Compostable Medical PPE and Food Waste On-Site Bio-Digestion, A Global First.

Investigating the impact of re-design and re-direction of healthcare waste streams in a real world setting.

‘The best time to tackle the single use plastic problem was fifty years ago, the second-best time is now.’

Healthcare is first do no harm, but we are now eating a credit card of plastic a week, with forever chemicals in foetal blood and increasing evidence that microplastics contribute to the risk of stroke. The plastic waste from the Covid-19 pandemic alone was in excess of 25,900 tonnes. It is equivalent to more than 2,000 double decker buses of plastic leaking into the ocean and yet we persist with single use throw away items.

98% of single use plastics are made from fossil fuels, which exacerbates climate change. Once used, these items are disposed of, creating pollution and waste. On average one-third of a hospital’s general waste is plastic but less than 10% of healthcare plastic is recycled. Innovative solutions to this problem are required and are emerging around the world, but there are barriers.

Some facts about healthcare waste (HCW) and hospital food waste:

• 80% of HCW is non-risk and this means it can be disposed of in the general waste cycle. This non risk healthcare waste includes non-contaminated gloves, aprons and masks.
• Of the waste that is Healthcare Risk Waste (20%), 94% of this category is treated by a process of sterilisation and incineration – an expensive model in terms of money and carbon emissions.
• In addition, it is not just plastic waste that is a significant burden of waste in healthcare. The 1297 NHS hospitals and 515 private hospitals produce 12% of the total food waste generated in the UK. That’s 1.1 million tonnes of the total of 9.5 million tonnes. (2018-19 figures from WRAP). The cost of hospital food waste is estimated as £230m per annum. WRAP estimate that around 18% of all food prepared goes to waste, equivalent to one meal in six.
• These figures are only estimates according to the NHS Digital, as 81% of NHS trusts did not file returns for their food waste in the survey. Also, most hospitals still use macerators to dispose of food waste into the drain system and was therefore not measured. This shows the importance of facilitating real-time monitoring of waste in each facility.

Future pandemic and emergency preparedness are also essential considerations when it comes to PPE. Local manufacturing and management of waste are key aspects that assist both the availability, usage, quality assurance and disposal of product but also leads to a significant reduction in carbon emissions by simply having a short supply chain from the outset. Local manufacturing also builds capacity in ‘peacetime’ manufacturing so that there is more national self-sufficiency and flexible scalability to meet demand during seasonal, epidemic and pandemic fluctuations. Finally, local manufacturing in general reduces carbon emissions by between 60 to 75% simply by reducing transport distance.1 However, currently almost all single use PPE manufacturing occurs many miles away from UK use points and local manufacturing capability is decimated. And yet, in many industries, single use PPE is critical kit to protect healthcare staff, patients and industry users. The use of PPE is not going to alter given current health and safety obligations.

PPE throw-away items are deceptively simple in design and are not given due consideration in innovation circles because of that perceived simplicity. However, they are deeply complex with regards to disposal due to their composite nature; mostly comprising low density polyethylene and synthetic elastic and even ‘natural’ rubber takes 20 years to degrade in landfill. The challenge is to innovate a compostable solution so that single use PPE items can be designed with no compromise in current functionality but are compatible with a sustainable end of life recovery method such as resin recapture or bio-digestion.

The current system of personal protective equipment use and disposal is as follows: Oil based, single use aprons, mop-caps, gowns and foot-covers, used for a moment, then thrown away to be incinerated or landfilled for 50 years. This is expensive in terms of money, environmental damage and carbon emissions.

We propose an alternative solution. HaPPE Earth uses sustainably sourced bio-resin to make our first product, the compostable splash apron. These splash aprons are used as before but this time, the value is recovered by using our specially designed, onsite medical bio-digester creating a pathogen safe, nutrient rich fertiliser or in time, be part of a resin recapture system. The waste is de-risked onsite in terms of pathogen elimination and also made into a valuable fertiliser product instead of waste – thereby reducing costs. This fertiliser can be used for horticulture or as a pre-processed material for anaerobic digestion and biofuel creation.

The whole process is monitored using real time monitoring tool and delivered as an easy, subscription service model. Think software as a service but for PPE. The apron was the test item for the development of the full product and waste cycle development. Monitoring aids reporting of real sustainable gains in waste reduction and the achievement of net zero waste targets rather than relying on estimates and ad hoc reporting. We design for end of life and take into consideration the full life cycle of PPE items ensuring compliance with CE, UK, Eudamed, and EU harmonized standards.

To reduce costs of healthcare waste (HCW), the aim is to ensure appropriate waste segregation at the outset so that only true healthcare risk waste reaches the hazard bin and that more non-risk HCW can be directed to other recycling /bio waste streams. The monitoring of the usage/weight and output is captured, by way of a proprietary software system, for ease of real time reporting. The bio-digestor also incorporates any hospital food waste converting both waste streams into a nutrient rich fertiliser without additional costs of off-site waste disposal. Bio-digestion is a complex science and it is important to get the most technologically advanced system if Greenhouse Gas Emissions (GHG) emissions are to be reduced. In addition, the accelerated thermophilic, plasma processes and digestate testing ensures that pathogens are eliminated.

The on-site method of bio-digestion disposal of healthcare waste is unique. Bio-digestion of medical consumables was not an option to date, because bio-products and advanced bio-digestion technology had not been readily available. With the availability of products like the bio-aprons and closed bio-digestion technology, it makes this full cycle combined with food waste now possible and so it has opened the pathway for end to end processing to be realised. This is why the solution is unique and has not been achieved anywhere else before.

So, let’s take a leaf out of nature’s book and refine our operations to be as aligned as possible with natural processes, where nothing is wasted.

References

Chantelle Rizan, Malcolm Reed, Mahmood F Bhutta. Environmental impact of Personal Protective Equipment supplied to health and social care services in England in the first six months of the COVID-19 pandemic. doi: https://doi.org/10.1101/2020.09.21.20198911

Authors