Tesalys, a French manufacturer of on-site HCW treatment solutions, compared the environmental impact of on-site treatment solutions versus transportation and incineration in a study. The results are stunning.
In many countries, HCW is mainly collected from the healthcare facilities by service providers and transported to dedicated incineration plants. Alternative technologies like shredder-sterilizers are available for on-site treatment of the HCW. Theoretically, on-site treatment should have less CO2 generation as waste is reduced in volume, avoids transportation containers and dedicated pick-up trucks as well as incineration emissions. However the avoided CO2 had never been measured. Tesalys, French manufacturer of on-site HCW treatment solutions, carried out a study of the environmental impact of on-site treatment solutions VS transportation and incineration of HCW.
Design of the study
The study, led by the independent sustainable development agency Primum Non Nocere was carried out in a private healthcare facility in the South of France (250 beds, 16 operating theaters) in real-life conditions. The initial situation was studied, particularly the composition and quantity of waste generated in each of the 16 operating theaters. The environmental impact study took into account all the direct and indirect modifications associated with the deployment of the on-site treatment solution, including waste segregation procedures, conditioning of the waste, machine water/electricity consumptions or transportation. This allowed a precise calculation of the CO2 emissions which would be included in the carbon footprint of the hospital.
During the test phase, an integrated shredder-sterilizer by Tesalys was deployed. Data collected by a qualified thermal engineer included weight and volume of the infectious HCW before and after treatment, cycle duration, machine consumption, impact of the on-site treatment on the segregation procedures.
The results in terms of reduction of the carbon footprint are significant, the study found (5 times less CO2 generation than incineration) and represent an opportunity for the reduction of CO2 emissions if on-site treatment was deployed at national / global scale. Extrapolating the findings in terms of CO2 emissions reduction, as much as 65 254 T equivalent CO2 could be avoided if all the infectious waste generated in France (141 000 T in 2018) were treated on-site instead of being transported and incinerated. 65 254 eqTCO2 equals the CO2 emissions of 1 300 000 flights Paris-London. A global deployment of on-site HCW treatment solutions at worldwide scale would avoid as much as the CO2 emissions of 1 million cars.
A significant reduction of weight and volume of waste leaving the hospital has been found. In terms of weight, during the decontamination cycle, weight of the waste increases due to the humidity of the steam sterilization process. However, a significant improvement in the segregation procedures (50% reduction in the operating theaters object of the study) has been identified due to the increased involvement of the medical staff during the waste generation/segregation. In terms of volume, the STERIPLUS system has contributed to reduce by 66% the volume of the treated waste. The treated waste being considered as household waste, compaction is possible (30%), thus making a total reduction in volume of 76% of the initial volume.
The study has shown other positive impacts of the on-site treatment of HCW, like the elimination of biological risk at source (particularly important during Covid pandemic), huge improvement of the segregation by the medical staff, autonomy of the hospital in waste management (thus respecting the regulations in terms of storage and waste disposal deadlines).
Finally, the shredded and decontaminated HCW has been analyzed in order to evaluate the recycling/revalorization possibilities. 96% of the materials contained in the shredded waste are recyclable or have some valorization options (cardboard/paper/natural fibers, PE, PP mainly). Some other options have been explored like energy recovery (shredded HCW has a high heat power which could be useful for waste-to-energy plant or cement kilns) or integrating the shredded waste in other raw material (asphalt, bricks). However recycling/revalorization of medical waste remains still at the experimental level in France.