Environmental impact of personal protective equipment distributed for use by health and social care services in England in the first six months of the COVID-19 pandemic

Abstract

Objective: To quantify the environmental impact of personal protective equipment (PPE) distributed for use by the health and social care system to control the spread of SARS-CoV-2 in England, and model strategies for mitigating the environmental impact.

Design: Life cycle assessment was used to determine environmental impacts of PPE distributed to health and social care in England during the first six months of the COVID-19 pandemic. The base scenario assumed all products were single-use and disposed of via clinical waste. Scenario modelling was used to determine the effect of environmental mitigation strategies: (1) eliminating international travel during supply; (2) eliminating glove use; (3) reusing gowns and face shields; and (4) maximal recycling.

Setting: Royal Sussex County Hospital, Brighton, UK.

Main outcome measures: The carbon footprint of PPE distributed during the study period totalled 106,478 tonnes CO₂e, with greatest contributions from gloves, aprons, face shields and Type IIR surgical masks. The estimated damage to human health was 239 DALYs (disability-adjusted life years), impact on ecosystems was 0.47 species.year (loss of local species per year), and impact on resource depletion was costed at US $12.7m (GBP £9.3m). Scenario modelling indicated UK manufacture would have reduced the carbon footprint by 12%, eliminating gloves by 45%, reusing gowns and gloves by 10% and maximal recycling by 35%.

Results: A combination of strategies may have reduced the carbon footprint by 75% compared with the base scenario, and saved an estimated 183 DALYS, 0.34 species.year and US $7.4m (GBP £5.4m) due to resource depletion.

Conclusion: The environmental impact of PPE is large and could be reduced through domestic manufacture, rationalising glove use, using reusables where possible and optimising waste management.

Keywords: Environmental issues; health policy; public health.

Figure 1.

Carbon footprint of individual PPE items. Carbon footprint of individual single-use PPE items, with breakdown of process contributions. Production of PPE materials includes the raw material extraction, production and transport to the PPE manufacturer. CO₂e: carbon dioxide equivalents; FFP: filtering facepiece; PPE, personal protective equipment.

Figure 2.

Mitigating the carbon footprint of personal protective equipment (PPE). Bar graph to left demonstrates the carbon footprint of the base scenario PPE use (modelled on total volumes of core PPE distributed to health and social care services in England between 25 February and 23 August 2020, and assuming shipping, single-use PPE and clinical waste), totaling 106,478 tonnes CO₂e (carbon dioxide equivalents). Bar graph to right at base demonstrates mitigation of the carbon footprint (modelled through combining scenarios), totaling 26,648 tonnes CO₂e. Bar graphs stacked above optimised scenario demonstrate the carbon savings from each mitigation strategy (reported in tonnes and as a percentage, compared with the base scenario). Scenarios from top to bottom: UK manufacture, eliminating glove use, reuse of gowns and face shields, recycling.

Figure 3.

Environmental impacts of alternative scenarios. Environmental impacts (endpoint categories) of alternative scenarios, modelled on total volumes of core personal protective equipment (PPE) distributed to health and social care services in England between 25 February and 23 August 2020, normalised to highest scenario for each impact factor, modelling base scenario (shipping, single-use PPE, clinical waste), use of UK manufacture, shipping, reduce (zero glove use), reuse (reusable gown, reuse of face shield, all other items single-use), recycling and combination of measures. Data labels above bars relate to absolute values, measured in disability-adjusted life years (DALYs), loss of local species per year (species.year) and extra costs involved for future mineral and fossil resource extraction (US $).