On a global basis, only 14 percent of plastic packaging is collected for recycling, according to The New Plastics Economy: Rethinking the Future of Plastics, produced by the Ellen MacArthur Foundation. Across the health care sector, these rates are significantly lower. The New Plastics Economy cited several problems. “Today’s plastics economy is highly fragmented. The lack of standards and coordination across the value chain has allowed a proliferation of materials, formats, labeling, collection schemes and sorting and reprocessing systems, which collectively hamper the development of effective markets. … The development and introduction of new packaging materials and formats across global supply and distribution chains is happening far faster than and is largely disconnected from the development and deployment of corresponding after-use systems and infrastructure.”
With the exception of durable goods and the currently limited amount of recycling of plastic products and packaging from clinical settings, plastics used in the health care industry are typically single-use materials representing a linear “take-make-dispose” economy. In this project and other efforts, the Healthcare Plastics Recycling Council (HPRC) and Plastics Industry Association (PLASTICS) are asking the question: Is it possible to radically increase the amount of health care plastics managed as technical materials in a circular “make-use-return” economy?
The potential solution
To answer this question, St. Paul, Minnesota-based HPRC and PLASTICS, Washington, designed and implemented a multihospital plastics recycling project in Chicago. Focused on noninfectious packaging and products collected from clinical areas, the project sought to demonstrate a viable business model for the recycling of health care plastics on a regional basis.
Prior HPRC-sponsored efforts included pilot projects at individual hospitals. However, single hospitals could not generate the quantity of materials needed for economic viability.
In bringing together multiple hospitals in the same area, the project aimed to overcome this barrier. It sought to demonstrate that these plastic materials have value and can be effectively collected in sufficient quantities from clinical areas to make recycling efforts economically feasible. In addition, HPRC and PLASTICS wanted to identify key success criteria, define market requirements and detail best practices so that the model could be replicated in other geographies and markets.
Participating hospitals collected a variety of health care plastics (primarily from operating rooms and ambulatory surgery centers), including products and packaging made of polypropylene (PP), polyethylene (PE) and other resins, in the form of sterilization wrap, irrigation bottles, basins, pitchers, trays, Tyvek, and rigid and flexible packaging materials. These materials were then transported by waste haulers to material recovery facilities (MRFs) or specialized plastics recyclers. It is at the MRFs that the team performed assessments to determine material composition and quality. (See sidebar below for a full list of project participants.)
The project team worked with the recyclers and waste haulers to define which materials were acceptable for recycling. Internal advocates were identified, and staff received training.
Commingled plastics were collected in color-coded bags and conveyed to the recycler using systems already in place for cardboard, paper, cans and bottles. Assuming a single-stream recycling program already is in place at the hospital (as was the case with the project participants) and is supported by the hospital’s waste hauler, separate handling costs and transportation charges can be avoided. This also eliminates the environmental impacts of having separate pickups for the commingled plastics and other recyclables.
However, the downsides of using the waste hauler’s single-stream pathway include an increased chance that the bags will rupture and be contaminated by other recyclables. Also, if the MRF is not capable of processing health care plastics, additional handling is needed to separate the bags from other recyclables and transfer them to a plastics recycler.
Alternatives to single-stream recycling include using a reverse distribution model in which materials are transported from the hospital by a service provider that already makes deliveries or pickups at the facility. Some examples include companies delivering medical supplies and equipment and document destruction firms. The primary benefit of using a reverse distribution pathway for plastics accumulation and transportation is that materials are handled separately from solid waste and other recyclables, thereby reducing the potential for contamination.
Sterilization wrap, a nonwoven product manufactured from PP resin, represented the highest volume of material collected and comprised up to 47 percent of the shipments by weight, depending on the recycler’s acceptance criteria. As part of this project, the material properties of sterilization wrap were evaluated as a viable substitute or supplement for virgin resins in product manufacturing. Other flexible packaging materials, such as film plastics, and rigid plastic packaging, also were collected in considerable and consistent quantities.
A full project report, including detailed data analysis, is available at www.hprc.org/chicago-project. Here are some takeaways from the pilot project:
Keep it simple. To encourage staff participation, the collection of clinical plastics needs to be simple. Including multiple types of plastics in the program while excluding others placed a significant burden on clinicians to sort materials at the source. Despite continual training and coaching efforts, ultimately the sorting exercise was too complex for clinicians and a low priority, given their primary focus of ensuring positive patient outcomes. A better approach would be to start with one easily recognizable material and then gradually add new material types to the program over time.
In addition to a simple collection process, clear handling methods must be established and communicated. Once recovered, the packaged materials must be easily distinguished from other types of waste and recyclables. Handling practices of accumulated materials must be simplified as much as possible to ensure that materials are delivered to proper containers or processing areas.
Find your champions. Critical to program success is the engagement and commitment of program champions within each stakeholder group who can assist with training, performing audits and reinforcing the behaviors necessary to ensure effective material collection. All stakeholders must see tangible benefits from participation, and those benefits must outweigh the costs of starting and maintaining the program, so it’s vital to be fully committed and have champions at each level. Having this support in place at the participating hospitals made a significant impact on the project’s success.
Commingled materials have marginal value. Ideally, a hospital will create a partnership with a recycler/processor that is willing to modify current practices to access a new source of recyclables. All parties need to recognize that once commingled, clinical plastics have limited value, and extracting value from individual components requires detailed sorting. But determining who will be responsible for this sorting can be a challenge.
Most hospitals and health care networks are unwilling or unable take on this responsibility. This creates the need to identify a recycling partner capable of mechanical sorting, to consider creative alternatives such as a partnership with organizations such as Goodwill, or Buckeye Industries, or to focus efforts on a single type of material and consider additional materials after systems are established.
Keep an eye on the economics. To be attractive to recyclers and their customers, hospitals must accumulate materials in sufficient volume, and processes must be in place to ensure a clean, continuous supply. This is necessary for securing the end users’ commitment to incorporating the recycled materials into their products, thereby creating a demand to keep the program running. A recycling program’s economic viability is a function of market pricing, so stakeholders must consider market volatility when evaluating the costs of collecting, aggregating, transporting, processing and marketing materials from a clinical source. Ultimately, the economics of a project must be favorable to recyclers, and including certain types of materials in the program may not be possible based on their value.
The market pricing for commodities derived from recycled materials is strongly influenced by the market pricing of comparable virgin materials, which in this case is strongly influenced by the prices of crude oil and natural gas. The significant decline in the prices of crude oil and natural gas in 2014-2015 resulted in a corresponding decline in the prices of most resin commodities during the project. This made it more challenging for participating recyclers to justify handling costs, such as those required to manually sort a highly varied mixture of materials (like the commingled health care plastics stream), if these materials cannot be sorted using an automated system.
Clinical plastics recycling supports broader sustainability initiatives. Beyond immediate economic benefits, organizations in a variety of industries have radically reduced the amount of solid waste they send to landfills and incinerators. Typically, these programs start with a pragmatic look at the composition of their solid waste streams and identify which materials may be reused, reduced or recycled; plastics are always part of the mix. Benefits can include enhanced employee engagement, greening of the supply chain and reduction of organizations’ carbon footprints. Considering many organizations’ broader sustainability goals, these benefits may greatly outweigh economic considerations.
Beware of wish-cycling and behavioral challenges. Some of the contamination encountered might have been because of staff who wanted to put as much as possible into the recycling stream; however, a clean stream is critical to the recyclers’ value, and these efforts, though well-intentioned, backfire.
It’s important to remember that change is a process. To begin recycling in a setting where there was previously little or no recycling requires a change in behavior, ultimately driven by a change in culture. People’s environmental awareness and propensity to participate in recycling programs varies throughout our society. When programs are voluntary, organizations have varying degrees of participation among their staff and varying results when trying to influence people to produce a clean stream of health care plastics.
This project, while just a first step in exploring the possibilities of regional collaboration, has yielded a number of practical actions that hospitals and recyclers can take to facilitate increased recycling of health care plastics.
- Start with one high-value material and build on that once the program is established.
- Explore transportation options for recyclables outside of traditional solid waste hauling and recycling contracts.
- Continue to reinforce staff education to prevent contamination and maintain quality.
- Consult the HospiCycle tool, which can be found on the HPRC website at www.hprc.org/hospicycle, (or other HPRC resources) for support.
- Approach a hospital system or multiple hospitals in a region to reach adequate volumes to sustain the program.
- Work with hospitals to mitigate contamination risk in the collection process, such as having bags tied off and removed before the patient enters the room.
The Chicago project has confirmed certain plastics found in clinical settings can be profitably recycled, including sterilization wrap (PP, or No. 5), saline bottles (PP), polyethylene terephthalate glycol-modified (PETG, No. 1) packaging trays and possibly other types of flexible and rigid materials.
In addition to exploring mechanical recycling opportunities for these materials, the team tested the potential value of energy conversion and chemical recycling. The project team partnered with RES Polyflow (www.respolyflow.com), Chagrin Falls, Ohio, to process a sample of health care plastics in its pyrolysis system, which converts plastics into liquid fuel products. The team also sent PETG packaging trays to Resinate (www.resinateinc.com), Plymouth, Michigan, for chemical recycling, where the PETG was converted to polyols for use in foams, coatings and adhesives. Both trials were successful, suggesting that when mechanical recycling options are not available for these health care plastics, value still can be realized through other recovery processes.
While market conditions and unforeseen challenges precluded the team and stakeholders from accomplishing some objectives, the exercise was still an invaluable experiment, providing insights that hospital networks and recyclers can use to implement or optimize their own recycling programs.
For more information: Healthcare Plastics Recycling Council, 562-206-2553, www.hprc.org