The large shift towards single use plastics is driven mainly by the need for sterility and patient safety considerations. Packaging has a significant role, ensuring integrity and maintaining equipment sterility. However, it is easy to become distracted by plastic packaging and perceived need for more recycling.
Is it as simple as cutting down on the amount of packaging? Is this all it takes for surgical specialties to become more sustainable? No. There are bigger factors within the wider picture including manufacture and transportation. Awareness of and addressing these are far more likely to achieve positive impacts for healthcare sustainability and climate change.
Life cycle assessments (LCAs) of products recognise environmental impacts of the entire process needed to get your suture to your bracket table. It shows where the biggest gains can be made in addressing environmental impact. Encouraging manufacturers/suppliers to publish LCAs is beneficial to encourage changing to more sustainable practices, and clinicians to identify where best to make informed changes.
Carbon emissions from transporting raw materials and products make up a significant part of our suture’s environmental impact. Horwood et al. (2020) showed multiple journeys occur during the manufacturing process for a single suture:
Transport of raw goods to a storage warehouse.
Transport by air of raw goods to a factory for manufacture
Transport by air of needles and suture thread to a factory for attachment/assembly.
Transport by air of assembled suture back to the original factory.
Transport of sutures to supplier and then to clinical workplaces.
The combined carbon emission output for these journeys is equivalent to:
Driving 65,261 miles in the average car
or The entire energy usage of 3 homes over a year
or 3.3 million smartphone charges
Good procurement practice makes a big impact on the need for additional transport.
E.g. one UK hospital created 4.5 individual orders per day for sutures, resulting in multiple trips to/from storage warehouses. Consolidating orders is advantageous to not only reduce additional need for travel, but saves time and money associated with creating and processing orders.
Communication between teams in larger practice groups or organisations can ensure joined-up collaborative purchasing of goods – rather than clinics ordering individually, resulting in multiple trips for the same organisation.
We can influence the carbon footprint of our procedures by educating colleagues and other dental stakeholders. Close collaboration and cooperation between manufacturers, regulators and end-users is key to ensure positive and sustained changes are implemented.
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