Abstract
IntroductionHealthcare contributes 10% of greenhouse gases in the United States and generates two milion tons of waste each year. Reducing healthcare waste can reduce the environmental impact of healthcare and lower hospitals’ waste disposal costs. However, no literature to date has examined US emergency department (ED) waste management. The purpose of this study was to quantify and describe the amount of waste generated by an ED, identify deviations from waste policy, and explore areas for waste reduction.MethodsWe conducted a 24-hour (weekday) ED waste audit in an urban, tertiary-care academic medical center. All waste generated in the ED during the study period was collected, manually sorted into separate categories based on its predominant material, and weighed. We tracked deviations from hospital waste policy using the hospital’s Infection Control Manual, state regulations, and Health Insurance Portability and Accountability Act standards. Lastly, we calculated direct pollutant emissions from ED waste disposal activities using the M+WasteCare Calculator.ResultsThe ED generated 671.8 kilograms (kg) total waste during a 24-hour collection period. On a per-patient basis, the ED generated 1.99 kg of total waste per encounter. The majority was plastic (64.6%), with paper-derived products (18.4%) the next largest category. Only 14.9% of waste disposed of in red bags met the criteria for regulated medical waste. We identified several deviations from waste policy, including loose sharps not placed in sharps containers, as well as re-processable items and protected health information thrown in medical and solid waste. We also identified over 200 unused items. Pollutant emissions resulting per day from ED waste disposal include 3110 kg carbon dioxide equivalent and 576 grams of other criteria pollutants, heavy metals, and toxins.ConclusionThe ED generates significant amounts of waste. Current ED waste disposal practices reveal several opportunities to reduce total waste generated, increase adherence to waste policy, and reduce environmental impact. While our results will likely be similar to other urban tertiary EDs that serve as Level I trauma centers, future studies are needed to compare results across EDs with different patient volumes or waste generation rates.
Highlights
Healthcare contributes 10% of greenhouse gases in the United States and generates two milion tons of waste each year
14.9% of waste disposed of in red bags met the criteria for regulated medical waste
We identified several deviations from waste policy, including loose sharps not placed in sharps containers, as well as re-processable items and protected health information thrown in medical and solid waste
Summary
Healthcare contributes 10% of greenhouse gases in the United States and generates two milion tons of waste each year. Quantifying Waste in the Emergency Department more).[3] Overall, the US healthcare industry contributes nearly 10% of all US greenhouse gas emissions as well as additional other pollutants that adversely affect human health.[4] Healthcare waste is a direct contributor to these emissions and an important indicator of the impact of procurement practices. Prior studies have shown that there is poor segregation of healthcare waste into proper waste streams, and there are many opportunities to divert waste from landfills, such as recycling and single-use device reprocessing for reuse.[5,6,7] Efforts to reduce healthcare waste generation and improve sorting practices have the potential to reduce the environmental impact of healthcare and significantly reduce hospital costs for waste hauling and supply procurement.[8]
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