Focus on reuse: reducing waste associated with topical preoperative antiseptics

Abstract

Purpose: Topical antiseptics have significant environmental and financial implications. This study outlines the environmental and financial costs associated with single-use topical antiseptic (5% povidone-iodine (PVI) solution) in the ophthalmology theatre setting and explores potential methods of repurposing topical antiseptics. Setting: This study was conducted at the Ophthalmology operating theatre of a large tertiary referral centre (Flinders Medical Centre, Australia). Design: A single-centre prospective observational study of the environmental and financial waste generated from single-use topical povidone-iodine preparations was conducted over a 3-week period. Method: Dedicated containers placed in the ophthalmology theatre of the participating institution were used to collect the number of disposed PVI bottles over the 3-week study period. Descriptive statistics were employed to determine the associated packaging bottle weight, mean unused quantity (in mL) and cost of the single-use topical PVI solution and costs of unused antiseptic. Results: The total amount of waste generated from the use of single-use PVI bottles during the surveillance period was 10.823kg, of which 21.9% was preventable; 72% of unused PVI by weight were discarded during the study period, equating to approximately $21857.60 in wasted pharmaceutical content per year. 100% of the discarded PVI was successfully redirected and reused at a local wildlife rescue organisation and diverted from landfill. Conclusions: This study has demonstrated that the utilisation of single-use topical pre-operative PVI preparations is associated with significant financial, pharmaceutical and environmental waste. Future studies examining the recyclability of single-use PVI bottles and investigating systematic strategies to recycle and repurpose this waste are required.