9.3% of global resources are devoted to the health sector [Q1]. It is time to make healthcare more environmentally friendly and, above all, resource-independent: In this article, we look at how to generate value streams from hospital waste and recycle it into the production of new medical devices and pharmaceutical packaging. In short: how the circular economy succeeds in healthcare.
The idea of a circular economy is based on the principle that resources are continuously reused, i.e. recycled or remanufactured [Q2].
The goal is to minimize ecological impact while ensuring efficient resource-independent supply. Establishing a circular economy in healthcare involves challenges: First, legal and regulatory frameworks must be considered. These are critical to the safe handling of medical waste and the safety of products and packaging made from recycled materials. Second, it requires a shift in thinking and extensive collaboration [Q3,Q4] between healthcare providers, manufacturers, and policymakers.
In this blog article we look at which waste categories available in hospitals, their suitability for reuse and what Recycling procedures to be followed for this purpose.
Hospitals generate different types of waste that can be categorized according to the waste hierarchy of LAGA M18 [Q5]. With proper separation and post-treatment, some of the waste codes are suitable for generating new value streams. In this chapter we present some of the categories. Don't feel like reading? Explained in the following video. Dr.-Ing. Julian Lotz the categorization in detail.
In a nutshell
LAGA M18 is an enforcement guide (i.e., it provides guidance) for the disposal of waste from all health care facilities. The abbreviation stands for “Bund/Länder-Arbeitsgemeinschaft Abfall Mittleiung 18′′.
Let us first consider the packaging category (AVV 15 01). These include sterile barrier packaging, for example. These are mostly made of plastic and often end up in the trash right after opening. As a rule, they have no patient contact and are therefore unobjectionable when disposed of. Recycling is readily available for this type of hospital waste. All it takes is a hospital waste management system that collects this waste separately from (potentially) contaminated waste and sends it to the disposer.
The next category is non-critical disposable products made of plastics (not AS 18 01 01/ -04). This could be unused disposable gloves, for example. The same specifications apply to these as to the packaging. In principle, therefore, they can be collected as recyclable materials and returned to the cycle by means of recycling.
It gets more exciting with plastic waste that is potentially contaminated (AS 18 01 03). For example, disposable products from the operating room, which may come into contact with blood or secretions and thus contain infectious material. There are, of course, stricter requirements for this. Currently, this waste is practically always burned. Thereby there is definitely the possibility to generate a value stream here. While the so-called Sharps (AS 18 01 01), such as scalpels, syringes, etc. must actually be incinerated, disposable plastic products, such as single-use tweezers could be recycled. There is currently also a theoretically predefined path here: for this, the plastic waste must be cleaned and decontaminated. Decontamination must be carried out and approved in accordance with RKI guidelines. In addition, the authority responsible for waste disposal must give its consent.
Potentially contaminated sharps, such as scalpels or syringes, must be incinerated. There is no recycling option here.
There are various recycling processes that allow plastic waste from hospitals to be recycled into the production of new medical devices, pharmaceutical packaging or laboratory equipment. There is mechanical recycling and chemical recycling. For the latter, the decision is between monomer recycling and feedstock recycling, pyrolysis. Let's take a closer look at these:
In a nutshell
In short, yes. Certain categories of waste can be recycled by means of mechanical or chemical recycling. The latter is suitable if you want to achieve a Medical Grade quality again.
The first approach is mechanical recycling, in which uncontaminated plastic waste is shredded, possibly regranulated, and then processed into new products. This process is very energy efficient and results in a very short material cycle - which is very good. However, the quality of the plastic decreases somewhat with each recycling cycle, and it may contain impurities or additives and aggregates not suitable for medical or food contact. By mixing different types, the properties also change more or less controlled. In addition, a medically compliant documentation of the material origin is almost impossible.
Chemical recycling offers an alternative. In this process, the plastic is broken down into its fragments,and assembled into new plastic that has the same properties as freshly manufactured plastic (virgin quality). This means that high-quality medical grade (bio)plastics can be produced here again. Materials, in other words, that are suitable for use in the highly regulated medical field. The choice of the appropriate recycling process depends on various factors, such as the type of plastic and the quality requirements. In the field of chemical recycling, there is monomer recycling and pyrolysis, also called feedstock recycling or feedstock recycling:
Monomer recycling is a chemical recycling process in which the plastic is broken down into its building blocks by enzymes or catalysts. These building blocks are then purified, i.e. freed from additives, colorants and the like. They are then reassembled into plastic that has the same properties as freshly manufactured plastic. This allows high-quality recycling at the same quality level and with the same safety, which is essential, especially for healthcare. Together with the still high energy and resource efficiency, this process is our first choice for medical grade bioplastics. However, this currently only works with polyesters, such as our MedEco compounds, PET and similar plastics.
Pyrolysis is another chemical recycling process that can be used for unsorted plastic waste or for polyolefins such as PP and PE. In this process, the plastic is split in an uncontrolled manner under high pressure and temperature. However, there are some disadvantages here: the yield is low (<50%) and many by-products are produced, some of which are only suitable as fuel or are even hazardous waste. Moreover, this value stream enters the cycle at the very front - pyrolysis oil is a petroleum substitute, and monomers and then polymers must first be produced from it again. This is a more complex process that also requires more energy than monomer recycling and therefore also involves higher CO2 emissions.
With the exception of so-called sharps, all plastic waste could be recycled. By chemical recycling even in medical grade quality, for example to produce sterile barrier packaging.
The choice of the right material depends on various factors. It is crucial to consider from the outset which recycling processes are to be used and what recycling quality is aimed for. Mechanical recycling is suitable for simple packaging products, while chemical recycling is needed for medically critical applications. For the latter, materials should be selected that can be chemically recycled particularly efficiently. One example is our MedEco bioplastics.
Another factor is the targeted sterilization procedure. Radiation-based sterilization processes, e.g. gamma rays, X-ray sterilization or e-beam sterilization, for example, can affect plastics and change their mechanical properties, in particular reduce elongation at break or strength, or limit meltability and thus recyclability by cross-linking the polymer chains.
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A circular economy in healthcare is not only possible, but also a benefit to society as a whole. Through efficient plastic recycling in healthcare, we can actively contribute to the conservation of resources and the reduction of environmental pollution. In this way, we are laying the foundation for sustainable healthcare that can function in the future.
To achieve this, a cooperationof politics, clinics, disposal companies, material manufacturers and producers of medical devices, pharmaceuticals and laboratory technology is required: although in principle many plastic wastes could be kept in a recyclable material cycle, there is currently still a lack of flexibility on the part of the authorities. There is also still potential at many hospitals, because value streams can only be created if waste is properly separated. And product and packaging distributors still have many non-recyclable plastic parts on the market.
However, the targeted separation and recycling of plastic waste is a crucial step towards a more sustainable future.
Citation of source
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For the creation of this blog article, I have used different sources. These are marked [Q...] in the text and can be found here:
[Q1] The Circularity Gap Report 2020
[Q2] Europäisches Parlament – Kreislaufwirtschaft
[Q3] Zühlke Insights – Kreislaufwirtschaft
[Q4] Medizin und Technik
[Q5] LAGA M18
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