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The Pandemic & Sustainability in Healthcare

By February 7, 2022November 6th, 2023No Comments

COVID-19 & Personal Protective Equipment

Personal protective equipment has played an indispensable role in infection control and disease prevention during the COVID-19 pandemic. Perhaps most notably, the implementation of face mask mandates is an inexpensive strategy to prevent viral transmission, which will likely have a long-lasting impact on social behaviour in numerous countries. Interdisciplinary studies continue to prove the efficacy of facial coverings and their role in protecting public safety by mitigating the spread of SARS-CoV2 (1). Despite these remarkable findings, face masks pose a serious environmental threat and have amplified the plastic pollution crisis.

The Environmental Impact of Surgical Face Masks

A surgical face mask is made from plastic materials that take hundreds of years to break down in the environment. Each month, an estimated 129 billion face masks are used globally, or three million per minute (2). Not surprisingly, these single-use disposables are littered and found in lakes, oceans, and other ecosystems. It is estimated that over five trillion plastic pieces are afloat in the world’s oceans, killing wildlife and disrupting ecological function (3). Alongside other plastics such as bottles and straws, face masks can be mistakenly ingested by animals, interrupting the food chain and leading to endangerment and extinction of species. Even if plastics are disposed of properly, US landfills release an estimated 115 million metric tons of carbon dioxide equivalents into the atmosphere each year (4). Unsustainable practices can consequently contribute to emerging health threats, as ingested plastics enter the human food chain and greenhouse gases enter the air we breathe.

Cloth face masks may provide a partial solution to this problem because they can be effectively washed and reused for protection against SARS-CoV2. Cloth face masks are also widely available to the public and can therefore drastically reduce the number of plastic face masks in use. However, there are multiple drawbacks to cloth masks that may prevent them from being used by healthcare workers. Firstly, there is a lack of standardization in the design and manufacture of cloth masks, this means that some cloth masks may be more effective than others in blocking the virus. This could also mean that masks are not properly fitted. Secondly, it is difficult to regulate healthcare workers and to ensure that they are regularly changing and washing their masks. The benefit of disposable face masks is that healthcare workers can easily opt for a clean one throughout the day, reducing the likelihood of transmission. As a result, healthcare workers in direct patient contact are generally required to wear surgical or N95 masks that can be easily disposed of. Because of this, sustainability in healthcare facilities has drastically lowered during the pandemic to meet mask regulations put in place by various regulatory bodies.

Sustainability in Healthcare

Independent of increased plastic disposal during the pandemic, sustainability in healthcare is a serious issue. Single-use plastic is an attractive option in other areas of healthcare including IV tubing, medication packaging, surgical gloves, gowns, and plastic bags for blood and urine. Each new plastic product provides a cheap and easy means to maintain a sterile environment. This explains the vast amounts of single-use plastics which account for 20 to 33 percent of total hospital waste (5). To quantify this, US healthcare facilities produce approximately 14,000 tons of waste per day and are thought to be the second-largest contributor to landfills behind the food industry (6). The sustainability of the healthcare system must be reformed to reduce the impact of the global plastics crisis while protecting the public against emerging health threats.

A unique threat to sustainability in healthcare is the lack of mattress repair programs. When hospital mattresses are punctured or torn, widespread practice is to replace the mattress cover. This is an extremely expensive practice that produces enormous waste. To complicate the issue, when mattress integrity is not maintained, bodily fluids and harmful bacteria can accumulate, putting vulnerable patients at risk of infection. With approximately one million hospital beds in the US and sixty thousand beds in Canada, the practice of premature mattress replacement is not sustainable.

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“References”

  1. Ju JT, Boisvert L, Zuo YY. Face masks against COVID-19: Standards, efficacy, testing and decontamination methods. Advances in Colloid and Interface Science. 2021 Apr 29:102435.
  2. Prata JC, Silva AL, Walker TR, Duarte AC, Rocha-Santos T. COVID-19 pandemic repercussions on the use and management of plastics. Environmental Science & Technology. 2020 Jun 12;54(13):7760-5.
  3. Eriksen M, Lebreton LC, Carson HS, Thiel M, Moore CJ, Borerro JC, Galgani F, Ryan PG, Reisser J. Plastic pollution in the world’s oceans: more than 5 trillion plastic pieces weighing over 250,000 tons afloat at sea. PloS one. 2014 Dec 10;9(12):e111913.
  4. (2019). Inventory of U.S. Greenhouse Gas Emissions and Sinks. EPA, United States Environmental Protection Agency. https://www.epa.gov/sites/production/files/2021-04/documents/us-ghg-inventory-2021-main-text.pdf.
  5. Kagoma Y, Stall N, Rubinstein E, Naudie D. People, planet and profits: the case for greening operating rooms. Cmaj. 2012 Nov 20;184(17):1905-11.
  6. Chung JW, Meltzer DO. Estimate of the carbon footprint of the US health care sector. Jama. 2009 Nov 11;302(18):1970-2.
  7. Li, X., Lam, I., Teska, P., Grinstead, D., & Becker, L. (2021, May). Infection Risks Associated with Damaged Mattresses and Management Strategy Using Repair Patches. InfectionControl.tips. https://infectioncontrol.tips/2021/05/04/infection-risks-associated-with-damaged-mattresses-and-management-strategy-using-repair-patches/.
  8. IMAGE: Fazio, M. (2020, July 25). Your Used Mask Needs to Make It to the Trash Can. The New York Times. https://www.nytimes.com/2020/07/25/climate/covid-masks-discarded.html.
  9. IMAGE: Simonite, T. (2020, February 26). Chinese Hospitals Deploy AI to Help Diagnose Covid-19. Wired. https://www.wired.com/story/chinese-hospitals-deploy-ai-help-diagnose-covid-19/.