To better understand current practices related to the use and disposal of healthcare plastics, the Healthcare Plastics Recycling Council conducted interviews with several hospitals across Europe. The information gathered through these interviews uncovers distinct barriers to plastic recycling in healthcare settings and identifies important opportunities for improvement, not just at the hospital level but across the supply chain.

Process

To gather detailed and consistent information during the hospital interviews, a questionnaire was developed to track specific medical devices and plastic packaging as they moved through the hospital. This included delivery and arrival to the hospital, movement through preparation and procedural areas, and disposal and exit from the hospital.

Speaking with Environmental and Sustainability Managers, and those whose accountabilities include waste management and recycling programs, HPRC interviewed hospitals from the following countries: United Kingdom, Spain, The Netherlands, France, Finland, Luxembourg.

Findings

Over the course of the interviews, several recurring themes surfaced related to plastic recycling barriers that could be mapped into three categories: hospital barriers, legislative barriers and waste processor barriers.

Hospital Barriers

Multi-Materials

Healthcare products and packaging that consist of multiple material types can be a barrier to recycling. For example, a product may be formed by combining bioplastics and petroleum-based plastics, packaging may consist of a plastic material with a paper layer glued on top. Both of these make it impossible for hospital staff to separate the materials and difficult for waste processors to recycle.

Related Resource: Best Practices for Recyclable Products and Packaging

Identification of Plastic Type

Given the variety of different plastic materials used in healthcare products and packaging, it is difficult for hospital staff to correctly identify plastic materials and which waste stream they go in. There is a general lack of knowledge around which plastics are recyclable and which are not – resulting in inconsistent collection of materials.

Related Resource: Common Recyclable Healthcare Plastics, Hospital Recycling Training Tools

Lack of Space

Good material separation and collection efforts often require adequate space for collection and waste bins. There is also an issue of storage space once materials are collected and awaiting pick up from a waste processor. Most hospitals were not designed to include these space needs and as a consequence, can severely limit a hospital’s ability to recycle.

Related Resource: Space Guidance for Hospitals

Legislation Barriers

Compliance Complexity

In Europe, there is a lack of understanding across EU countries as how to treat healthcare plastics by local waste-stream specific directives. This complexity then leads to lack of clarity around regulatory compliance.

Contaminated Products

Due to environmental policy and licensing, contaminated waste materials must be separated out from other waste streams. Contaminated waste materials are the biggest contributor to a hospitals total waste stream – and currently there is a lack of guidance on whether contaminated healthcare materials can be safely cleaned and recycled.

Waste Processor Barriers

Lack of Waste Acceptance

It is oftentimes difficult for hospitals to find a waste processor who will accept their plastic waste stream. The relatively small amount of plastic waste from a hospital, when compared to other industries, can seem insignificant to a waste processor. Additionally, the potential for contaminated materials can be seen as a safety risk by waste processors.

Related Resource: Finding a Recycling Partner for Your Hospital, Questions to Ask Your Recycler

Opportunities for Improvement

Based on the identified barriers, hospital interviews also included discussions on what actions could be taken to make improvements in these areas. Following is a summary of potential solutions that would help reduce current recycling challenges.

Supplier Improvements

There is a clear desire by hospitals for more guidance on material types and labelling of plastic packaging materials. Hospitals are often fast-paced and stressful environments, and hospital staff don’t have time to waste trying to identify plastic types and determine which collection bins to place them in. A simple label, mark or resin code could go a long way in improving material separation at the source.

Another significant opportunity for improvement is the increased use of mono-materials in product and packaging design. The elimination of multiple material types within one discrete product or package not only removes the labor and associated costs of manual separation, but it also creates a cleaner, higher value waste stream.

Hospital Improvements

Investments in education and training for staff can be vital for successful healthcare plastic recycling programs. It is important that hospital staff understand how to identify different material types and which collection bins they should be placed in. Short but frequent meetings, communications and signage can help improve material sorting and yields.

Hospital staff should also consider working with procurement to develop a purchasing policy that prioritizes sustainable products and packaging — and ultimately their ability to be recycled. This includes not only evaluating the costs of materials, but also the costs associated with disposal.

Lastly, hospitals should engage waste processors in discussions to help improve recycling rates. Find out what capabilities waste processors might have to conduct mechanical sorting of materials at their processing facility. Hospitals could save space and effort by transferring material sorting to the waste processor.

Legislation Improvements

Regulatory bodies should work together with hospitals and medical device suppliers to research and evaluate the actual differences between hospital waste and waste from other industries. Currently, there are many hospital waste items that are automatically designated as non-recyclable, even though these items are in fact able to be recycled.

Waste Processor Improvements

Waste processors should continue to invest in improved sorting techniques and work together with hospitals and medical device suppliers to ensure these techniques are effective for healthcare plastic waste. Doing this will help create homogeneity of waste streams and higher market value.

Building on the findings of the infographic above, this paper aims to provide an understanding of legislative barriers regarding recycling healthcare plastics. In particular, the barriers related to legislative requirements applicable to the handling of hazardous healthcare waste. The paper concludes that a robust and unambiguous legislative framework does not yet exist for the recycling of hazardous medical plastic waste nor for plastic medical waste as recycled content for other applications. The paper identifies at least five conditions that need to be met to improve the recycling infrastructure for hazardous plastic medical waste.

Process

This foundational paper presents the insights gained during this research by answering the following research question:

”HOW CAN BARRIERS TO THE RECYCLABILITY OF HAZARDOUS AND NON-HAZARDOUS HEALTHCARE PLASTIC WASTE BE IDENTIFIED AND ADDRESSED, IN RELATION TO HEALTHCARE SYSTEM PRACTICES AND REGULATIONS IN SELECTED EUROPEAN COUNTRIES?”

This research has been conducted in collaboration with Aalborg University and aims to understand the current regulations on hospital waste in various EU countries. A special focus was placed on contaminated (including biohazardous, chemical, and pharmaceutical) hospital waste. The research helps to identify where actions are needed to improve the recyclability of plastic medical waste.

The research has been conducted by doing desk research, following seminars, and conducting twenty guided interviews with professionals in the healthcare industry. Four countries were selected as focus areas: Denmark, the United Kingdom, the Netherlands, and Germany.

Findings 

• • There is a strong awareness and willingness among healthcare providers to improve the recyclability of medical plastic packaging.
  • A robust and unambiguous legislative framework does not exist (yet) for the recycling of (hazardous) medical plastic waste nor for plastic medical waste as recycled content into other applications.
  • At least five conditions are identified that need to be met to improve the recycling infrastructure for (hazardous) plastic medical waste such as ‘’alignment of unambiguous legislation within and across European member states.’’