Abstract

In the healthcare industry, the issue of plastics and plastic waste poses significant challenges, including major environmental concerns. Driven by the urgency to address plastic pollution, the CAHO Action Plan on Sustainability (CAPS) has been initiated to address healthcare sustainability multi-dimensionally, explicitly focusing on plastic waste and its use and disposal. Launched on World Environment Day, CAPS aims to raise awareness, seek support and initiate a call to action for the healthcare sector to take decisive steps towards sustainable healthcare operations. As part of CAPS’s multiple initiatives, this article helps put context and colour on the importance of reducing plastic waste at its source. It highlights the impact of plastics on the environment, particularly within the healthcare sector. Through such resources, we aim to equip healthcare organizations with the necessary means to adopt greener practices, educate staff members, and drive meaningful action on climate change and sustainability.

Introduction

This year on World Environment Day, we draw everyone’s attention to the theme of plastics and plastic waste and overcoming this issue. In healthcare, plastics and their impact on the environment are particularly significant. The issue of plastic waste and its responsible disposal is a recognised reality in the health sector. As significant users of plastics and generators of hazardous waste – both plastic and non-plastic, there is a need to create strategies for managing plastic waste.

CAPS to Beat Plastic Pollution

CAPS represents a well-structured initiative to make healthcare more environmentally friendly. It aims to inspire and encourage our member organizations to commit to meaningful climate change and sustainability action. Our role in this program is to equip individuals and member organizations with the necessary resources to empower themselves, adopt greener healthcare practices, and engage in capacity building. We will collaborate on the development of various resources to train and educate staff members about the plastic crisis.

The Plastic Crisis in Perspective

To put things into perspective, India generates approximately 3.2 million metric tons of plastic waste annually. India ranks among the country’s top five contributors to plastic waste generation. Within the healthcare sector, the diversity of plastics is notable, ranging from single-use plastics to intricate, reusable, virgin, and recycled plastics. A staggering 56,000 metric tons of biomedical waste is generated in healthcare, with the past three years of the COVID-19 pandemic witnessing a significant surge in this volume. The necessary protocols to ensure the safety of healthcare staff and patients, particularly in the face of the SARS-CoV-2 virus, have resulted in a doubling of biomedical waste generation. However, this surge has also brought the issue of biomedical waste to the forefront. Of the total biomedical waste generated, approximately 25% comprises plastic waste. This signifies that a substantial portion of healthcare waste is composed of plastic.

When we analyse the categorization of biomedical waste into hazardous and non-hazardous, it becomes evident that while 85% of the generated waste is non-hazardous, the remaining 15% is classified as unsafe. Within this 15%, approximately 50% consists of dangerous plastic waste. This is primarily due to the nature of the medical supplies and equipment used, which often contain toxic substances. Unfortunately, this poses challenges for recycling, resulting in a significant portion of hazardous plastic waste being incinerated, a poisonous waste management practice.

Subsequently, it finds its way into landfills.

Let’s consider a thought-provoking fact. A single PET plastic bottle takes around 450 years to decompose. Now, when we contemplate the lifecycle of plastics in healthcare, their usage may span only a few days or months. At the patient’s bedside, their duration of use may be reduced to just minutes or hours. However, the environmental impact has persisted for over 400 years. This realization has prompted a resounding call within the healthcare community to adopt greener practices and re-evaluate plastic consumption. We must reduce plastic waste at its source since options for handling plastics at the end of their lifecycle are limited. This urgency is shared not only within the healthcare community but also by the broader environmental community.

The Climate Crisis is a Health Crisis – But there is more

Given the impact on environmental health, the healthcare community must take meaningful steps to reduce the 56,000 tonnes of biomedical waste generated, particularly by addressing the footprint of plastic waste. The climate crisis serves as the fuel for this initiative. It is also recognized as a health crisis, as its impacts are directly experienced by patients seeking care within our organizations, families, and friends. It is essential to acknowledge that the healthcare sector plays a significant role in contributing to the climate crisis, exemplified by the plastic waste generated by the industry.

To illustrate the carbon footprint resulting from a single medical procedure, let’s consider the example of a coronary artery bypass graft (CABG) performed at an advanced healthcare centre in India. This procedure alone generates a carbon dioxide equivalent comparable to a small petrol car travelling approximately 250 kilometres from New Delhi to Chandigarh.

Extrapolating from this, one can imagine the cumulative emissions the entire healthcare system produces. Globally, the healthcare sector contributes approximately 2.7 gigatonnes of carbon dioxide, which accounts for 5% of global emissions.

When comparing the carbon footprint of the healthcare sector with industries like steel and cement, it becomes apparent that the healthcare sector is not far behind, accounting for 5% of global emissions. In addition to carbon emissions from operations and supply chains, the healthcare sector also generates a significant number of toxic substances released into the environment and water, impacting landfills. The urgency for climate action within the healthcare sector is undeniable, leading CAHO to launch CAPS.

Under CAPS, there are four strategic pillars.

• Creating awareness and building capacity will be prioritized, with various materials becoming available in the coming months. These resources, including best practices, research, and publications, will empower members and the general public to drive change in hospital operations, healthcare practices, and private settings. Even if sustainability may not be the direct focus of research projects, incorporating some sustainability measures would be highly beneficial. This issue permeates the entire healthcare value chain and should not be limited to specific departments or individuals.
• Developing standards tailored to the maturity and complexity of healthcare organizations. These guidelines will enable organizations to enhance their sustainability efforts effectively.
• The progress of sustainability projects launched within organizations will be measured and validated, assessing their meaningful impact on reducing carbon footprints. Audits will be conducted, and the best-performing projects will be acknowledged and reported.
• We extend an appeal to join us in this mission to make healthcare greener and contribute to restoring our planet’s vitality. Your participation and support are essential to achieving this shared goal.

Conclusion

Plastic pollution in healthcare is a pressing issue that demands immediate attention and action. We appeal to the need for sustainable practices across the health sector and offer the CAPS program as a credible partner in this initiative. The healthcare community must recognize its role in contributing to the climate crisis and take meaningful steps to reduce plastic waste generation. By creating awareness, building capacity, developing tailored standards, and measuring progress, organizations can take significant steps in reducing the plastic burden on the planet. At the same time, even as individuals, it is time to embrace sustainability and actively work towards a greener future. Joining forces and supporting the cause of sustainability is crucial in achieving the shared goal of mitigating plastic pollution and restoring the vitality of our planet.

FAQ

Q1: What options are available for compostable and biodegradable plastics in the hospital segment?

A: Compostable and biodegradable plastics can be used in various areas, such as bio-medical waste packs, general waste bags, and pharmacy dispensing. However, limited data are available regarding the healthcare sector’s usage percentage.

Q2: What is India’s current uptake of compostable and biodegradable bags?

A: According to the Ministry of Environment, forests, and climate change, the uptake of compostable and biodegradable bags in India has been poor. As a result, the government has mandated the use of sure micron-thickness compostable bags and plans to enforce this mandate later this year.

Q3: Is there a price differential between regular plastic bags and biodegradable alternatives?

A: Previously, there was a price differential between regular plastic bags and biodegradable alternatives, but now the price difference has decreased. In some cases, the cost of biodegradable bags is expected to become half that of regular plastic bags in the next two to three years.