Environmentally Sustainable Management of Used Personal Protective Equipment
Environmentally Sustainable Management of Used Personal Protective Equipment
Environmentally Sustainable Management of Used Personal Protective Equipment
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declaration of COVID-19 as a global pandemic.
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Figure 1. Medical waste generation and compositions in China. The quantity of waste is expected to increase by more than 25% in 2020.7,11 In the
U.S., there is no national database on medical waste generation because the Medical Waste Tracking Act (MWTA) of 1988 expired in 1991 and the
U.S. Environmental Protection Agency has not had the authority, specifically for medical waste, since then.
present hazard due to improper decontamination.6 Improper worldwide and the lack of coordinated governmental policies
disposal or handling of contaminated waste can transmit viral that require minimum recycling content in new products will
pathogens to healthcare and recycling workers. For example, it likely lead to an increase in virgin plastic manufacturing in the
has been estimated that up to 30% of hepatitis B, 1−3% of postpandemic period. The U.S. plastics manufacturing
hepatitis C, and 0.3% of HIV rates have been communicated industries have requested more than $1 billion in emergency
from patients to healthcare workers due to improper disposal funds to deal with the extra demands attributed to COVID-19
of medical waste. Studies conducted in Pakistan, Greece, impacts.9 To ensure that increased plastic PPE production
Brazil, Iran, and India show that higher than normal prevalence does not lead to increased pollution, restrictions on the
of virus infection in solid waste collectors’ can be traced emergency funds are warranted to support investments in
directly to pathogens in contaminated wastes.7 research and development of used PPE collection, sorting, and
The United Nation’s Basel Convention on the Trans- recycling. Implementing a sustainable PPE waste management
boundary Movement of Hazardous Wastes and their Disposal system will benefit from public-private partnerships (PPPs). In
has recently urged member countries to treat waste manage- countries with economies in transition, the role of artisanal
ment amid COVID-19 as an urgent and essential public service solid waste collectors and recyclers is indispensable. Develop-
to minimize possible secondary impacts upon health and the ing safe and sustainable PPE management beyond the
environment. Therefore, safe and sustainable recovery and healthcare settings (hospitals and clinics) under emergency
treatment of PPEs should be intensified. It is important to conditions is complicated because it requires a clear under-
clarify the role of informal recyclers in developing countries, standing of best practices, monitoring, and enforcement of
where medical waste has not been adequately regulated. policies and regulations. In healthcare settings, thermal,
The PPE response to the COVID-19 pandemic has also chemical, irradiative, and biological processes can be
impacted plastic recovery and recycling and will increase implemented locally or scaled-up in regional facilities where
landfilling and environmental pollution. The material compo- collection and waste transportation are possible.
sition of PPE includes plastics as major constituents Single-use PPE is not a sustainable practice, and multi-
representing 20−25% by weight. Ultimately, if not recycled, disciplinary technical expertise, including biomedical sciences,
their disposal contributes substantially to hazardous environ- environmental science, public health, materials science, and
mental pollutants such as dioxins and toxic metals. Contrary to engineering is essential for tackling the PPE pollution problem.
recommendations from the World Health Organization, which New research since the beginning of the current pandemic
encourages safe practices that reduce the volume of wastes indicates that PPE disinfection and reuse is possible on a large
generated and that ensure proper waste segregation at origin,7 scale through methods such as infusion of hydrogen peroxide
plastic-based PPE discarded from households is mixed with vapor, ultraviolet or gamma-irradiation, ethylene oxide gas-
other domestic plastic wastes such as single-use plastic bags, ification, application of spray-on disinfectants, and infusion of
the use of which has multiplied rapidly since grocery stores base materials with antimicrobial nanoparticles.10 Many of the
disallowed customers to bring their own bags for fear of disinfection methods are in the preliminary stage, and they
additional virus transmission routes. Polypropylene is a must be calibrated to ensure that material degradation during
common constituent of PPEs such as N-95 masks, Tyvek each disinfection cycle does not compromise the primary
protective suits, gloves, and medical face shields. Polypropy- function of PPEs to prevent penetration of pathogens and
lene also represents a substantial proportion of the human exposure.
approximately 25 million tons of plastic materials that are The circular economy principle focusing on reducing,
disposed of in U.S. landfills annually, with recovery and reusing, and recycling resources should guide policy develop-
recycling accounting for only 3% of the polypropylene plastic ment for PPE management during and after the current
generated.8 pandemic. National policies should be designed to require that
The potential to recover polymers from mixed healthcare plastic manufacturers add minimum recycling content in new
waste including PPE is challenging. Recycling without risking products, and product pricing should reflect environmental and
infection of individuals working as recyclers in middle- and health externalities. Public education campaigns to promote
low-income countries is limited by the low proportion (15− appropriate PPE stewardship should be integrated into policy
25%) of healthcare waste that is not contaminated. implementation, monitoring, and enforcement. Development
Furthermore, the low recycling rates for plastic waste of infrastructure to ensure safety in informal waste collection
8501 https://dx.doi.org/10.1021/acs.est.0c03022
Environ. Sci. Technol. 2020, 54, 8500−8502
Environmental Science & Technology pubs.acs.org/est Viewpoint
and recycling in low-income countries is essential. To be (5) Reuters, Discarded coronavirus masks clutter Hong Kong’s
sustainable, PPE management policies need be integrated into beaches, trails. https://www.reuters.com/article/us-health-
economic models that promote the adoption of green coronavirus-hongkong-environme/discarded-coronavirus-masks-
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2020/5/11).
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assessments and consumer preferences. Medical Waste Related To COVID-19. https://www.indiaspend.
In summary, the COVID-19 pandemic has strained solid com/sanitation-workers-at-risk-from-discarded-medical-waste-related-
waste management globally, while also highlighting the to-covid-19/ (2020/5/11).
bottleneck supply chain challenges regarding PPE manufacture, (7) WHO, Health-care waste. https://www.who.int/news-room/
demand-supply, use, and disposal. PPEs will continue to be in fact-sheets/detail/health-care-waste. 2018 (accessed 2020/51).
high demand, and this is the time to invest in research and (8) U.S. Environmental Protection Agency. 2019. Facts and Figures
development for new PPE materials that reduce waste about Materials, Waste and Recycling - Plastics: Material-Specific
generation, and for improved strategies for safe and sustainable Data. https://www.epa.gov/facts-and-figures-about-materials-waste-
management of used PPE with policy guidance at the global and-recycling/plastics-material-specific-data (accessed 2020/5/8).
(9) Lerner, S., Big plastic asks for $1 billion coronavirus bailout. The
level.
■
Intercept. https://theintercept.com/2020/04/27/plastic-industry-
coronavirus-bailout/ (accessed 2020/5/11).
AUTHOR INFORMATION (10) Price, A. D.; Cui, Y.; Liao, L.; Xiao, W.; Yu, X.; Wang, H.; Zhao,
Corresponding Author M.; Wang, Q.; Chu, S.; Chu, L. F., Is the fit of N95 facial masks
effected by disinfection? A study of heat and UV disinfection methods
Oladele A. Ogunseitan − Department of Population Health & using the OSHA protocol fit test. medRxiv 2020.
Disease Prevention, University of California, Irvine, California (11) Statistics of China’s medical waste generation and market size
92697, United States; orcid.org/0000-0003-1317-6219; forecast. https://www.reportrc.com/article/20200506/6615.html (ac-
Email: [email protected] cessed 2020/6/8).
Authors
Narendra Singh − School of Environmental Science and
Engineering, Southern University of Science and Technology,
Shenzhen 518055, China; orcid.org/0000-0002-6519-
9722
Yuanyuan Tang − School of Environmental Science and
Engineering, Southern University of Science and Technology,
Shenzhen 518055, China; orcid.org/0000-0003-2710-
6967
Complete contact information is available at:
https://pubs.acs.org/10.1021/acs.est.0c03022
Notes
The authors declare no competing financial interest.
■ ACKNOWLEDGMENTS
Work by N.S. and Y.T. is supported by the National Science
Fund of China (41977329), and the Shenzhen Postdoctoral
Funding (29/K19297523), respectively. O.A.O. codirects the
Lincoln Dynamic Foundation’s World Institute for Sustainable
Development of Materials (WISDOM) at UC Irvine.
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8502 https://dx.doi.org/10.1021/acs.est.0c03022
Environ. Sci. Technol. 2020, 54, 8500−8502