Intended for healthcare professionals


Coming round to recycling

BMJ 2009; 338 doi: (Published 11 March 2009) Cite this as: BMJ 2009;338:b609
  1. David C J Hutchins, medical student,
  2. Stuart M White, consultant in anaesthesia
  1. 1Brighton Anaesthesia Research Forum, Royal Sussex County Hospital, Brighton, East Sussex BN2 5BE
  1. Correspondence to: S M White stuart.white{at}
  • Accepted 18 November 2008

Increasing numbers of people are trying to reduce and recycle their domestic waste, but hospitals have been slower to get the message. David Hutchins and Stuart White look at the potential environmental and financial benefits

Both the UK government and the British Medical Association have recently published strategies for “greener” health care.1 2 An audit of anaesthetic waste at our hospital found that about 40% of all waste (roughly 950 kg/theatre/year) was potentially recyclable paper, card, plastic, and glass, and only 4% by weight of sharps bin contents was true sharp waste. Although recycling has potential environmental and financial benefits, it is hampered by convenience, technology, lack of knowledge, concerns about environmental safety, and statutory regulation. We discuss how clinicians might cut the amount of waste they produce by reducing, reusing, and recycling resources and suggest ideas for future research.

Anaesthetic waste

The NHS produced 408 218 tonnes of waste in 2005-6, 29% of which was clinical waste, and spent nearly £73m (€80m; $103m) on its disposal. This is equivalent to 5.5 kg of waste per patient per day. By comparison, France and Germany, which historically have a greater cultural, political, and statutory commitment to waste minimisation and recycling,3 produce only 1.9 kg and 0.4 kg/patient/day, respectively.4

Over the past 5-10 years, concerns about the risk of prion transmission and sterility have led to large increases in both the amount of anaesthetic packaging and the use of disposable devices. Most of the waste is incinerated, although some of it is potentially recyclable.

We recently completed a two week audit of the waste produced by six operating theatres at the Royal Sussex County Hospital in Brighton. The results were striking: 540 kg of sharps and non-sharps anaesthetic waste was produced (about 2300 kg/theatre/year), 40% of which was potentially recyclable paper, card, …

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