CHICAGO — There is a great deal to consider when deciding whether to use reusable or disposable textiles when providing patient care. Single-use disposables are viewed as being convenient and less costly—reusables proponents frequently rely on life-cycle analyses in an attempt to disprove the latter—while reusables offer a decidedly greener alternative.
It seems that reusables advocates certainly have their work cut out for them in this tug-of-war, because the healthcare community widely accepts disposable products as evidenced by their dominant market share.
“Hospital personnel have become accustomed to using disposable products,” says Nancy Jenkins, executive director of the American Reusable Textile Association (ARTA), a group of suppliers and laundry operators who work to promote greater awareness, appreciation and acceptance for reusables. “It’s estimated that the majority of healthcare providers use 80% disposable products to 20% reusable textiles.”
Surgical gowns, isolation gowns, surgical drapes and incontinence pads are just some of the items that some hospitals choose to use and then dispose of. But single-use products generate a lot of solid waste, which is something that most hospitals are striving to reduce.
In 1998, the American Hospital Association (AHA) and the U.S. Environmental Protection Agency (EPA) signed a landmark agreement that included goals to reduce the impact of healthcare facilities on the environment. The initial goal was a 33% waste reduction in all facilities by 2005, with an overall goal of 50% reduction by 2010.
As healthcare facilities strive to become better environmental stewards, proponents of reusable textiles are eager to ride this emerald wave into ERs and ORs across the country. Their goal: To demonstrate that not only are reusables more enviro-friendly than disposables, they cost less when all related costs are calculated.
‘TRUE COST’ OF USING DISPOSABLES
When doing a cost analysis between a reusable product and its disposable alternative, healthcare managers often commit the mistake of accounting only for the purchase price of the single-use item, according to Practice Greenhealth, a membership organization that provides guidance, training, consultation and business solutions to healthcare institutions.
The true cost of using a disposable includes not only the purchase price but also the costs of waste disposal, occupational health, environmental impact, and warehousing, it says.
America’s hospitals generate 6,600 tons of waste each day, and it costs $44 to $68 a ton on average to dispose of it. Hospitals that choose to use disposables produce a substantially greater amount of solid and medical waste, pushing their disposal costs even higher.
According to the 2005 Comparative Operating Revenues and Expense Profile for the Healthcare Textile Maintenance Industry, which included 49% of all U.S. hospital beds, hospitals with 300 or more beds use approximately 6.5 pounds of surgical textiles per bed each day. If a 300-bed hospital used disposables rather than reusables, it would have to pay an additional $250,000 in costs to discard the single-use items.
Disposable gowns and drapes are often seen as providing more reliable protection against bloodborne pathogens and infectious bacteria, but a study by the American National Standards Institute (ANSI) and the Association for the Advancement of Medical Instrumentation (AAMI) demonstrated that when laundered properly, reusable garments and drapes are 70% more effective in providing barrier protection.
“Now that two generations of surgical professionals have worked predominately with disposable items, they might not realize that the barrier-protection qualities of reusable textiles are as good or better than disposable options,” Jenkins says. “Reusable drapes and gowns are now manufactured with fabrics that provide breathable comfort and levels of barrier protection as good as or superior to disposable alternatives. Gone, too, are the linting problems that had concerned many infection-control preventionists.”
Whether sent to a landfill or burned, disposable medical textiles potentially can pollute water supplies and the air. Meanwhile, innovations in laundering have cut the amounts of water, energy and chemicals used in processing reusables by two to three times.
The warehousing of disposables is an aspect not often considered when weighing single-use products against reusables. Reusable products are provided on a daily basis, while disposables must be stored, taking up space that a hospital could use to generate additional revenue, Practice Greenhealth says.
OPPORTUNITIES TO MAKE INROADS
With its “Greening the OR Initiative,” Practice Greenhealth has set its sustainability sights on the hospital operating room. The organization has identified a dozen areas there for green interventions, including “Reusables vs. Disposables: Gowns, Surgical Drapes, Basins and other Reusables.”
“The advent of sterile, disposable items in healthcare over the last 20 years brought some advantages, but it is time to reconsider where reusable items may be superior because the quality of materials has improved, the cost-benefit analysis now points back in the direction of reusables, and environmental performance improvement is driving the need for this reassessment,” an organization fact sheet states.
Over the next year, a collaborative group of hospitals, healthcare leaders, manufacturers, vendors and sponsors will develop a series of guidance documents, including case studies and implementation recommendations addressing these and other related areas.
Truth be told, neither reusable nor disposable products alone will meet every single healthcare requirement. It makes sense to use one or the other as the need dictates, but reusables advocates will continue pushing for what they believe is the better product choice.