Hospitals account for 3% of US greenhouse gas (GHG) emissions1 and are striving to increase their sustainability and decrease their global warming potential (GWP). Of their emissions, 54% are derived from supply chain goods and services.1 Targeting supply chain points1 and replacing disposable products with reusables2 can reduce their GWP. We estimate US hospitals dispose of their needles, scalpels, etc, into 35 million disposable (DSC) or reusable (RSC) sharps containers generating 90,000 metric tons of carbon dioxide equivalents (MT CO2eq) in their manufacture, use and disposal. We posed the question, “Could a hospital reduce their GWP by converting from DSC to RSC?” Using a life cycle assessment (LCA) we addressed the question using data from Northwestern Memorial Hospital (NMH) Chicago IL, an 850 bed hospital, which converted from DSC to RSC.
Using established principles,3,4 we developed a lifecycle inventory and a product-system (sharps-containers) LCA tool. Utilizing a 12 month before/after intervention model, we calculated GHG emissions (CO2, CH4, N20), expressed in MT CO2eq before and after NMH’s conversion from polypropylene DSC (BD, Franklin Lakes NJ) to the RSC (Daniels Sharpsmart Inc, Chicago IL). We utilised site-specific primary energy input data for RSC manufacture, washing, autoclaving and transport distances; US industry information for DSC manufacture and DSC/RSC transport energy inputs;5 and international values for plastics manufacture.6 We converted energy data using grid-specific CO2eq factors for electricity and national factors for fuels.4,5 RSC manufacturing emissions were divided by anticipated lifetime-years.3 The DSC were not recycled nor had recycled content. Data were analysed using Fisher test on rate ratio, with P ≤0.05.
In baseline year DSC manufacture/use generated 99.1 MT CO2eq compared to 20.2 MT CO2eq for RSC (P < 0.001).
The GWP generated by RSC manufacture/use is significantly less than that of DSC. DSC manufacture accounted for 95% of CO2eq disparity between the two systems. Confirmatory studies need particularly address electricity “cleanliness” and transport distances. With RSC, NMH reduced its annual, bed-normalized GHG by 88 MT CO2eq. If RSC were used nationally we estimate annual hospital GHG would fall by 55,000 MT CO2eq. While only a small fraction of the 115 million MT CO2eq generated by US hospital supply chain emissions,1 RSC use is a positive step to consider when formulating a sustainable hospital supply chain purchasing policy.