2023-03-19_22-32-43

Featured Article
by Dr Andrea Yap

Recycling PVC in Hospitals

Polyvinyl chloride (PVC) is polymer made by adding chlorine to ethylene. It is a commonly used plastic in the medical industry as it has the advantage of being transparent and durable, has a high biocompatibility, is easily sterilised and is more affordable than other alternatives in the market. PVC is commonly found in medical equipment such as intravenous fluid bags, oxygen masks and tubing. In its natural form PVC is hard and brittle, and plasticisers are required to make them suitable for medical use.

While PVC is safe and has many advantages, it does have a significant environmental impact. Its production relies heavily on fossil fuel extraction, and the refining and manufacturing of PVC is also energy intensive and contributes to global warming. Plastic material takes hundreds of years to breakdown and micro- and nano-plastics have been found in our soil and marine ecosystems. Micro- and nano-plastics have also been detected in human tissue but its effects are yet to be determined. Most PVC waste is incinerated and this process results in the release of dioxins and other toxic chemicals which can affect our neurological, reproductive and immune systems. Exposure to these chemicals have also been linked to cancer.

 

Plastic waste was one of the largest contributors to Singapore’s total waste in 2021 but only 6% of it was recycled. In healthcare, plastic waste accounts for around 25% of hospital waste and sadly most of it is disposed of in general waste and incinerated. In Singapore, the ashes are then sent to Semakau island. PVC, however, can be recycled and repurposed to make new products such as garden hoses, rain boots and plastic bags. Studies have shown that recycling PVC instead of incineration can reduce CO2 emissions by 77% and will have a huge impact on our carbon footprint.

The National University of Singapore uses approximately 1 million IV fluid bags a year and started recycling their fluid bags in November 2022. All IV fluid bags that are not contaminated with blood or infectious substances can be recycled. They do not need to be cleaned before they are discarded. The empty bags are disposed of in designated bins on the wards or in theatre before being brought down by the housekeepers to the main waste holding area and are placed in a dedicated PVC recycling bin. The bags are then collected by a local PVC company for processing.

 

Source: NUH Department of Anaesthesia

The recycling of PVC in hospital is simple and does not require much change from our day to day routine. Hundreds of tonnes of IV fluid bags are used in Singapore each year and all hospitals in Singapore should consider recycling their PVC waste. Educating staff on the ground about what items are made of PVC and how they can be recycled is key to the successful implementation of the initiative. Placing bins in a location that is easy to access and with good signage will also help to prevent PVC being thrown into general waste.

Recycling takes time and effort but with limited space in Singapore, and Semakau island quickly filling up, we need to focus on how we can reduce, reuse and recycle to ensure sustainability in our healthcare system and on our planet.

IV fluid bags ready for collection by a local recycling company

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