An Inconvenient Lab Report

Rhona O’Neill

Medical Scientist, Wellington SCL.

Hippocrates

(4th century BC)

Advocated a framework that related medical and public health practices

“Airs peculiar to each particular region”

“Properties of the waters”

“Modes of life”

Florence Nightingale

(19th century)

Emphasized the importance of clean water and air

Rudolf Virchow (19th century)

Described medicine as a social science and politics as the practice of public

health on a large scale

Growing divergence between medicine and public health

• The irony with ‘health care’ is that it is now one of the most relatively environmentally impactful industries

• On a sq ft basis, hospitals and related facilities are second only to manufacturing in electricity use

• US EPA states that medical waste incinerators are the second leading qualified source of dioxin emissions

• Second only to municipal waste

Capital & Coast DHB (CCDHB) generates between 4000 - 5000 kilograms of waste every

day. • Biohazardous materials

– Shipped to Brisbane in refrigerated containers, incinerated and destroyed

– This process itself is carbon intensive

• General waste

– 85% of hospital waste is non – hazardous (WHO, 2015)

• Recyclable waste?

• Hospital infectious wastes costs $1/kg ( Australia)

• Tenfold that of non – infectious waste

Science is Wonderful!!

Hospital Laboratories

• Operate 24 hours a day, 365 days a year

• Generate large quantities of waste

• Infectious, solid, hazardous, general

• PLASTICS PLASTICS PLASTICS!!

• Use materials that may have toxic effects to the environment

• More than 80,000 chemicals registered with EPA

• Health and environmental impacts are uncertain

• Consume large amounts of energy and generate significant greenhouse gas emissions

• -80 °C freezers

• Fume cupboards

• Consume copious amounts of water

• Analysers running on a constant basis

Is it possible to minimise environmental impact when working in the lab?

Can we be tree huggers AND scientists?

Step 1. Start the conversation

…..and keep it going

• Share ideas and concerns with co – workers

• Make sustainability a regular agenda item

• Create the culture

• Start from the ground up

• Ask questions

• From the people who can make the changes

Reduce

• Lean management of the lab

• Stock ordering audits to highlight any waste

• Optimal management of stock (assess over or under ordering)

• Collection tube audit

• Identify minimum sample volume

• Less cost, less wastage, less storage, less volume to transport

• Electronic documentation to reduce amount of hard copies

• Choose, where possible products that don't require regulated disposal

Reduce

• Energy consumption

• Turn off monitors when not in use

• Close that fume hood!

• Defrost freezers regularly to maintain optimum efficiency

• Optimise air conditioning

• Identify equipment that CAN be switched off at end of shift

REUSE

• Pool bulk reagents

• Printer paper

• Default to double sided printing

• Cardboard inserts

• Unsoiled specimen bags

• Irradiate and recirculate

• Plastic bags for specimen transport

‘Santa Sacks’ – alternative for collection room sample transport??

RECYCLE• Hard plastics

• Correctly dispose of pipette tip holders and other hard plastic packaging

• Wash and appropriately recycle empty reagent containers

• Soft plastics

• Negotiate to reduce amount of packaging when engaging with supplier

• Request vendors use biodegradable or recyclable packaging

• Ask vendors to take back their packaging for reuse

• Cardboard boxes

• Recycle or reuse for transport

• Availability of recycling bins

Make more conscious purchases

• Buy from suppliers that employ green practices of their own

• Bioplastics, recyclable products

• Involvement in sustainability initiatives

• Supply and demand

• Buy local where possible

• Reduce carbon footprint due to transport costs

Make more conscious purchases

• When replacing big pieces of equipment

• Factor in environmental impact of equipment

• Buy energy efficient refrigerators and safety cabinets

• Give less priority to analysers with larger water and power requirements

• Analysers requiring significant air conditioning or heating requirements

Make it personal

• Hospital staff are a well caffeinated workforce

• Keep cups

• Reusable containers when buying lunches

• Recycling initiatives amongst staff

• Cycle or Walk to work schemes

• Plastic free or low carbon challenges

Some good news stories

• International Conference on Sustainability Science

• Switzerland, August 2017

• Global and Climate and Health Alliance

• Greenstar Healthcare environmental rating systems – Australia

• Health Care Without Harm – International coalition of 53 countries

A greener future?

• Sustainability or green practices - a requirement for accreditation?

• Voluntary → Mandatory

• Bioplastics

• Plastic derived from renewable mass, often starch, cellulose.

• 2% of polymer industry

• Rapidly growing industry

• Lego and Coca Cola are investing in bioplastic alternatives

• Green architecture

• Hospital and lab design

• Solar powered hospitals?

Useful resources

• www.mygreenlab.org

• Thelabs21.wiki

• www.green.harvard.edu/labs

• www.labconscious.com

• ‘A Plastic ocean’ – Documentary

“the health sector should lead by example by greening itself and reducing its ecological footprint…to improve global health

and the health of the planet”

(Institute of Medicine 2013 Workshop Summary)

References

• De Soete W, Jimenez-Gonzalez C, Dahlin P, Dewulf J. Challenges and recommendations for environmental sustainability assessments of pharmaceutical products in the healthcare sector. Royal Society of Chemistry 2017, 19, 3493.

• Lopez R, Badrick T. Proposals for the mitigation of the environmental impact of clinical laboratories. Clincal Chemistry and Laboratory Medicine 2012;50(9) 1559 – 1564

• Lopez R, Jackson D, Gammie A, Badrick T. Reducing the Environmental Impact of Clinical Laboratories. The Clincical Biochemist Review 2017; 38(1)

• Schettler, T. Environmental Challenges and Visions of Sustainable Healthcare. CleanMed Conference 2001.

Thank you for listeningDiscussion welcomed