Sustainability in HealthcareRethinking waste management

The healthcare sector faces a daunting challenge: balancing patient safety and sustainability.

There is an enormous amount of waste left behind by the pandemic – masks, tests, protective suits – yet this is only the top of a massive mountain of garbage that demands innovative solutions.

The healthcare sector is responsible for 5.2 percent of CO2 emissions - solely in Germany. Its emissions are thus almost as high as those of the steel industry. Every year, hospitals in Germany generate around 100,000t of medical trash. The total amount of waste from hospitals is even estimated at 4.8 million tons per year.

In this context, the Corona test kit illustrates a dilemma that applies to the entire healthcare sector: the conundrum between recycling and reusability on one hand, and patient safety and sterility on the other.

It is essential to consider two fundamental dimensions to resolve this dilemma: the system within which the specific product operates and its governing and logistical framework.

The system

The efficient collection of recyclables is crucial, but it's often a complex task for healthcare facilities. The biggest challenge is collecting the recyclables to make them accessible to mainstream recycling processes. However, in clinics and other healthcare facilities, it is mainly consumables such as glass, paper, or cardboard that get separated for collection. Everything else is usually added to residual waste and mixed with contaminated hospital waste.

Considering the already high workload of healthcare personnel, it is unrealistic to demand a much more precise separation of waste, primarily since many medical devices consist of difficult-to-classified combinations.

An amendment to the Closed Substance Cycle Waste Management Act (KrWG) is worth mentioning: In §9 of 2021, it will also allow contaminated medical devices to be sent for material recycling.

This can be particularly attractive for valuable medical products like EP catheters since it allows for the recovery of valuable metals. This law aligns with the European Union's Green Deal and Circular Economy Action Plan, and further adjustments and tightening of the legal framework can be expected.

So what are the options for recycling medical products?

Collaborating for a sustainable healthcare future

For valuable products – including disposables- introducing innovative business models such as pay-per-use or deposit systems might make sense. To collect more valuable disposables or consumables cost-effectively, the material flow shares of individual manufacturers are often insufficient. There are promising approaches for establishing a cross-manufacturer return system, thus harnessing potential synergies.

To streamline the process, manufacturers can take the lead in structured disposal across the industry. This not only reduces bureaucracy but also boosts profitability and positions us ahead of low-wage competitors.

However, these systemic approaches are highly dependent on the nature of the products used in the healthcare sector that will be added to the recycling stream sooner or later.

The product

The product is the sphere of activity in which the requirements for subsequent efficient reuse should be established as early as the product development stage.
Since cost-intensive approval procedures in the medical sector often make minor changes such as the use of a sustainable alternative material uneconomical, every opportunity for product revision or new development should be used to design the products in a way that is suitable for recycling.

In our quest for sustainability, we must analyze the lifecycles of healthcare products. Can we design disposables that are incinerated as contaminated waste with non-critical materials?

Closing the loop: circularity in healthcare product lifecycles

A first step in this process is to analyze in which cycles the product could circulate. For instance, if the product is a disposable product that will be incinerated as contaminated waste anyway, it makes sense to use correspondingly non-critical materials and minimize the use of materials. If the products can be taken back, reused or recycled, a check is required as to whether the product can also consist of only one material or whether materials can simply be separated in the recycling process and thus recycled according to type, or whether valuable components can even be reused. Reprocessing or recycling must be considered as intensively in the development process as the actual functional use.