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Protecting public health and the environment: addressing the dual crisis of PPE

As planning begins for global recovery from the pandemic, the opportunity must not be lost to explore possibilities for the design and production of sustainable PPE, says Tessa Corina | Credit: PA Images

Tessa Corina | Dods Monitoring

5 min read

We have the opportunity to solve two problems together: reducing the environmental impact of PPE whilst ensuring that public health is not threatened by a continued “hand to mouth” dependence on single-use PPE.

The coronavirus pandemic has led to the term ‘Personal Protective Equipment’ – or PPE – being familiar not only within healthcare and manufacturing professions, but a feature in the wider public’s day-to-day lexicon.

When used correctly, PPE can act as an infection control system - a barrier reducing the risk of transmitting and catching infectious diseases.

Therefore, a global shortage during a pandemic is of serious concern, particularly for those on the “front line” of the crisis.

Aside from this shortage, however, PPE is cause for another concern – one which, perhaps rightly, has not been dominating the same number of headlines.

The vast majority of PPE is for single-use only and the increased use, production and demand has therefore prompted concerns about its impact on the environment.

A concern that has become more visible as we notice discarded gloves and masks on streets around the globe.

The environmental impacts are across the lifecycle

Analysis of the lifecycle of single-use PPE is key to fully understanding its environmental impact. Single-use PPE largely comprises nonwoven materials made of synthetic polymers, which are derived from fossil fuel resources and are non-biodegradable.

For example, polypropylene is common in facemasks and some surgical gloves are made with vinyl: both are types of plastic, about whose environmental impact there is widespread global debate. Global plastic production has quadrupled in the past four decades, and if the trend continues, plastics manufacture will account for 15 percent of greenhouse gas emissions by 2050.

The environmental impact of PPE is not confined to its production, however, as most PPE is not made in the country where it is used.

Supply chains involve long distance air and sea transport, which in turn increase greenhouse gas emissions but also limit governments’ ability to increase and distribute supply quickly in crises.

Disposal is not straightforward either, and methods differ between healthcare professionals and the public.

Hospital waste such as coronavirus waste is labelled as infectious and is therefore incinerated, and although incineration is controversial, technologies in many modern waste plants remove emissions that contribute to climate change and can harm human health.

However, many waste plants around the globe do not use these technologies and their emissions therefore pose a risk to human and environmental health.

The public are encouraged to dispose of their PPE items with household waste to be sent to landfill. As the demand for personal PPE has increased, so too has the burden on waste disposal.

However, the increase in PPE litter across the globe has been widely documented and poses an infectious risk to refuse workers, whilst also finding its way into waterways, rivers and oceans.

Oceans are already swelling with plastic pollution, and PPE can be mistaken as food by wildlife, or break down into microplastics. Ironically, these microplastics can re-enter the food chain, potentially posing further threat to human health.

Looking to the future

Whilst the coronavirus has highlighted the real threat that viruses pose to humans, and attention has, rightly, been focussed on the immediate impact on global health, the crisis has also illustrated the fragility of the PPE supply chain and its environmental impact from production through to disposal.

The drive to find alternatives is gaining traction. Possibilities being explored include decontamination of existing PPE through methods such as vaporised hydrogen peroxide, the potential use of biodegradable nonwoven fabrics and reusable or recycled materials.

However, record lows in the price of virgin plastics also acts as a hurdle to the recycling industry, as recycling could be rendered unprofitable.

Reusable items could reduce solid waste, energy, water use, transport and cut greenhouse gas emissions.

However, there are concerns about the upfront costs of reusable PPE, the effectiveness of sterilization procedures, and the availability of technology for its production.

The question around sustainability is complex but must be addressed

The question of sustainability of PPE is clearly complex, but must be addressed given that its increased use will continue. In the immediate coronavirus crisis, it may be difficult to transform the PPE supply chain, and public health is paramount.

However, gradual changes across the PPE lifecycle of production, use and disposal could stimulate dialogue and innovation to develop sustainable, reusable equipment.

As the NHS launched their ‘For a greener NHS’ campaign earlier this year, with the aim of stepping up action to tackle the climate “health emergency”, options for reducing the environmental footprint of PPE could be explored.

As planning begins for global recovery from the pandemic, the opportunity must not be lost to explore possibilities for the design and production of sustainable PPE. Protection of the environment need not be at the expense of public health.

We have the opportunity to solve two problems together: reducing the environmental impact of PPE whilst ensuring that public health is not threatened by a continued “hand to mouth” dependence on single-use PPE.

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