reassemble surgical kits and load
bundles of linen into a wall of sterilizing
machines. Green and yellow plastic bowls are
stacked on a trolley, waiting to be washed,
packaged and put back into circulation.
“A lot of hospitals
wouldn’t have this at all,” McGain says, nodding
toward the reusable bundles. “It would all just
be chucked away.”
Hospitals are among
the most resource-hungry
institutions, packed with single-use plastics
and equipment and energy-intensive machines.
They’re also surprisingly large sources of
greenhouse gases like anesthesia.
In Australia,
hospitals are responsible for an estimated 7% of
national emissions, while in the US, healthcare
accounts for 8.5% of greenhouse
gas pollution. Globally, if the healthcare
sector were a country, it would be the fifth-largest emitter,
well above Japan and Canada.
That puts
clinicians like McGain at the center of a
paradox: The business of saving lives has become
one of the planet’s most polluting industries,
and breaking medicine’s addiction to disposables
is no simple task.
The stakes are
growing. A warming planet is driving more disease, from
heatstroke and heart attacks to mosquito-borne
infections, while also heaping new pressures on
health services already under strain. That puts
hospitals on the frontlines of climate
change even as they contribute to it.
What’s at risk isn’t just emissions, but the
long-term resilience of healthcare systems
themselves.
Climate
Medicine
McGain is an
accidental climate reformer. What began as a few
suggestions to reduce waste became a doctoral
thesis, and eventually a role as associate dean
of healthcare sustainability at the University
of Melbourne. Between ICU shifts, he is leading
a push to replace disposable gowns, drapes and
trays with washable alternatives — proving that
doing so saves both carbon emissions and money.
“We were going to
switch to disposables because everyone said it
would save us money,” he says. “But in reality,
it doesn’t — and that’s what I find disturbing:
These assumptions get made without any
scientific rationale.”
Dr. Forbes
McGain Source: Indimax
To take just one
example, his team’s time-and-motion study found
that even after paying staff to wash and
sterilize equipment, single-use products are
still more expensive.
Fixing the problem
won’t just require changing how hospitals run.
It will mean upending multibillion-dollar
markets: The global medical plastics industry
alone is on track to surpass $87 billion by
2030. For decades, manufacturers equated
disposability with safety — a narrative that
built a global supply chain on fossil fuels and
throwaway products. “If you’re a single-use
company, you want to flog things,” McGain says.
McGain’s awareness
of medicine’s material footprint stretches back
to Kalgoorlie, the gold mining town in Western
Australia where he grew up. His father was a
geologist, trained to extract resources from the
Earth. “That got me thinking about where things
come from and how they get to where we are,” he
says. Ore dug up in Australia might be smelted
in China, shaped into single-use medical tools
in Pakistan or Germany, then shipped back to
Australia, only to be discarded after a single
use.
“That lifecycle is
pretty crazy,” he says. “It’s a very
unsustainable, linear, non-circular model.”
The
Pandemic Wakeup
Covid-19 forced the
world to confront the
fragile systems that make and manage medical waste. The
surge in the use of personal protective
equipment exposed gaps in disposal capacity and
raised questions about the long-term
sustainability of single-use items.
During the height
of the pandemic, McGain’s hospital group threw
away more than a million gowns in a single
year. By November 2021, Covid-19 vaccinations
had generated an estimated 144,000 metric tons
of syringe and needle waste globally, while test
kits were responsible for 731,000 liters of
chemical waste, according to the World Health
Organization.
Hospitals only
began to lean heavily on disposables after World
War II, when plastics got cheaper. The trend
hardened in the 1980s amid HIV fears and
aggressive manufacturer marketing that sold
throwaway items as safer.
US healthcare
facilities generate an estimated 5.9 million tons of
waste each year — almost 30% of it plastic. Intensive care units
mirror that trend, with single-use items making
up a third of their waste stream.
Modern
medicine uses many single-use plastic, paper,
cardboard, glass and metal items. Photographer:
Steve Allen Travel Photography/Alamy Stock
Photo/www.alamy.com
Today, waste is
entrenched and rising, yet policies to address
it are lacking, particularly in the US. In
January, the US Department of Health and Human
Services disbanded its
Office of Climate Change and Health Equity after
President Donald Trump ordered the
elimination of “environmental justice”
initiatives.
“Places of healing
should be leading the way, not contributing to
the burden of disease,” says Tedros Adhanom
Ghebreyesus, WHO’s director‑general.
“Reducing medical waste must be a mindset that
informs every part of health care, including
planning, financing, procurement and delivery.
That makes it everyone’s job: health ministers,
hospital managers, health workers, cleaners and
patients themselves.”
Read more on
the systemic changes hospitals are making to
fix the problem of medical waste on Bloomberg.com.
|
