Is PVC the answer to a circular economy in healthcare?

Tobias Johnsen, consultant at VinylPlus, discusses the possibility of a circular plastic economy in healthcare.

The use of plastics in healthcare presents a paradox. As a direct product of the petrochemical industry’s breakthrough after World War II, plastics paved the way for a tremendous innovation within medical devices. Suddenly it was possible to manufacture sterilisable, single-use medical equipment at a price that traditional materials such as metals, ceramics and glass could not beat. With rising living standards in many countries in the following decades, the demand for quality healthcare grew dramatically, which plastics helped to fulfil. 

The other side of the coin was seen during the COVID-19 pandemic. Though single-use plastic medical devices played an essential role in the prevention and control of infection in hospitals, COVID-19 highlighted the challenges of properly managing and discarding the same life-saving devices after use.  

What’s the solution? 

The enormous amounts of waste generated has obliged hospitals to reconsider their waste management systems towards more cost and environmentally efficient practices. In addition, the increased focus on plastics in society acts also as a driver to make the use of polymers used in health settings more circular.  

Some call for a phase-out of plastic in healthcare as a solution to the waste crisis. Though reduction is on top of the waste pyramid, it will be very difficult for health professionals to not have access to safe, reliable plastic-based medical devices in critical situations. In addition, the ageing population in some countries and rising incomes in others mean the demand for quality, affordable healthcare will not subside in the future. 

The same voices then call for reuse, and of course this idea is appealing, it remains to be seen whether washing and re-sterilisation is practically and economically feasible for the many different low-cost disposable medical devices that doctors, nurses and other health staff rely on for diagnosis, treatment, and care. 

Recycling is a step down from reuse in the waste pyramid but preferable to incineration or landfill. Here, the PVC industry has taken a leading role. In early 2022, the VinylPlus Med recycling programme was launched to accelerate sustainability in European healthcare. Starting in Belgium, the aim is to help hospitals sort their PVC waste stream. Currently 10 hospitals have joined VinylPlus Med, with more than 35 on the waiting list.  

But why PVC?  

First, market studies show PVC is the single most used polymer for disposable medical devices such as oxygen masks, tubing and dialysis bags. Importantly, PVC will remain the material of choice in the years to come. Successful recycling depends on volume, so it makes sense to start with the most used plastic.  

Second, PVC is easily recyclable due to the polymer’s chemical composition. As PVC can be made rigid and soft, it is also possible to manufacture mono-polymer products – another key to successful recycling. Medical grade PVC is sought after by recyclers and plastic converters, as it can be turned into a wide variety of applications. An example is vinyl wall covering, which can incorporate regrind PVC obtained through an environmentally benign process. After many years, the wall covering can be recycled and used in new wall covering. 

When mentioning PVC in the context of healthcare, the discussion always gravitates towards the additives that give PVC its unique functional properties such as softness and flexibility. It must be stressed that only REACH-compliant non-DEHP PVC waste is collected. To meet this objective, a cost efficient portable near-infrared (NIR) scanner has been developed. By use of artificial intelligence, the scanner can detect the presence of DEHP in the waste stream. This scanner can be used on PVC waste streams from other sectors, thus facilitating an easy sorting of flexible PVC. 

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