Standards for Sustainable Healthcare

Tim Sprinkle

It’s no secret that healthcare costs are among the largest expenditures for everyday Americans. According to the Centers for Medicare & Medicaid Services, the average person spent nearly $13,000 on healthcare in 2021, a figure that accounted for 18.3% of the country’s gross domestic product that year. What’s more, that spending is expected to continue growing by roughly 5% per year going forward.

Still, as large as the healthcare industry has become, it has one dirty secret that can be easy to overlook: waste.

The industry’s waste-producing footprint is immense. According to the American Medical Association, each U.S. hospital patient generates about 33.8 pounds of waste every day. Of that waste, 25% is plastic.

At hospitals, sterilized instruments come wrapped in plastic. Single-use utensils are commonplace. And just about everything – from syringes, to intravenous bags, to gloves – is made to be disposable.

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That fact is one reason that ASTM International’s committee on sustainability (E60) recently took steps to create a new subcommittee on sustainable healthcare (E60.42) to develop standards “related to sustainability, sustainable development, and resilience as it is associated with the value stream related to healthcare.” Its intended audience will include healthcare facilities, procedures, products, and more, including every part of the value stream from raw materials suppliers, to medical product producers, to clinical offices, surgical centers, hospitals, pharmacies, nursing homes, medical waste treatment facilities, and regulatory bodies.

“From a healthcare perspective, we have been talking about dentistry for a while,” says committee chair Amy Costello, who is product stewardship and sustainability manager with Armstrong World Industries. “We have a dentistry standard [Standard practice for managing sustainability in dentistry (E3014)] that we finalized a few years ago, but more recently, we decided that it should go broader to address all of healthcare.”

The time is right. Given the ongoing focus on the cost and impact of healthcare around the world, new attention is being paid to sustainability across the industry. And, the fact is, healthcare waste is disproportionate to the size of the sector, given the wide range and application of products in use at hospitals and other facilities every day. Healthcare comes with some unique regulatory circumstances as well that are different from what other segments have faced in their own sustainability efforts.

“In other sectors you don’t have the FDA and the Joint Commission looking over every hospital to make sure that their operations are following regulations,” Costello says. “How waste is handled, how patient safety is addressed, even how things are procured. A lot of these regulations expand into day-to-day operations around waste and what is and is not permitted.”

The subcommittee isn’t starting from scratch, however. There have been a number of efforts around the world to address the healthcare waste stream and try to make the industry more sustainable. For instance, several pilot programs in the U.S., Europe, and Australia have looked at how to take so-called challenging waste streams such as contaminated waste and make those products useful again through recycling and other means.

To start, the subcommittee will be reviewing the steps toward sustainability that have been happening in dentistry and looking for ways to expand those standards into other parts of the healthcare space. For example, the group is reviewing what can be done at the practice level to improve sustainability and their next work item is focused on supplier management and other things that can be done on the procurement side. From there, they will focus on things like design guidance practices to help hospitals set up and administer their own sustainability programs.

“What ASTM brings to this is really what we always do,” Costello says. “It's consensus-based standards that can be used across the globe so that everybody is using the same criteria to define what sustainability is within healthcare.”

Anyone interested in helping with this effort can contact E60 staff manager Kristy Straiton at The committee will meet at ASTM October Committee Week in Washington, D.C. (October 30-November 2, 2023).

Tim Sprinkle is a freelance writer based in Colorado Springs, Colorado. He has written for Yahoo, The Street, and other websites.

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