Grace Hatton: Plastic waste—ambiguous instructions on clinical waste bins don’t help

According to recent estimates from the Ellen MacArthur and World Wildlife Federations, there will be more plastic by weight in the sea than fish by the year 2050. [1]

Plastic waste is ubiquitous, and the healthcare industry is a huge, albeit often underestimated, contributor. Sustainability is becoming increasingly topical because of this growing problem but has yet to be formally addressed in clinical environments.

While I personally have noticed the odd recycling bin dotted around various hospital food courts, none have ever appeared to sit in any clinical areas. This piqued my curiosity, so I investigated further and, to my horror, discovered that there are in fact no established nationwide in-hospital recycling schemes in the UK, nor are there any effective alternatives to plastic use in place. Indeed, current estimates indicate that just 7% of all healthcare plastic waste is recycled, [2] with the rest simply contributing to ongoing environmental pollution.

Ambiguous instructions on clinical waste bins are also unhelpful. Currently, pictograph labels attached to clinical waste bin lids usually indicate that, as well as being for contaminated clinical waste, these bins are for any waste that has contained products intended for clinical use, or any waste has come from the same packaging as products intended for clinical use. Ironically, several of these clinical waste bins in my own hospital are also labelled with, “Please recycle where possible,” albeit without clear instructions on where such recycling facilities are located.

During one particular A&E night shift, a nurse colleague and I looked at the volume of disposable plastic items—packaging, lids, syringes, lines, and bags—that we both put into the clinical waste bins. Within an hour we had filled a 20 litre clinical waste bin with almost entirely uncontaminated plastic waste. As this uncontaminated, potentially recyclable plastic waste fell under the clinical designation, it had to be disposed of accordingly; meaning, to the landfill, or worse, an incinerator.

All this is what prompted me to develop the non-governmental initiative Recycle Health Organisation®—in part, to petition the government to implement stringent recycling practices in clinical environments across the UK, but also to implore manufacturers within the healthcare industry to address their unsustainable practices.

Several UK based organisations are already developing viable solutions to some of these problems—such as SteriMelt® who have developed recyclable wrapping for surgical equipment, and Recircle Recycling® who have developed technology to separate recyclable materials. However, whether for cost reasons or otherwise, recycling strategies like this have yet to be integrated into NHS infrastructure.

Manufacturers have a crucial role in addressing and resolving the current catastrophe but are not solely to blame. We need the enforcement of top down changes to regulate plastic production, implement formal recycling and reusing methods, and reduce waste generation.

While we wait for these changes in policy there is plenty that can be done to promote the implementation of viable, safe, and cost-effective recycling solutions for healthcare plastics, including: educating healthcare staff and the public, raising awareness locally and on social media, petitioning the government, and supporting plastic recycling campaigns.

Grace Hatton is an academic foundation doctor at King’s College Hospital London, pharmacy graduate, and research scientist at UCL @recyclehealthuk

Competing interests: Grace Hatton is founder of the non-governmental and not-for-profit organisation Recycle Health Organisation®