A global economy and scientific advancements would be impossible without plastic. A primary product of petroleum refining, plastic is integrally linked to numerous global supply and production chains. Plastic is especially important in medical applications, which accounts for almost 85% of annual medical waste today (1). The most common medical devices that use plastic are packaging, syringes, surgical tools and bodily fluid collection vessels. Medical waste unfortunately has been one of the largest sources of plastic pollution worldwide, but the creation of a new plastic-based economy driven by efficient reuse and minimal leakage will help reduce the environmental footprint of medical plastic waste.
Plastic waste proliferation is only a recent phenomenon, as plastics and similar artificial chemical polymers were developed, and mass produced by Dupont and other American chemical companies during World War II. Medical devices have long been manufactured from materials such as stainless alloys, rubber, certain types of cloth, all of which can be disinfected and reused multiple times. However, in the aftermath of the HIV/AIDS epidemic during the 1980s, public fears of the virus’ bloodborne transmission instigated the medical community to adopt a standard use of disposable, plastic devices. Patient safety and virus containment were the top priority at the time, which led to the swift and widespread adoption of disposable medical devices (1). Due to the convenience, cost effectiveness and perceived public approval of plastic equipment, no major advances have been made to improve the existing system.
Currently, the annual global plastic production has topped 350 million tons with an estimated cumulative production of 7 billion tons since 1950. In 2010, almost 275 million tons of plastic are thought to be circulating the oceans and global environment as waste. Current waste management techniques are still yet to catch up, as 55% of global plastic is discarded into landfills, while only 25% of parent plastic was incinerated and 20% of parent plastic was recycled. (5)
In the US, the health care sector alone produces 5.9 million tons each year that results in increased risk of bio hazard contamination and the high cost of medical procedures. For example, a single hysterectomy produces on average 20 pounds of plastic waste. The most cost-effective method of dealing with bio hazard plastic waste is incineration, which accounts for 60% of hospital waste management. The other 40% being either disposed of chemically or in municipal landfills unsuitable for containing large quantities of medical waste. (4) There have been questions on whether perfectly viable equipment that is functionally intact should be disposed of after a single use.
In addition to environmental concerns, the proliferation of plastics in medical settings has harmful long-term consequences for human health. Bisphenol A, a common additive in disposable plastics, is a known carcinogen that has destructive reproductive and neurological effects. It has also been determined in a 2008 study by the Government Accountability Office that disposable plastics have no significant effect in improving safety of medical equipment as compared to reusable devices. (5) With no significant benefits and increasing costs for petroleum-derived plastic, there is currently ripe opportunity for emerging research and companies to develop more sustainable alternatives.
Sustainable plastic solutions require economic incentives, policy measures and scientific innovation to fully realize its benefits. Contamination of different plastics in designated streams is an obstacle in expanding recycling operations, as lower grade plastics decrease the overall quality of plastic available for repurposing. Additionally, due to the decades old supply lines and cheap petroleum, many state-affiliated hospitals are forced to use cheaper plastic devices due to budgetary constraints.
Existing viable strategies includes collectively developing policy and infrastructure for a novel plastic economy that is based on upcycling material and reducing leakage. Governments and companies must create value through a “after use plastics” economy through establishing cross value chain mechanisms, efficient sorting and processing, and alternative matchmaking mechanisms. According a joint report from the Ellen MacArthur Foundation and McKinsey, there is approximately 80-120 billion dollars in value that can be captured from the amount of plastic circulating around the world. Fortunately, researchers are currently developing methods to optimize production of polyhydroxylalkanoate (PHA) and polylactic acid (PLA) based bioplastics. (6) These plastics have limited practical value at the moment, due to economies of scale that prevent widespread use in medical applications.
In order to pursue such a novel economic system, widespread protocols must be established on reusing certain types of plastics. Increased funding will create the robust scientific understanding necessary for accurately informing policy and economic decision-making. Lastly, policymakers must be actively engaged and transparent with the corporate leaders in this plastic economy. Even with a fully fledge economic framework, however, further regulatory steps must be taken in verifying the efficacy and safety of medical devices made from the recycled plastics.
Emerging companies such as Pond, Eggplant and 100Bio are leaders the reusable plastics industry by laying the foundations for an after-use plastic economy. Pond is startup based in Denmark working on integrating bio-resins with natural fibers to create a 100% biodegradable product which can be integrated in general transportation containers, gauze pads and non-sterile material applications. Eggplant is a biotechnology that specializes in producing polyhydroxy butyrate bioplastics (PHB) through a zero emissions process. PHB is known to be an effective biodegradable plastic that be used in highly disposable medical equipment, such as surgical tools, wrapping and storage of biological liquids. Eggplant is currently funded by a single grant from the European Union Executive Agency for SMEs but is projected to roll out an improved version of their PHB products. 100BIO is a biotechnology that specializes in producing Polylactic Acid Styrofoam without harmful additives that is common in typical Styrofoam. Applications of this technology include new containers for packaging organs for donation and gauze functions. 100BIO is currently in the early stages of developing disposable food ware, but their research focus could soon shift to developing drug storage and delivery applications. (8)