Dan Vukelich

Reducing greenhouse gas emissions from hospitals, one pair of surgical scissors at a time

June 21, 2024
By Dan Vukelich

Most people who work outside of hospitals are shocked to learn that commonly used medical devices, sometimes costing thousands of dollars, and some containing over 35% metals (including gold, copper, and platinum), are transported from their places of manufacture, often outside of the US, used just once, and thrown out. These products include electrophysiology catheters, harmonic shears, and laparoscopic dissectors.

Yes, some hospitals are literally using a product with gold in it and throwing it out.

Surgical procedures generate an incredible amount of waste, often from medical devices labelled for single-use by their manufacturer. Seeing the waste from just one medical procedure is enough to make anyone sick. A recent peer reviewed article, published life cycle assessment (LCA) of five commonly used single-use surgical items found that 68% of CO2 emissions from the U.K.’s National Health Service come from items labelled for single-use.

In the U.S., we know that emissions from what researchers label “Scope 3,” those emissions coming from products brought into t hospitals, create a whopping 82% of greenhouse gas emissions. This puts the finger on the pulse of a shocking problem: the health sector, if taken collectively, would be the 5th worst polluting nation on the planet.

Tackling the problem of CO2 emissions from hospitals is a daunting task. Starting with lights that shut off automatically when not in use is a common place to start. But this focuses on a hospital’s scope 1 or scope 2 emissions – a great start, but the majority of emissions are coming from the supply chain, where emissions are notoriously hard area for hospitals to track.

Over 20 years ago, Congress and the Food and Drug Administration created a pathway to regulate commercial reprocessing companies, resulting in reprocessed single-use devices that are as safe and effective as original devices. Over 300 types of single-use devices (SUDs) have been reviewed by FDA and are green lighted for reprocessing. Later the EU began issuing CE marks for reprocessed (often, “remanufactured” in European markets) single-use devices. Today, over 9,500 hospitals, including most U.S. military hospitals and all US News & World Report “Top hospitals” use at least some reprocessed devices.

And for good reason. For each device used, the hospital saves 30% to 50% in cost. And eight peer reviewed life cycle assessments find that the reprocessed version reduces CO2 by on average 44% compared to using a virgin device each time. The studies are listed on the last page of our explanation for how our new CO2 calculator for works.

The calculator takes the average of the emissions reductions found in these studies by using reprocessed versions of the single use device, and quickly and easily shows the emissions reductions. But it also shows how wasteful using virgin single-use devices is.

By offering the calculator for free, AMDR hopes to demonstrate the environmental benefits of reprocessed SUDs to health and environmental policymakers, as well as to help hospital purchasing decision-makers and sustainability coordinators to calculate emissions savings from their reprocessing programs. To achieve this, we evaluate relevant, peer-reviewed LCAs comparing reprocessed SUDs to their original device counterparts to power the emissions savings formulas used by the calculator. Because LCAs use dozens of inputs for the specific devices, manufacturer and processes studied, these formulas result in estimated savings only. However, they are the best estimates available for calculating emissions savings from the use of reprocessed SUDs currently. With time, and the input of more LCAs, we anticipate data reliability will increase.

The calculator is of particular importance now that the Joint Commission is now voluntarily accrediting hospitals for sustainability. Hospitals are expected to benchmark their emissions and show improvement in reductions over time. This calculator is a way to credibly measure emission reductions. CMS also just announced its TEAM Decarbonization and Resilience Initiative, a clear indication of the need for more resources like our calculator that hospitals can use to reduce waste and emissions.

The calculator reminds all who use it that a simple switch to FDA regulated, reprocessed single-use devices reduces cost, waste, and greenhouse gas emissions. But it also strengthens our supply chain by keeping devices more locally available. What’s more, when hospitals choose reprocessed devices, they drive a circular economy that should incentivize more manufacturers to join.

AMDR members are ready to help hospitals reduce emissions using reprocessed devices. By working with our members, hospitals know they are partnering with companies that want to help them reduce cost, waste, and emissions.

About the author: Dan Vukelich is the president and CEO of the Association of Medical Device Reprocessors.