Hospitals under pressure to ‘do something' about plastics

Hospitals and medical device makers are starting to face the same pressures for more sustainable use of plastics that consumer product companies have been grappling with.

The medical industry doesn't face the intense scrutiny that has been directed at soft drink makers or other big consumer brands, but there's been a clear push for the sector to "do something" about plastics, said Peylina Chu, executive director of the Healthcare Plastics Recycling Council.

"For all of the large health care organizations, sustainability is becoming more and more of a priority," Chu said. "They are very vocal and have huge procurement budgets, and they're pushing hard on their suppliers like Johnson & Johnson and Baxter and BD to do something about all of the plastics that are coming into our hospitals."

"Doing something" in some cases has meant pledges to use more recycled content in packaging and, when possible, devices.

Greening the materials used in health care has always been more challenging than for other industries because of the overriding need for patient safety. The failure of a medical device is a lot more serious than the failure of a Coke bottle.

The coronavirus pandemic, as well, has introduced a new wild card. Chu said it's basically put a pause on new plastics recycling initiatives while hospitals deal with an unprecedented situation for both patient care and finances.

Still, she said that advocates for more sustainable use of plastics in health care will keep working.

HPRC released two reports in recent months making a case for more plastics recycling in hospitals, with one suggesting potential for collecting flexible medical packaging waste and turning it into pellets with real world applications.

The group also plans to focus this year on the potential for chemical recycling in handling medical plastics waste, an area where it sees strong potential, Chu said.

There's interest from other sources: A government-funded materials research center at Troy University in Alabama, for example, announced a multiyear project in early April tackling technical challenges around medical plastics recycling.

Chu said pressure is coming both from the public and from health care workers who want to see their workplaces use plastics in a more environmentally friendly way.

HPRC's reports note that many innovations in health would not be possible without the design innovations and performance of plastics. But the group points to growing interest among hospitals to move away from the "make-use-dispose" model of consumption.

"Johnson & Johnson, Baxter, BD, Medtronic — they're all part of HPRC because they are feeling the pressure from their customers to, again, just do something about all of this plastic," Chu said. "You have very passionate nurses that see all of this plastic coming into their workplace and everybody's recycling at home and they don't understand why their hospital is not able to recycle."

But addressing environmental issues have extra challenges in health care, with its complex regulations, requirements for safety and product performance, and strict traceability standards around sourcing materials, according to a February HPRC report "Circularity for Healthcare Plastics: Challenges and Opportunities."

Medical plastics are good-quality materials; that's one potential economic draw for more recycling.

But there are practical concerns about processing costs and being able to use them in end products, both for recyclers and for medical manufacturing companies.

"From a practical point of view, the private sector simply does not want to touch medical waste," said Govind Menon, director of the Center for Materials and Manufacturing Sciences at Troy University. "But this is still high- grade plastics that is being used in medical applications."

On April 6, Menon's center announced a project to look for new avenues to recycle medical plastic waste, as well as boost production of personal protective equipment with plastics.

It wants to see if medical plastics waste can be recycled back into medical products or have a reasonable path back to being used in something like car bumpers, he said.

While the work is at an early stage and a detailed research plan is not likely until later in the year, Menon believes ultimately there will be a need for government involvement to make large-scale systems work.

"When it comes to applications of this sort, recycling centers cannot be expected to treat this because their profit is pennies to a pound," he said. "So the federal government will have to interfere at some level to incentivize the processing of medical waste."

HPRC says some health care organizations are pushing recycled content and other green initiatives.

Its report noted, for example, that Kaiser Permanente, one of the country's largest nonprofit health plans, and Vizient Inc., the largest U.S. health care purchasing organization, have each set goals of 10-30 percent recycled content in various packaging and devices.

There are similar movements in hospitals in Denmark, Norway, Sweden and the United Kingdom, it said. HPRC expects recycled content and medical packaging to eventually be taken up in European Union legislation.

"As EU customers continue to push for more packaging recyclability and the inclusion of [post-consumer] content in new products, their views will undoubtably become formalized in EU recycling legislation," it said in the report.

There seems to be little legislative interest at the moment, however. Chu said in contrast to consumer packaging, there's no current legislation in North America targeting recycled content in medical devices or packaging.

Chu and Menon both argue there's sizable untapped potential to pull usable resins from medical products.

For example, collection is easier to solve. In much of plastics recycling, collecting material efficiently is among the biggest hurdles, but not so in a hospital, Menon said.

"The good thing about medical waste is we know how to collect it, unlike for PET, which is everywhere," he said.

The volumes are also worth considering, HPRC says.

It estimates that U.S. hospitals generate about 28 million pounds of waste a day, with 20-25 percent of that plastic packaging and products, which works out to roughly 5.6 million to 7 million pounds of plastics a day.

The group's reports also estimate that about 85 percent of that plastic is free from patient contact and any contamination, counter to what it called the "common misperception" that medical waste is too hazardous to handle.

Another HPRC study, released in April, suggested it is possible to recycle flexible packaging in operating rooms, separate it without contamination and at least from a technical perspective, reprocess it back into usable resin.

The study evaluated a pilot program collecting materials in four hospitals in Ohio, Pennsylvania and Massachusetts.

The discarded plastics were processed by recycling equipment supplier Erema, and then scientists at the plastics engineering school at the University of Massachusetts Lowell tested it with commercially available compatibilizers, HPRC said.

The report said it found two streams of materials with potential commercial uses: one that could replace some low density polyethylene resins and one that could replace some polypropylenes.

HPRC's report called the results a "game-changer," but also noted major hurdles like finding specific markets and proper logistics to scale up.

"We hope it's a game-changer; we hope that it's going to create a market pull for these materials," Chu said. "I think that's still yet to be seen. But that's the idea, by publishing this information, hopefully recyclers will see this now as a desirable material."

She said the group has also launched work this year taking a detailed look at new chemical recycling technologies for health care plastics, an area where it sees real potential.

"There's been a lot of discussion, a lot of buzz around chemical recycling, and we see that there's some really great opportunities for health care platforms," she said.

The economics around plastics recycling will remain a major challenge, though, given the complexities of both health care and the plastics markets, she said.

But Chu sees interest continue to grow around these sustainability issues among the corporations that make up and fund HPRC. In February, the group added global plastic packaging giant Amcor Ltd. as a member, for example, and discussions continue with others, Chu said.

"Over the last year, we at HPRC has gotten many more inquiries to join and we've added two new members over the last four months," she said. "I think within the last year there's been an increased focus on plastics overall."