The Financial and Environmental Costs of Reusable and Single-Use Plastic Anaesthetic Drug Trays

McGain, Forbes; McAlister, Scott; McGavin, Andrew; Story, David A

doi:10.1177/0310057x1003800320

Cited by 80 publications

(57 citation statements)

References 19 publications

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“…Details of decontamination loads are not routinely kept by the hospital sterile supply department (unlike all sterilised loads). The costs for water, electricity, gas and detergent use for anaesthetic loads were based on a previous study at our hospital . Records were obtained of the procurement of re‐usable anaesthetic circuits at the 24‐h and 7‐day time periods.…”

Section: Methodsmentioning

confidence: 99%

The microbiological and sustainability effects of washing anaesthesia breathing circuits less frequently

et al. 2014

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SummaryIn the presence of single-use airway filters, we quantified anaesthetic circuit aerobic microbial contamination rates when changed every 24 h, 48 h and 7 days. Microbiological samples were taken from the interior of 305 anaesthetic breathing circuits over a 15-month period (3197 operations). There was no significant difference in the proportion of contaminated circuits when changed every 24 h (57/105 (54%, 95% CI 45-64%)) compared with 48 h (43/100 (43%, 95% CI 33-53%, p = 0.12)) and up to 7 days (46/100 (46%, 95% CI 36-56%, p = 0.26)). Median bacterial counts were not increased at 48 h or 7 days provided circuits were routinely emptied of condensate. Annual savings for one hospital (six operating theatres) were $AU 5219 (£3079, €3654, $US 4846) and a 57% decrease in anaesthesia circuit steriliser loads associated with a yearly saving of 2760 kWh of electricity and 48 000 l of water. Our findings suggest that extended circuit use from 24 h up to 7 days does not significantly increase bacterial contamination, and is associated with labour, energy, water and financial savings.

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Section: Methodsmentioning

confidence: 99%

The microbiological and sustainability effects of washing anaesthesia breathing circuits less frequently

et al. 2014

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“…To give some perspective to our findings, the carbon footprint of the manufacture of 100 mg of morphine (204 g of CO 2 ) is similar to that of a single use plastic anaesthetic drug tray,14 or driving an average Australian car 1 km 35. We deliberated what the wider environmental ‘carbon impact’ of a nation's morphine production would be, but caution that such considerations would likely be inaccurate due to the lack of robust data.…”

Section: Discussionmentioning

confidence: 82%

The Environmental footprint of morphine: a life cycle assessment from opium poppy farming to the packaged drug

McAlister

Neff³

et al. 2016

BMJ Open

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ObjectiveTo examine the environmental life cycle from poppy farming through to production of 100 mg in 100 mL of intravenous morphine (standard infusion bag).Design‘Cradle-to-grave’ process-based life cycle assessment (observational).SettingsAustralian opium poppy farms, and facilities for pelletising, manufacturing morphine, and sterilising and packaging bags of morphine.Main outcome measuresThe environmental effects (eg, CO2 equivalent (‘CO2 e’) emissions and water use) of producing 100 mg of morphine. All aspects of morphine production from poppy farming, pelletising, bulk morphine manufacture through to final formulation. Industry-sourced and inventory-sourced databases were used for most inputs.ResultsMorphine sulfate (100 mg in 100 mL) had a climate change effect of 204 g CO2 e (95% CI 189 to 280 g CO2 e), approximating the CO2 e emissions of driving an average car 1 km. Water use was 7.8 L (95% CI 6.7– to 9.0 L), primarily stemming from farming (6.7 L). All other environmental effects were minor and several orders of magnitude less than CO2 e emissions and water use. Almost 90% of CO2 e emissions occurred during the final stages of 100 mg of morphine manufacture. Morphine's packaging contributed 95 g CO2 e, which accounted for 46% of the total CO2 e (95% CI 82 to 155 g CO2 e). Mixing, filling and sterilisation of 100 mg morphine bags added a further 86 g CO2 e, which accounted for 42% (95% CI 80 to 92 g CO2 e). Poppy farming (6 g CO2 e, 3%), pelletising and manufacturing (18 g CO2 e, 9%) made smaller contributions to CO2 emissions.ConclusionsThe environmental effects of growing opium poppies and manufacturing bulk morphine were small. The final stages of morphine production, particularly sterilisation and packaging, contributed to almost 90% of morphine's carbon footprint. Focused measures to improve the energy efficiency and sources for drug sterilisation and packaging could be explored as these are relevant to all drugs. Comparisons of the environmental effects of the production of other drugs and between oral and intravenous preparations are required.

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“…Indeed, McGain and colleagues have highlighted that use of single use drug trays cannot be justified either financially or environmentally. [14] Other authors [15,16] have suggested that reusable products are more environment-friendly; they reduce medical waste and the cost associated with waste disposal. Another important feature, however, of the using disposable material is the reduction in the risk of infection.…”

Section: Discussionmentioning

confidence: 99%

Is non-woven fabric a useful method of packaging instruments for operation theatres in resource constrained settings?

Devadiga¹,

Thomas²,

Shetty³

et al. 2015

Indian Journal of Medical Microbiology

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The introduction of non-woven spunbond-meltblown-spunbond fabrics did reduce the proportion of resterilisation of packaged instruments. The decline was sharp and sustained over time, even after accounting for the change in the number of procedures. Furthermore, though the switch from woven to non-woven fabric was cost-effective in our situation, it may not be directly translated to other scenarios.

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The Financial and Environmental Costs of Reusable and Single-Use Plastic Anaesthetic Drug Trays

Cited by 80 publications

References 19 publications

The microbiological and sustainability effects of washing anaesthesia breathing circuits less frequently

The microbiological and sustainability effects of washing anaesthesia breathing circuits less frequently

The Environmental footprint of morphine: a life cycle assessment from opium poppy farming to the packaged drug

Is non-woven fabric a useful method of packaging instruments for operation theatres in resource constrained settings?

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