Austin Bennett, OMS IV
West Virginia School of Osteopathic Medicine, Lewisburg, West Virginia
Prior to medical school, I worked as an ED Tech. Some of my duties included unpacking the boxes of supplies from the manufacturers and stocking the patient care rooms. I also often helped my friend Edgar in environmental services/housekeeping take the trash out before shift change. I vividly remember pondering one shift about the amount of waste that must be produced nationally from emergency departments, let alone entire hospitals. Day after day, more boxes would come, filled with single use supplies which I would restock. As a medical worker, I understood the necessity for single use supplies and sterile packaging, however, I found it hard to believe that there could be no method to reduce this waste, even if just a little bit. I would send suture tools home with the patients to add to their tackle box for fishing or for use in home crafts, but that helped repurpose only the tiniest fraction of the ED waste. I questioned the waste production and whether there could be a better way. How can we individually “green” our own daily efforts in the ED?
My ability to see other hospitals, and specifically emergency departments, during my third- and fourth-year clerkships solidified my concern with the amount of waste which I had seen years prior while working as a tech. It is imperative for hospitals to minimize their environmental footprint, even through simple measures. As I write this, I am aware of how lofty of a goal it is to change the practices in waste management in the highly complex United States healthcare system. However, I believe small change will create big change.
After a quick internet search, I realized that many others in healthcare are of the same opinion. The United States Healthcare sector is responsible for 10% of the nation’s greenhouse gas emissions1. A study published in the Western Journal of Emergency Medicine in 2020 titled “Dumpster Diving in the Emergency Department: Quantity and Characteristics of Waste at a Level I Trauma Center” stated that the Level I Trauma Center in which the study was conducted produced 671.8 kilograms of waste in one 24-hour period, with the majority being plastics. Interestingly, those conducting the study identified only 14.9% of red bag (biohazard) waste disposal truly qualifying to be disposed of in the red bag.1 My immediate thought was: “I have used the wrong trashcan a lot myself!” I cannot count the number of times that I have put in a peripheral IV line and promptly thrown all the trash in the closest receptacle (often the red bag waste). Disposing of our medical trash mindfully is a simple fix in our daily practice at the hospital to limit our footprint. As mentioned in the study above, “85% of all waste thrown into regulated medical waste (RMW) did not meet the criteria for RMW. Given that RMW costs 5-10 times as much to dispose of compared to solid waste, diverting non-RMW from the red biohazard bags is a significant opportunity for cost savings.”1
Health Care Without Harm, an international group focused on “transforming health care worldwide so that it reduces its environmental footprint,” states that “before going to the disposal site, infectious wastes must undergo treatment processes: Autoclaving, thermal disinfection, microwave sanitation or incineration.”2 Not only is this process incredibly expensive, but it also requires significant resources and contributes measurably to greenhouse gas emission. Most of the trash produced daily in the hospital can be characterized as municipal waste – some of which may be recovered and recycled. By choosing the right receptacle, we can have a tiny impact on our individual footprint. By educating ED Staff about this simple change, a step in the right direction can be made.
- Hsu S, Thiel CL, Mello MJ, Slutzman JE. Dumpster Diving in the Emergency Department: Quantity and Characteristics of Waste at a Level I Trauma Center. Western Journal of Emergency Medicine. 2020;21(5):1211-1217
- Tips for Waste Reduction. Health Care Without Harm. https://noharm-uscanada.org/issues/us-canada/tips-waste-reduction. Published May 14, 2013. Accessed April 18, 2022.