Our third tip for practices looking to improve their sustainability surrounds waste management.
Waste is a massive global issue that has been highlighted by the extensive use of PPE during the Covid-19 pandemic. The environmental charity, Healthcare Without Harm, estimates that if healthcare were a country, it would be the fifth biggest carbon emitter in the world. Healthcare, including veterinary healthcare, generates a lot of waste, including wastes from packaging, wastes generated by producing sterile instruments, single use items, etc. We have an obligation under the Environmental Protection Act 1990 to understand waste and how it should be managed. By dealing with waste appropriately we can minimise the environmental impact of the waste that we generate, and also achieve financial savings.
Image from whatplastic.co.uk
The waste hierarchy pyramid is a useful way to look at how we can minimise waste – the most important ways of reducing the environment impact of waste are firstly to prevent/reduce waste generation, then reuse items, and then, if possible, recycle materials; recycling keeps materials within the circular economy. Veterinary waste should be segregated carefully to reduce the quantities going for high temperature incineration. Proper segregation of clinical waste also saves money for the practice. Some useful resources include the BVA Handling veterinary waste guidance posters and the In Practice article by Ellie West and colleagues on How to manage healthcare waste and reduce its environmental impact.
Veterinary waste segregation:
OFFENSIVE WASTE BAG (yellow bag with black stripe)
WHAT GOES IN:
•Blood, faeces, urine or saliva-contaminated materials from non-infected patients
•Food-contaminated materials
•Empty blood / fluid bags
•Latex examination gloves
WHAT DOESN’T GO IN:
•Waste from infectious patients
•Drug-contaminated waste
CLINICAL (INFECTIOUS) WASTE (Orange bag)
WHAT GOES IN:
•Waste from ‘infectious’ patients (with a suspected infectious disease or its toxins)
•Waste from most ‘barrier-nursed’ patients
WHAT DOESN’T GO IN:
•Non-infectious waste
•Drug-contaminated syringes
•Cytotoxic waste
•Drugs
Waste audits can be very helpful to quantify the amounts and different types of waste being generated by veterinary practices and can help identify where improvements can be made.
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^Surgical waste from a routine arthroscopy
Surgery often generates enormous quantities of waste, and it can be quite an eye opener to collect and analyse the waste from a single surgical procedure. Single use gowns and drapes constitute a major part of the waste. It has been estimated that less than 5% of human medical plastics are recycled (Rizan et al 2021), although 40-64% of medical plastics are potentially recyclable but typically disposed of in clinical waste (McGain et al 2015). Vasanthakumar (2019) showed that the currently available evidence doesn’t strongly support the use of single use drapes, so it may be that reusable drapes can be safely employed in some surgical procedures. Reusable gowns reduce natural resource consumption by 64%, reduce greenhouse gas emissions by 66% and reduce solid waste generation by 88% (Vozzola et al 2020).
Wherever possible, materials should be recycled. Make sure the whole team is aware of what can be recycled. Some useful resources can be found at Wrap, Recycle Now and Terracycle. Switch from single-use plastics bins. Use reusable sharps bins such as these from Sharpsmart and Stericycle or cardboard-based pharmaceuticals bins such as bio-bins or 4G Safe bins.
Rizan, C., Bhutta, M.F., Reed, M. and Lillywhite, R. (2021) The carbon footprint of waste streams in a UK hospital. J.Clean.Prod. 286 125446
McGain, F., Storey, D. and Hendel, S. (2009) An audit of intensive care unit recyclable waste. Anaesthesia
Vasanthakumar (2019) Reducing Veterinary Waste: Surgical Site Infection Risk and the Ecological Impact of Woven and Disposable Drapes. Vet.Evidence 4
Vozzola, E., Overcash, M. and Griffing, E. (2020) An Environmental Analysis of Reusable and Disposable Surgical Gowns. AORN J 111 315-325