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Two years on: tackling the environmental impact of PPE

Nadine Sheikh-Sobeh

08 Jun 2022

Nadine Sheikh-Sobeh

Nadine Sheikh-Sobeh is the Public Affairs and Policy Officer at RCS England. She is involved in our work on sustainability in surgery and is interested in greening the health sector. 

Just over two years ago, the United Kingdom entered its first national lockdown. As scientists globally worked night and day to develop a vaccine against COVID-19, health systems ramped up their usage of personal protective equipment (PPE) to control the spread of the virus.

Fast forward to May 2022, and over 19.8 billion items of PPE have been distributed across the health and care sector in England alone. An estimated 10-16 million items of PPE are required daily in the UK, most of which are made of single-use plastic. To accommodate this demand, the global disposable face mask market is expected to grow at a rate of 53% from 2020 to 2027.

Composition of PPE and its environmental consequences

The environmental impact of PPE is significant. With the key material in surgical masks – polypropylene – a member of the thermoplastic family, it’s estimated that single-use masks could take up to 450 years to degrade and completely disappear from the environment. Neither recyclable nor biodegradable, single-use PPE breaks down into micro-plastics, contaminating the ocean and posing a threat to marine life.

In May 2020, environmental activist Laurent Lombard shared a video showing several pairs of latex gloves and surgical masks being strewn across the ocean floor, near the coast of Cannes, France. Captioning the video, Laurent wrote, ‘Soon there will be more masks than jellyfish in the water of the Mediterranean…!’. The video quickly went viral and sparked global public outcry.

Plastic pollution levels across the world’s oceans is on the rise. In 2010, the charity Ocean Conservancy estimated over 8 million metric tons of plastic entered the ocean each year, which, for comparison, is 80 million times the weight of a blue whale. They had predicted this figure would double by 2020, but never could have foreseen the impact of a global health pandemic on single-use plastic consumption.

Initiatives to tackle the environmental impact of PPE

As we continue to battle emerging COVID-19 variants of varied transmissibility and severity, it is widely accepted that PPE is here to stay. Attention has now turned to how we can reduce its environmental impact.

The Royal College of Surgeons of England (RCS England) is actively facilitating innovative solutions and providing comprehensive guidance to help organisations improve sustainability in the operating theatre and reduce the environmental impact of single-use PPE.

For example, we were a proud partner of last year’s Green Surgery Challenge, co-organised by the Centre for Sustainable Healthcare. The competition saw multiple teams present innovative solutions for maximising reusable surgical instrument use and devising reusable surgical gowns, alongside other projects to make the surgical practice more environmentally, socially and economically sustainable.

We have also established a Sustainability in Surgery Group, which looks at sustainability in surgical practice, in associated industries and within the College itself. Our Sustainability in Surgery Strategy outlines how we plan to embed financial, environmental and social sustainability into everything we do.

Beyond RCS England, an initiative spearheaded by the NHS, UK Make, is exploring domestic PPE manufacturing solutions to help reduce Scope 3 (indirect) emissions. This involves developing resilient and strategic domestic supply chains and procuring made-for-reusable PPE items, including masks and gowns.

Other strategies being touted to reduce the environmental impact of PPE involve the age-old practice of reducing, reusing and recycling. A recent study on the environmental impact of PPE by health and social care services in England found that reducing the use of gloves by using hand washing alone would have reduced the carbon footprint of PPE by 45% during the first six months of the COVID-19 pandemic.

Embracing innovative solutions to achieve net zero

As we look ahead to achieving net zero emissions in the health sector, our reliance on single-use PPE will need to change. Climate change presents real and far-reaching consequences to healthcare systems and is now widely recognised as one of the greatest threats to the health of global populations.

Though only a small piece of a much larger jigsaw, projections for the growth of PPE are alarming and its potential environmental impact severe. As we begin to shift from pandemic to endemic, we need to embrace innovative solutions to PPE, both in the health sector and beyond, as part of our collective effort to tackle the climate crisis.

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