Switching from disposable to reusable PPE
BMJ 2024; 384 doi: https://doi.org/10.1136/bmj-2023-075778 (Published 18 March 2024) Cite this as: BMJ 2024;384:e075778Linked Editorial
Sustainable practice: what can I do?
- Rebecca Bromley-Dulfano, PhD student in health policy1 2 4,
- Joshua Chan, masters student in management science and engineering3 4,
- Navami Jain, masters student in biomedical informatics3 4,
- James Marvel, clinical assistant professor, emergency medicine1 4
- 1Stanford University School of Medicine, Stanford, CA, USA
- 2Harvard University, Department of Health Care Policy, Boston, MA
- 3Stanford University, Stanford, CA
- 4Stanford Climate and Health, Stanford, CA
- Correspondence to R Bromley-Dulfano rabd{at}stanford.edu, rbromleydulfano{at}g.harvard.edu
What you need to know
Globally, demand for PPE is rising, despite a recent decrease relative to its peak in the covid pandemic
In 2020, use of isolation gowns and surgical masks in the US alone contributed the carbon dioxide equivalent of 78 coal fired power plants running continuously
Reusable PPE preserves safety, while offering less severe environmental consequences and reducing costs. Successful deployments of reusable gowns at large US medical centres have resulted in the diversion of hundreds of tons of landfill waste with cost savings of nearly 50% per gown with no impact on infection rates.
Sustainable sourcing, use, and disposal of personal protective equipment (PPE) can help healthcare providers reduce the environmental impacts of their work. In this article we review supporting evidence and provide guidance for healthcare institutions to adopt reusable forms of PPE as safe, cost saving, and sustainable alternatives to single use disposables.
The first step to reducing the environmental impact of PPE usage is to reduce unnecessary consumption of supplies.12 However, we discuss those situations where PPE use is unavoidable, and offer more sustainable alternatives with a focus on reusable isolation and surgical gowns, masks, and eye protection. The evidence for alternatives to single use gloves, surgical drapes, and other PPE is still emerging.34
Why change is needed
Global PPE usage has been rising over the past several decades,5 driven by heightened attention to employee safety (particularly that of healthcare workers), increasingly stringent regulations for work environments, and robust economic growth in middle and high income countries.5 The covid-19 pandemic caused usage of PPE to surge globally to unprecedented levels.67 Unicef estimated that 2.2 billion surgical masks, 1.1 billion gloves, 13 million goggles, and 8.8 million face shields were needed to protect against covid-19 during the first year of the pandemic.8 Global production …