The Canadian Coalition for Green Health Care led research on reusable personal protective equipment in an effort to identify opportunities for waste reduction and reuse across the health system. Most of the PPE used in Canada is made of plastic.
Reusable, safe and Infection Prevention and Control Canada- (IPAC) approved PPE gowns emerged as the most promising item to lower greenhouse gas emissions. Medical glove use generated the most significant waste quantities.
“It was important to consider the question of reusability of PPE as a strategy to address both waste plastics and GHG emissions, while also enabling a secure supply of safe, IPAC-approved PPE products,” Dr Myles Sergeant, executive director of the Canadian Coalition for Green Health Care, said in a media release.
The project, ‘A circular economy model for hospital-generated PPE and medical single-use plastic waste: Demonstrating opportunities for reduction and reuse’, also explored the synergies with other government and health system priorities that would enhance opportunities and support for a reusable PPE system.
Dr. Fiona Miller, professor of health policy at the University of Toronto, was an advisor to the project. “Disruptions to the health care supply chain, whether it is through a pandemic or through climate change-related events, can affect the quantity and quality of PPE or other medical supplies and can impact the safety of both patients and health care workers,” she said. “Development of strategies to ensure 100% continuous access to essential health care products is needed.”
Dr. Andrea MacNeill, medical director of planetary health for Vancouver Coastal Health in British Columbia, and one of the project hospital partners suggests scaling up the laundering of reusable gowns and keep up with demand. ““It is a lot easier to scale up your reuse cycles such as laundering gowns or replacing the filters in your reusable respirators than it is to remanufacture more of something … and of course it creates less pollution,” she said. “In some of our BC hospitals the reusable gown use ranges from 80-100% now.”
Timely access was cited as a key reason many hospitals desire reusable PPE.
“Converting to reusable gowns immediately introduced a predictable supply of product for the foreseeable future. The fact that it also reduced our environmental footprint was an added benefit,” Altaf Stationwala, CEO of Mackenzie Health in Ontario. “Mackenzie Health has now converted all of the isolation gowns used in the ICU to reusables.”
University Health Network (UHN) in Ontario was another project partner. More than 99 per cent of the isolation gowns currently used at UHN are reusable. Joanne Bridle, executive director, FM-PRO Operations, said UHN’s linen services partner was able to scale-up during the pandemic and launder and return clean reusable isolation gowns up to three times a day during the peaks of COVID-19 when use had more than tripled to 120,000 gowns per week.
Hospitals with reusable gowns also reported cost savings. UHN reported that reusable isolation gowns were 60 per cent of the cost of disposables. Toronto-area hospitals that used reusable isolation gowns saved about $70 million over the first two years of the pandemic. Memorial Hospital in Surrey, B.C., reported that these gowns were nine times cheaper per use than disposable gowns.
Randy Bartsch, executive chairman of Ecotex Healthcare Linen Service, and the incoming Chair of the Washington, D.C. based Textile Rental Services Association (TRSA), stressed the critical importance that health care laundry processing facilities play. “Our TRSA members process more than 80% of all the health care laundry at hospitals in Canada, and are key suppliers of reusable PPE gowns and other protective medical garments and textiles.”
A copy of the Coalition’s paper, Reusable personal protective equipment in Canadian healthcare: Safe, secure, and sustainable is available in Healthcare Management Forum, volume 36(4), 2023. More information about the project can be found here.
