International study highlights OR waste management strategies, barriers

Editor's Note

Effective waste segregation and adopting a circular economy approach can significantly reduce environmental impact of incinerating hospital waste incorrectly classified as hazardous, according to a narrative review published August 19 in the Medical Journal of Australia. However, surgeons' concerns about patient safety and insufficient systemic policies can hinder implementation.

The review involved a systematic search of several global academic databases in mid-2022 for peer‐reviewed research relevant to waste management in Australian operating rooms, which are estimated to generate 20% of the country’s total hospital waste. Researchers used thematic analysis to enumerate and characterize the strategies and barriers to sustainable waste management in the operating room. For example, effective waste segregation could significantly reduce the amount of waste incorrectly disposed of as hazardous, which currently stands at 73% of operating room waste, despite only 15% of hospital waste being genuinely hazardous.

Waste reduction strategies highlighted in the review include:

• environmentally preferable purchasing (EPP)
• reducing overage
• reusing or reprocessing medical devices.
• improved recycling.

Barriers to implementation include:

• prioritization of single-use surgical products resulting from a “constrained interpretation” of the “first do no harm” concept
• ineffective or insufficient waste education
• costs
• lack of facility and government policies and regulations.

The review also details knowledge gaps, such as lack of benchmarking data and standardized regulations on reusable or reprocessed devices.