It’s the bane of many waste treatment facilities. Blue spun (non-woven) polypropylene wrap often ties its way around the best of shredders causing many hold-ups and some equipment damage during shredding of autoclave floc, and in automated feed systems for autoclaves, augers, microwave and incinerator plant.

Used for surgical drapes, the wrapper for sterile instrument packs, and for many single use disposable gowns used in theatre, radiology, in laboratories, and as the now universal disposable replacement for bed curtains that are found on every hospital ward, the material might be ideal for material recovery if separated effectively.

A new resource recovery service promises to do just that, but only for non-contaminated wrap. Strangely identifying itself as an environmentally aware non-profit .org organisation but nonetheless a limited company, Alternative To Landfill Ltd aims to be at the fore front of the recycling industry, concentrating on the recovery of waste for reuse, recycling and seeks alternatives for material that would otherwise end up in landfill sites.

Good for them. We are of like mind and would be happy to support their ideals. However, restricting the operation to accept only non-contaminated material is a serious drawback. Clearly aiming for the lower fruits, and avoiding the regulatory framework that might conflate operations that may then include wastes considered more accurately as clinical wastes, the problems that this may cause make the business model difficult to accept.

Chosen waste volumes must be low, especially since source segregation will permit recovery of non-contaminated feedstock for this operation only from the largest and most dedicated environmentally-aware surgical centres. They may be found centred around only the larger conurbations, leaving the logistics operation to bring together sufficient waste for a cost-efficient operation looking a little thin.

And of course, there is the thorny problem of source segregation. Will it be good enough? Will an item of miscellaneous plastic make a difference, or some stray sheets of paper? Probably not. But the ‘what if’ of contamination with some contaminated or bloodstained material is more difficult to predict.

How much contamination is necessary to define a contaminated load?

What about the contamination that is not visible? How hard should we look, among a skip full of compressed wrappers?

And once identified as contaminated, will the entire batch comprising multiple collections be rejected? And what becomes of that rejected material, since rejection must accept reclassification as clinical waste, consequentially bearing a high cost for disposal.

Mush spun or non-woven polypropylene drape and gown material finds its way to clinical waste treatment, and quite rightly so. The recovery of this fraction from autoclaved clinical wastes, after sterilisation and either before or after shredding, would be a major advance.

The developments of  Alternative To Landfill Ltd are an important step forward and, at least in theory, looks to be of value though there are practical and operational matters of concern that may impact upon profitability and overall success. It’s a good idea, and if the regulatory framework permitted should be extended to seek the development of technologies to capture other non-woven wastes from ATT treatment floc.

 

 

 

Clemson University in South Carolina has developed a certificate program on medical device recycling and reprocessing.

This is an interesting, and perhaps rather brave step since the product liability issues of medical device reprocessing have frightened off many potential users. However, many high quality devices can be reprocessed and reused, though this can require substantial effort in re-validation that any cost advantage is lost.

In recent years, the explosion of the single use device market has left some red faces. Single use, when reprocessed and reused, invites the lawyers to ask if this is really safe. Prove it? And prove it again if the device is reprocessed twice, or more. And of course many informal and in-house reprocessing activities simply cannot provide that necessary re-validation.

The next step was partly altruistic, to ship used single-use items to under-resourced or ‘developing’ countries since they had nothing. But the ethicists as “Is that right, to offer these devices for use by the poor and disadvantaged, if they are provided without the validation and safety certification that we would expect at home. And then that stopped too!

There are many possibilities for device recycling and reprocessing, and for those items that do not have a second, or third, life there is no need to consider these as waste since the material resources can also be recovered. This may necessitate source segregation and separate disposal, or post-processing separation using one of the many separation techniques that are now common in the recycling sector but which have not found their way to clinical waste processing activity.

Much more developmental work is required, but before that happens those with experience in the field – rather, in these many different fields – need to consult with the designers and manufacturers, to move toward more uniform materials selection and less complex manufacture that support separation and more profitable and advantageous materials recovery on disposal. Though there are many agencies quick to stand up and say no, or at least to put barriers in the way of progress toward recycling, reprocessing and materials recover, regrettably that forum, to work collaboratively toward improvement in device re-use and cost-effective materials recovery does not yet exist.

 

 

 

 

 

Recycling is good. Well, it’s almost always good and we should do all we can to promote it, including the recovery for recycling and reuse of material resources from appropriately treated clinical wastes.

In some regions however, the desire for a quick buck – that on occasions can be the difference between life and death for those at the bottom of the chain – results in attempts at materials recovery from clinical wastes without the inconvenience of any treatment to render those wastes safe.

In Lahore, the Environmental Protection Department has started a programme to educate hospital staff about the proper disposal of waste and the hazards of not doing so. A large amount of plastic waste from hospitals – urine and blood bags, syringes and tubes – is sold to manufacturers of plastic cutlery and furniture, without the benefit of any treatment to render it safe, which is both illegal and dangerous to public health.

“There is a mafia of doctors, nurses and sanitary workers across Punjab who resell used plastic items, spreading disease to our homes,” said EPD Deputy Director (technical) Azmat Naz, who heads the training initiative.

http://tribune.com.pk/story/445450/bad-recycling-epd-hopes-workshops-will-curb-sale-of-medical-waste/

 

That is so true. Repeatedly, we have spoken of the corruption that results in fresh wastes leaving the hospitals’ back door in exchange for cash, to be reprocessed as new medical supplies or other items, and bought back cheaply to provide “profit” for those who engage in this illicit trade at every stage in the process. Sadly, the fate of patients, who may find themselves treated with non-sterile items of used equipment including used dressings, syringes and needles, is not so rosy.

The public health issues are horrendous, while for recovery of plastics and reprocessing as plastic cutlery the risks are different. Dangerous for those working in this trade, the pre-treatment and heating necessary to remould plastics may well be sufficient to remove any risk to end-users. Some of these plastic cutlery products may enter the UK, so for your picnic or that airline meal, it is the aesthetics that is the greater concern.

 

 

It’s a bold claim, but one that is not implausible and certainly to be applauded. Southend Hospital is celebrating becoming 100% landfill free with its waste. Continue reading “Southend Hospital is ‘landfill waste free’” »