RECYCLING: Plants Recovery:Just What The Doctor Ordered

As the recycling infrastructure continues to mature, communities are looking beyond municipal solid waste (MSW), towards non-traditional waste streams from businesses and institutions, including hospitals.

Each day, hospitals generate 12 million pounds, or 1 percent, of the United States' MSW, according to William Rutala's Infection Control and Hospital Epidemiology position paper. Of that 1 percent, plastic packaging and products represent between 15 percent and 20 percent, making some hospital plastics a valuable recovery resource (see chart).

Depending on where plastic packaging originates in the hospital, it is often clean and free of contamination. For example, according to Hollie Shaner, a registered nurse in Vermont, nearly 80 percent of the waste from a single operation is generated before a patient even enters the operating room. Since this is a sterile environment, the plastic packaging used to transport supplies, equipment and instruments remains clean even after delivery.

Several factors make a hospital's waste reduction efforts worthwhile. For instance, increasing disposal costs has spurred hospitals to use incinerators; however, more than half of these hospital incinerators have been shut down in the past 10 years. Additionally, as the cost of retrofitting incinerators to meet new abatement regulations is realized, hospitals will have to consider other waste management options, including recycling.

In 1992, the American Plastics Council (APC), Washington, D.C., initiated a waste characterization study to determine how much plastic could be recovered from a hospital waste stream. Conducted at three hospitals in Seattle, Wash., the study found that overall disposal rates for plastics vary from approximately two pounds per average daily census (adc) to more than five pounds per adc.

Additionally, the results showed that about 255,000 pounds of plastics per year generated by the three hospitals were considered clean recoverables. Combined, the plastics represented approximately seven percent of all the waste disposed from the hospitals' targeted areas.

Nationally, as more hospitals have recognized the potential value of this material and begin to look beyond paper and cardboard recovery, hospital plastic waste reduction programs have been implemented in New York, Massachusetts, Vermont and Washington.

These recovery programs, however, are no simple task. Hospitals are regulated by organizations such as the U.S. Environmental Protection Agency, Occupational Safety and Health Administration, Department of Transportation, Joint Commission on Accreditation of Healthcare Organizations, and Centers for Disease Control and Prevention.

These regulatory bodies compound the complexity of recovering hospital wastes since they each have their own definitions and instructions for handling and labeling. Additionally, 42 states have distinct definitions of what constitutes regulated medical waste, and many of them differ, leaving hospital personnel guessing as to which packaging and products can be recovered legally.

Despite these barriers, several hospitals have been successful. For example, Beth Israel Medical Center in New York City began recycling in the early 1990s and has expanded its program to include products such as bed pans, wash basins, denture cups, intravenous bags and tubing.

Ultimately, these plastics are used to manufacture products such as plastic lumber and flower pots. In Vermont, the Medical Center Hospital collects 32 separate materials for recycling including plastic bottles, containers, medical instrument wrap, trash bags, trays and stretch wrap.

Recycling businesses also are realizing the benefits of recovering hospital plastics. For example, Washington State-based All-Star Recycling has been involved with a recovery project in the Pacific Northwest. Through technical assistance from the APC, All-Star has been able to process 130,000 pounds of hospital plastics so far this year.

Fifty-three area hospitals participate in this program, and their material collection has recently expanded to include polyethylene terephthalate (PET) packaging; high density polyethylene (HDPE) jugs, bottles and bags; polyvinyl chloride (PVC) intravenous bags; low density polyethylene (LDPE) bags and wraps; polypropylene (PP) sterile bottles, wraps, tubs, trays, cups and pitchers; and (polystyrene) PS packaging. All collected plastics are recycled into new products, such as X-ray film into polyester pillows.

In the East, Conigliaro Industries, Framingham, Mass., is recycling more than 150 different materials, including plastics recovered from the healthcare and biomedical industries. Conigliaro currently accepts mixed operating room plastics, including instrument trays, blister packaging, saline bottles, sterile blue wrap, intravenous bags and tubing, as well as plastic basins, bed pans and pitchers. These plastics are manufactured into products ranging from asphalt and cold-patch sealants for pot holes to check book covers, plastic binders and video cassettes.

Conigliaro, with assistance from the APC, was able to purchase new processing equipment, design a processing line and begin writing a manual on safe handling and recycling of hospital plastics. Recognizing the importance of educating and training healthcare professionals, Conigliaro also provides an education program complete with signs and computerization of the entire processing operation.For more information, contact: Erin Kelly, American Plastics Council, 1275 K St., N.W., Ste. 400, Washington, D.C. 20005. (202) 371-5319. Fax: (202) 371-5679.