Medical waste is a bigger problem than you might realize

The nature of the crime? Bringing my reusable food container down for meals. I just wanted to avoid the Styrofoam plates and plastic silverware, but the lunch ladies were convinced I was asking for two portions’ worth of side dishes and then only paying for one. I wasn’t, although I admit to once sprinkling cheese from the salad line on my soup [gasp!]. But by that time, I already had a large target painted on my scrubs.

My innocent food container — my small attempt at being mindful of waste — was barred from the cafeteria. The exclusion sent a clear message: Eat on our single-use plates, or do not eat at all. Coming from the same organization that tosses all the contents from its recycling bins into the landfill, I shouldn’t have been surprised.

My cafeteria episode apparently was a big deal in the world of hospital food preparation. One of the cafeteria supervisors sent a message straight to my program director. “Your resident isn’t coloring inside the lines,” was essentially how it read. No matter how trivial the issue, having to explain yourself to your program director is obviously undesirable.

Medical waste is a bigger problem than you might realize

Our medical-industrial complex exerts a significant negative effect on the environment. I am likewise not impressed by the degree to which health care contributes to pollution. A 2016 study reported that 9.8 percent  of national greenhouse gas emissions are attributable to the health care sector. For reference, the study authors explain this amount of emissions supersedes total emissions from all but the thirteen highest-producing countries worldwide.

The problem is bigger than just greenhouse gasses. Medical waste takes up space in landfills. Health care practices create chemicals that are carcinogenic to humans and toxic to the environment. Particulates generated by hospitals and by production of medical goods are spewed into the air. All of these things have implications to the health of the patients we are supposed to be helping.

What can be done?

With a last name like “Hippe,” I had best not get too far out in left field on environmental issues. Clearly, some amount of energy has to be devoted to powering our facilities and providing health services. But, “how much energy?” is the important question. In my opinion, we can be doing much better.

There are many levels on which the discussion of environmental health needs to occur, from top tiers of hospital administration down to each individual person. The environmental impact of our activities needs to be highlighted at the organizational level, but lofty aims like this are not readily accessible for the majority of health care personnel.

If you find yourself just trying to survive from one day to the next (cough, I’m talking to you, fellow residents, cough) rather than participating in high-level policy discussions, a more realistic place to start might be to decrease your personal waste. Use a coffee mug rather than disposable cups. Stop using sterile gloves for minor skin procedures, because they are associated with no difference in infection rates. (Wash your hands!) Among acceptable surgical techniques, choose the one that employs the least amount of single-use equipment. Save trees by writing concise hand-off reports.

I would be curious to hear other ideas about how you have individually reduced environmental waste, and any inspirational facility-wide policies that have been successful at your institutions.

Lastly, for the truly brave folks out there: Bring your own dish down to the cafeteria — but watch out for the cafeteria staff!

Scott Hippe is a family medicine chief resident who blogs at Insights on Residency Training, a part of NEJM Journal Watch.

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