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Environmental Sustainability

Makes the Case for Reusable Textiles


Reusable Textile Products Reduce Environmental Risks

ARTA’s comparative life cycle assessments (LCAs) have demonstrated that reusable healthcare textiles offer critically-needed reductions in energy and water consumption, greenhouse gas emissions, and waste for nearly a decade. But its message that “The Future is Not Disposable” has never resonated as strongly as it does today.

The healthcare industry is among the most carbon-intensive service sectors in the industrialized world, responsible for nearly 5% of global greenhouse gas emissions and 9% to 10% of domestic greenhouse gas emissions, which arise directly from healthcare facilities and indirectly from their supply chains of goods and services. And the problem has been getting worse. U.S. healthcare greenhouse gas emissions rose 6% from 2010 to 2018, and are now the highest among industrialized nations, according to HealthAffairs.

Medical waste is a particularly important issue because it results in carbon dioxide and other greenhouse gas emissions that stay in the earth’s atmosphere for tens to hundreds of years, warming the climate and impacting present and future generations.

Broader adoption of reusable textiles would help because products like reusable gowns, cleanroom coveralls, and incontinence pads  reduce solid waste by 84% to 97% versus single use items because a reusable textile is used many times, while a disposable item is used once and sent to the landfill or incinerated.

Numerous proponents including policymakers, scientific researchers, some healthcare providers, and industry associations have shared their concerns about the need for the industry to reduce its waste, conserve natural resources and prevent exposure to hazardous materials and recommend life cycle assessment as a tool for decision making in procurement.

The Association of Perioperative Registered Nurses (AORN) has been a strong advocate for the environment for 20 years. It’s current position statement says, “All healthcare professionals have an ethical and professional responsibility to protect patients’ health through advocacy. Because human health is affected by and is dependent on the surrounding environment, healthcare professionals must actively work to incorporate best practices that mitigate negative environmental impact.”

AORN’s list of environmentally responsible practices includes using LCA data when evaluating products for purchase and use, selecting reusable equipment, supplies, and materials when they are equivalent in performance and safety, and reprocessing equipment, supplies, and materials.

But few of the statements have been starker than The World Health Organization’s 2022 report on global medical waste. WHO’s 70-page analysis found that the COVID-19 pandemic led to large increases in medical waste – tens of thousands of tons of extra medical waste composed of PPE and COVID-19 testing and vaccination supplies that placed an extraordinary burden on healthcare waste management systems around the world.

The WHO noted that the waste volume it tracks, based on the United Nations (UN) procurement system, doesn’t include the much larger amount of COVID commodities purchased outside of the UN system and therefore represents only a small fraction of the incremental volume of waste.

The report warned that one in three healthcare facilities globally doesn’t safely manage existing healthcare waste loads, much less the increased volumes generated by the pandemic. Today diposable medical products and packaging are “straining under-resourced healthcare facilities and exacerbating environmental impacts from solid waste,” said the report. The potential impact is not only to healthcare workers but to entire communities around poorly managed landfills and waste disposal sites based on contaminated air, poor water quality and disease-carrying pests.

The WHO urged healthcare facilities to incorporate safer and more environmentally sustainable waste management practices into their pandemic response to protect human and environmental health. It highlighted the need for investment in non-burn waste treatment technologies, a focus on eco-friendly packaging and shipping, the adoption of safe and reusable PPE, and use of recyclable or biodegradable materials.

Some keen observers of industry practices have estimated the country’s future need for gloves, isolation gowns and face masks should another surge of COVID-19 infections strike. Johns Hopkins estimated that a single 100-day COVID-19 surge would require an additional 321 million isolation gowns on top of baseline isolation gown use in hospital inpatients, emergency departments, emergency medical services, outpatient visits, and nursing homes in the U.S.

That sentiment was echoed in a November, 2020 meta study conducted by Stanford University researchers in the context of the COVID-19 pandemic. The study, peer reviewed and published in Frontiers of Public Healh, assessed whether disposable isolation gowns are more effective barriers than reusable gowns. “No existing literature shows nonwoven (disposable) fabrics to be safer than impermeable woven fabrics, especially woven polyester,” the study concluded.

Wrote the Stanford researchers, “The circumstances of the pandemic forewarn the need to shift our single-use PPE practices to standardized reusable applications. Ultimately, sustainable forms of protective equipment can help us prepare for future crises that challenge the resilience of the healthcare system.”


ARTA Life Cycle Assessment Research

Life cycle assessment (LCA) is the most comprehensive and widely used tools to evaluate environmental impacts of products, services, or processes from cradle-to-grave and published, peer-reviewed life cycle assessments are the cornerstone of ARTA’s case for reusable textile products. Since 2013, ARTA has conducted comparative LCAs on cleanroom coveralls, isolation gowns, surgical gowns, incontinence pads, and in 2022, microfiber cleaning cloths and flat mops.

The studies, conducted by Environmental Clarity researchers Michael Overcash, PhD., and Evan Griffing, PhD., use the LCA process and data from the Environmental Genome database to compare the environmental impacts of reusable healthcare textiles versus their single-use counterparts from the origin of the raw materials, through the manufacturing process and transport, use and reuse, to the final disposal. 

ARTA’s Next LCA

The next research project is an LCA the ARTA Microfiber Committee is conducting to compare reusable and disposable products for two common environmental services products – the microfiber cleaning cloth and the flat mop. The studies of both the reusable and the disposable cleaning products, to be completed in 2022, include the following components:

  • The cleaning cloth/wipes and flat mop, their different materials, and construction
    Laundry process (with CDC guidelines) for reusable products with different materials and construction
    Chemicals for disinfection and for laundry process
    Primary, secondary, and tertiary packaging
    Cradle-to-product supply chains for the materials used
    End-of-life scenarios

The Evolution of ARTA Research – Economic Impact Studies

ARTA understands that product purchase decisions are multifactorial and that understanding the true economic costs of the available alternatives is critical. So, it has undertaken a series of Economic Impact Studies for reusable and disposable cleanroom coveralls, isolation gowns, surgical gowns, incontinence pads, and microfiber cleaning products.

Environmental Clarity published the first of these Economic Impact Studies on cleanroom coveralls in 2021, based on a compilation of 22 cleanroom customer documents from laundry operators and suppliers representing all four regions of the U.S. and with a wide range of annual usage. Published in the peer-reviewed PDA Journal of Pharmaceutical Science and Technology, the study was the first such report on cleanroom garments, which are used by many industries, including the semiconductor, pharmaceutical, life science research, medical device manufacturing, and food manufacturing.

Conducted for ARTA’s Cleanroom Committee, the study documents that the cost per use of reusables is 58% less expensive than their disposable counterparts, which saves $120 million in annual garment purchases and laundry costs annually. Reusable cleanroom coveralls also save 136 million megajoules (MJ) of natural resource energy and global warming potential, the equivalent of removing 1,600 automobiles from the roads annually. The solid waste landfill savings for selecting reusables was $340,000 per year.


By Dory Trinka. Trinka is a freelance writer and editor and provides content management services to businesses and nonprofits. dtrinka@nextpathpartners.com

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