Waste segregation strategies


Divert noninfectious waste during the back table set-up.


• Have a large solid waste container and recycling container.


• Line the red regulated medical waste container with a clear bag to capture the noninfectious waste and set it aside by tying it off before the procedure starts to avoid contamination.


Segregate noninfectious waste after procedures during clean up.


Segregating noninfectious waste during the procedure.


• Noncontaminated surgical wastes and drapes, remaining packaging, and sterile wrap can be removed by placing in clean plastic bags similar to pre-procedure waste collection.


• Set up alternate containers for solid waste and recycling along with the regulated medical waste container to capture the noninfectious waste during the actual procedure.


• This step needs a high level of awareness and commitment from everyone, as placement of a single infectious waste in the wrong container can cause problems with regulatory compliance.


An assessment of the procedural waste collected in the IR suite showed that approximately 55% of the total weight of the products used in IR contribute to waste and are not utilized during the actual procedure, and 76% of the waste generated from these products is recyclable.6


However, much of it is


not recycled due to improper sorting and disposal.7


This can be alleviated


by educating staff, procuring recycling bins and instituting facility-wide recycling policies.


Every item used during an IR procedure has about two waste packages, and some have as many as five.8


It is worth


questioning if medical companies can redesign the packages to remove layers that don’t contribute to product protection or sterility. The paper instruction booklets included in all disposables can be replaced with digital instructions accessed online, possibly via a QR-code. And commonly used kits such as central lines or enteric feeding tubes can be assessed regularly to identify which components aren’t used during procedures and only contribute to waste. Since medical device and consumable product packing isn’t governed by an international standard, there is no reason not to take the steps needed to create sterile packaging that produces less medical waste.


It is critical to understand how our clinical practice affects the planet’s ecosystem. As leaders in medicine and society, we are adequately positioned to spearhead initiatives around sustainable health care practices. Creating a sustainable IR practice requires multidisciplinary collaboration between health care personnel and hospital management, staff education, appropriate guidance and leadership, and the development and use of environment-friendly technologies.


References


1. Eckelman MJ, Huang K, Lagasse R, Senay E, Dubrow R, Sherman JD. Health care pollution and public health damage in The United States: An update: Study examines health care pollution and public health damage in the United States. Health Affairs. 2020;39(12):2071–2079. Doi:10.1377/hlthaff.2020.01247.


2. Chung JW, Meltzer DO. Estimate of the carbon footprint of the US health care sector. JAMA. 2009;302(18):1970–1972. doi:10.1001/ jama.2009.1610.


3. Chua ALB, Amin R, Zhang J, Thiel CL, Gross JS. The environmental impact of interventional radiology: An evaluation of greenhouse gas emissions from an academic interventional radiology practice. JVIR. 2021;32(6):907–915.e3. doi:10.1016/j.jvir.2021.03.531.


4. United States Environmental Protection Agency EPA. Greenhouse Gas Equivalencies Calculator. Greenhouse Gas Equivalencies Calculator. epa.gov/energy/ greenhouse-gas-equivalencies-calculator.


Purchase products that are likely to have lower GHG emissions or are produced sustainably.


How to produce less waste


Sort waste generated during


procedures correctly for more effective recycling (solid waste, recyclable waste, regulated medical waste),


Lobby medical device and


supply companies to reduce their packaging footprints.


Shift to using supplies that can be reprocessed for reuse, rather than relying on single-use, disposable products.


5. Chawla A, Chinchure D, Marchinkow LO, Munk PL, Peh WCG. Greening the radiology department: Not a big mountain to climb. Can Assoc Radiol J. 2017;68(3):234–236. Doi:10.1016/j.carj.2016.10.009.


6. Clements W, Chow J, Corish C, Tang VD, Houlihan C. Assessing the burden of packaging and recyclability of single-use products in interventional radiology. Cardiovasc Intervent Radiol. 2020;43(6):910–915. Doi:10.1007/s00270-020-02427-3.


7. Blessy J, James J, Kalarikkal N, Thomas S. Recycling of medical plastics. 2021;4(3):199–208. Doi:10.1016/j.aiepr.2021.06.003.


8. Shum PL, Kok HK, Maingard J, et al. Environmental sustainability in neurointerventional procedures: A waste audit. J Neurointerv Surg. 2020;12(11):1053-1057. doi:10.1136/neurintsurg-2020-016380.


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