The ecological impact of switching from single-use to reusable healthcare products: A systematic review of life-cycle assessments

Main Presenter: Mattis Keil 

Co-Authors: Tobias Viere Kevin Helms Wolf Rogowski

Session: Poster Session 1

To combat climate change, there is a need to reduce emissions of greenhouse gases (GHGs). Given that the healthcare systems of Western countries were responsible for 4–8% of their respective national GHG emissions in 2014 (Pichler et al., 2019) , they are likely to present a particularly worthwhile target for climate change mitigation activities. In addition to global warming, healthcare systems also contribute to other impacts that are ecologically detrimental such as nitrous oxide emissions, sulphur dioxide emissions and water use (Lenzen et al., 2020).
Switching from single-use to reusable healthcare products might have a reducing effect on these impacts. Reusable products potentially need less material and energy in their production and create less waste. However, to avoid cross-contamination, reusable healthcare products need to be treated after each use, which can be connected to higher resource and energy use.
In health sciences systematic reviews are frequently used to aggregate existing evidence to give a comprehensive overview over a topic or specific research questions. Part of systematic reviews are critical appraisals of the included studies. Usually standardized checklists, such as the CHEERS checklist for health economic evaluations (Husereau et al., 2013) are utilized for a critical appraisal. These checklists are developed by a variety of stakeholders in a deliberative process. Given that no standardized assessment instrument for LCAs could be identified, we constructed a checklist based on the ISO norms 14040 and 14044. The final checklist consists of 22 reporting items divided into five groups based on the life-cycle phases defined in the ISO norms.

23 studies were included in the analysis. At the mean, the studies reported on 62% of the items (between 36% and 86%). Only two papers fulfilled criteria concerning data quality requirements and external critical review respectively . Mean effects were mostly negative (i.e. reducing environmental impacts), but data showed differences between product groups , showing invasive medical devices with the highest relative mitigation potential. GHG emissions were reduced by means between 38% and 56%. Results for non-invasive and invasive medical devices show an increase in water use of 49% and 1364% respectively.

This study showed, that, except for water usage, using reusable healthcare products instead of disposable reduces the environmental impact and differences in mitigation potential between invasive medical devices, non-invasive devices and protection equipment. The results might be affected by a location bias towards western, industrialized nations, small sample sizes and a missing assessment of grey literature.

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