"O.R. GOES GREEN": a first step toward reducing our carbon footprint in the operating room and hospital

Abstract

Hospitals in Europe produce approximately 6 million tons of medical waste annually, about one-third of this originating in operating rooms. Most of it is solid waste, which can be recycled if bodily fluids do not contaminate it. Only 2-3% of hospital waste must be disposed of as infectious waste, and this is much lower than the 50-70% of garbage in the biohazard waste stream. In June 2021, at the main operating room of the Department of General Surgery of the University of Turin, we began a separate collection program for materials consisting of plastic, paper, TNT (material not contaminated by bodily fluids), and biohazardous waste. We calculated the number of boxes and the weight of special waste disposed produced every month in one operating room for 18 months. The monthly number of Sanibox and the monthly weight of biohazardous waste decreased during the observation period. The reduction trend was not constant but showed variations during the 18 months. Direct proportionality between number of low-complexity procedures and production of biohazardous waste was found (p = 0.050). We observed an optimization in the collection and filling of plastic, paper and TNT boxes separated and sent for recycling. One of the barriers to recycling hospital waste, and surgical waste in particular, is the failure to separate infectious waste from clean waste. A careful separate collection of waste in the operating room is the first step in reducing environmental pollution and management costs for the disposal of hospital waste.

Keywords: Biohazardous waste; Carbon footprint; Environment pollution; Hospital waste; Operating room; Separate collection waste.

Fig. 1

Surgical procedures with trendies indicating no relevant trends that can influence statistics

Fig. 2

Number bins of collected waste with trendlines indicating no relevant trends that can influence statistics

Fig. 3

Sanibox weight (Kg) with trendline showing a small decline in number of waste bins during the pilot

Fig. 4

Plastic bins in high complexity surgical procedures recoded as tertiles (p = 0.012)

Fig. 5

Sanibox in medium complexity surgical procedures recoded as tertiles (p = 0.030)

Fig. 6

Number and weight of sanibox in low complexity surgical procedures recoded as tertiles (p = 0.046; p = 0.050)