Clinical waste watch

By Ros Morgan*
Tuesday, 11 December, 2018

Nurses, midwives and carers want to do more to reduce waste in health care. Here are a few tips.

Global Green and Healthy Hospitals has a platform of 10 ways in which health care can reduce its carbon footprint.¹ The one that usually stands out for nurses and midwives is ‘waste’ — it’s in our hands and we decide which bin to put it in.

There is so much waste in health care. Vigilant nurses, midwives and carers see this every day and are increasingly looking for opportunity to reduce waste, recapture value and preserve resources.

But how?

There is confusion about waste segregation in the community before we add in the complexity of health care and our already busy clinical loads. And then — isn’t hospital waste irritating?

It’s right to be cautious. Managed inappropriately, there are serious risks. At the same time, 75–80% of healthcare waste is comparable to municipal garbage.² Even the Victorian Clinical Waste Guidelines (IWRG612.1) include the responsibility, where practicable, to avoid the generation of the waste stream and maximise re-use and recycling.³

Victoria’s Department of Health and Human Services has linked the funding of health services with an obligation to have and report on an Environmental Management Plan.⁴ This inevitably includes waste management. Since July 2017, the Department also requires public health services to report waste data. This is entered into the Environmental Data Management System (EDMS). When you recycle, not only are you doing the right thing — you are an asset to your organisation as they implement and report on their mandated governance expectations. Have you found out who manages your organisation’s Environmental Management Plan? Are they capturing your stellar efforts?

There are many examples of streams that can be diverted from landfill inside of health care. These include:

Commingled: the same as at home. If the plastic can be scrunched, leave it out of the recycling. Paper towel is a low-quality, short fibre — so it’s landfill. In fact, when in doubt, throw it out. Planet Ark advises that is better to have a few things go through to landfill that perhaps are recyclable, than to risk contaminating the stream and seeing it all go to waste.⁵ To this we must add that infection control is always the priority.
Surgical blue wrap: made into park benches and road signs.
PVC: it only takes 2.5 kg of PVC to make 18 m of garden hose!
Single-use metal instruments: melted into new product.
E-waste: did you know that in 2015 Apple recovered over a ton of gold from its recycled phones and computers? That’s US$40million!

Don’t know where to start? Start where you are, use what you have, do what you can! No one is going to argue with you getting your clinical waste right, yet this is one of the most intensive and expensive waste streams. Melbourne Health won the 2016 Premier’s Sustainability Award for reducing their dialysate clinical waste from 2.4 kg per patient treatment to 1.55 kg.

Of course, there is the question — should we even bother? We’ve all seen the headlines about China not taking our recycling and threats of sending it to landfill. How would you respond to a work colleague asking about this?

First, we must keep up the pressure for all levels of government to solve this problem by supporting appropriate technologies and market outlets for recycled content. That means keeping the recycling bins full.

Here in Victoria, we already recycle most of our waste locally and the Andrews government 2017–18 budget invested $30.4 million over four years to improve management of waste and recover more resources.⁶ There are already Australian businesses turning this crisis into opportunity.⁷ Our planet has finite resources and we must recycle to keep the virgin materials extracted at their highest and best use for as long as possible. We consider this further in the ‘Nursing for the Environment’ course. Keep your eye out on the ANMF (Vic Branch) website, anmfvic.asn.au, for the next program — not to be missed!

What does that symbol mean?

It is easy to be confused by the many symbols that are present, or even absent, from the items we want to segregate.

The mobius loop is the universal recycling symbol, with three folded arrows that form a triangle.

The resin code is when you see a number inside a triangle. Numbers identify the type of synthetic material used to manufacture the container. They do not necessarily indicate that the item can go into commingled recycling. For example, you may see a resin code on a soft plastic bubble packaging or on a polystyrene cup. These are both contaminants in the general commingled recycling. Some items made overseas have no symbol on them. Go by the general rule. If you can scrunch it — landfill. And if in doubt, throw it out.

*Ros Morgan is the Environmental Health Officer for the Australian Nursing and Midwifery Federation (Victorian Branch).

Clinical waste watch

What does that symbol mean?

References

The role of culture and connection in improving Aboriginal health

COP29: positioning health at the core of climate negotiations

Clinician burnout: evidence-based strategies to improve wellbeing

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