Implementation of a More Sustainable Waste Management Policy in the Operating Room.

Abstract

The waste produced by an operating room represents on average 20 to 30% of the waste of a health institution.1 At the Toulouse University Hospital (Toulouse, France), more than 100 tons of waste are produced per month.In 2020, only noninfectious waste and infectious waste existed within our institution in terms of waste sorting. There was no recycling channel, and nearly 40% of the waste from the operating room was treated as infectious waste (fig. 1, A and B).The treatment of infectious waste is more expensive than that of noninfectious waste in terms of cost (1 ton of noninfectious and infectious waste costs 270€ and 720€, respectively, to treat at the Toulouse University Hospital) and carbon dioxide impact, because the treatment of 1 ton of noninfectious waste corresponds to 362 kg of CO2 compared to 934 kg of CO2 for infectious waste in France.2 We have set up a policy of better waste management within our university hospital with the objective of reducing the proportion of waste treated as infectious waste on the one hand, and, on the other hand, identifying reusable materials by setting up channels for the treatment of recyclable waste.First, to reduce the amount of waste treated as infectious waste, staffs were made aware of the cost of treating this waste, the recommendations of the institution’s health care–associated infectious risk prevention unit were updated, and the members of the green teams accompanied the teams in the field to gradually modify practices and improve sorting.The second objective was to identify reusable waste. To do this, the teams specializing in waste management worked in the operating room to improve their knowledge of the care-related waste generated by the operating room activity. Subsequently, specific partnerships were established with various service providers (copper, laryngoscope blades, cardboard, bottles, etc.), and we reorganized the operating rooms to facilitate waste sorting. As an example, our green dynamic allowed us to reduce infectious waste and total carbon dioxide production with a consequent reduction in costs (fig. 1).The implementation of the recycling channels in 2021 enabled the sorting of more than 60 tons of waste in the first year, with near 2 tons of precious metals (laryngoscope blades, aluminum packaging, and copper cables), 15 tons of plastics, 5.9 tons of paper, and 35.9 tons of cardboard. The perspectives of our work are to continue and extend the green project to the other departments of the university hospital, to reduce the global quantity of waste by setting up “custom packs” specific to each surgical procedure, and to avoid overconsumption by educating the staff and raising awareness on a daily basis.3The authors thank all the green teams who have worked to support the staff of the Toulouse University Hospital (Toulouse, France), and particularly the staff of the operating room, in their efforts to improve waste management practices. The authors also thank Dr. Jean-Marie Conil, M.D., Ph.D., Anesthesiology and Critical Care Medicine, Toulouse University Hospital, for his help in reviewing the statistics.Support was provided solely from institutional and/or departmental sources.Dr. Labaste has received funding from SANOFI (Paris, France) unrelated to this publication. The other authors declare no competing interests.