PPE saves lives but also creates vast amounts of waste. Professor Peter Hopkinson explains why a ‘circular’ approach is needed to tackle a new environmental crisis.
Personal Protective Equipment (PPE) has become a key tool in the fight against coronavirus. In 2020, more than one billion single-use disposable masks were used by NHS workers (an annual increase of over 3000 per cent). That’s not to mention the number of disposable masks used by individuals, households, and businesses.
A new environmental crisis
Facemasks, gowns, and other types of PPE have been shown to be effective in limiting the chances of people contracting this airborne disease (Liu et al 2019). But another, potentially more harmful, crisis is starting to emerge – PPE waste.
A recent study found that if every person in the UK used one single-use mask each day for a year it would create 66,000 tonnes of contaminated plastic waste – the equivalent weight of six Eiffel Towers. With the PPE industry forecast to grow at an annual rate of 8 per cent, urgent solutions are needed to tackle the vast amounts of contaminated single-use plastic going to landfill.
The need to achieve net zero
Unfortunately, many of the solutions previously used by the NHS – such as incineration, melting and low-value recycling are not enough to prevent the continuing PPE plastic crisis. With the NHS committed to becoming net zero (for direct carbon emissions) by 2040, systemic approaches to designing out waste and greenhouse gas emissions are urgently needed. Worryingly, this is also starting to become an environmental dilemma and impacting the planet underpinned by a mistaken belief that re-use impacts risk and patient safety (McNeil et al 2020).
Benefits of a circular approach
Against this background, the argument for circular thinking – where fewer resources are used and more waste materials reused – is becoming ever more powerful. In this case, it means PPE that is designed, procured, and re-used for as long as possible, at their highest value, before being recycled back into a new product or alternative uses.
Key to success will be embedding new behaviours amongst NHS supply chain co-ordination staff, sustainability teams and front-line staff to overcome the embedding of single use plastic across all patient care and operational activities. This will require a re-design of patient services and change in practices.
Continuous monitoring and widespread education and awareness training is critical to any widespread roll out. This includes simple systems for the collection and segregation of plastics, challenging perceptions that single use is safer and avoiding regrettable substitutions – for example purchasing compostable plastics might seem the right thing to do but many are not actually compostable and actually contaminate and reduce the effectiveness of plastic recycling systems.,
Case study: sustainable PPE in action
A ‘circular’ mindset is at the heart of the project. Tom Rutherford at Revolution Zero approached Exeter to provide support and validation for a proposed circular economy business model. Working together we have developed test sites and evaluated the model including infection control, and how to design systems to ensure PPE is re-used and eventually returned at the end of its life.
The PPE is made from the most appropriate material based on a variety of factors including environmental, social, economic impact and effectiveness. It is manufactured using renewable energy (sources from the sun, wind, and water). The reusable PPE, including masks, gowns, coveralls, aprons, or caps, can be reprocessed 20-100 times. When it reaches the end of its life cycle it can be reused fully through either repurposing for other uses or taken back through a full recycling process and manufactured into textiles such as such as blankets or insulation curtains.
NHS reuse trials started in September 2020. Since February, the masks have been procured by several NHS Trusts and GP surgeries with the take up increasing. Recently the Royal Cornwall Hospital Trust became the first in the UK to roll out re-usable PPE widely at scale. Compared to single use PPE masks, re-use produces 85% less waste, approximately four-time lower costs and is carbon neutral for its life cycle.
Moving away from single, use disposable plastic is not only desirable but can be cost effective and produce many benefits over and above financial items. Starting with re-usable PPE, you can find out more at www.revolution-zero.com and https://ce-hub.org/
Professor Peter Hopkinson is Professor in Circular Economy and Co-Director of the National Interdisciplinary Circular Economy Hub, which champions business models in which fewer resources are used and more waste materials reused.
Liu M, Cheng S, Xu K, Yang Y, Zhu Q, Zhang H et al. Use of personal protective equipment against coronavirus disease 2019 by healthcare professionals in Wuhan, China: cross sectional study BMJ 2020; 369 :m2195 doi:10.1136/bmj.m2195
MacNeill, A.J et al. (2020). Transforming The Medical Device Industry: Road Map To A Circular Economy. Health Affairs vol. 39, no. 12: Climate & Health Analysis. https://doi.org/10.1377/hlthaff.2020.01118