Impact on carbon footprint: a life cycle assessment of disposable versus reusable sharps containers in a large US hospital.

Hospitals are striving to reduce their greenhouse gas (GHG) emissions. Targeting supply chain points and replacing disposable with reusable items are among recommendations to achieve this. Annually, US hospitals use 35 million disposable (DSC) or reusable sharps containers (RSC) generating GHG in their manufacture, use, and disposal. Using a life cycle assessment we assessed the global warming potential (GWP) of both systems at a large US hospital which replaced DSC with RSC. GHG emissions (CO(2), CH(4), N(2)O) were calculated in metric tons of CO(2) equivalents (MTCO(2)eq). Primary energy input data was used wherever possible and region-specific conversions used to calculate the GWP of each activity. Unit process GHGs were collated into manufacture, transport, washing, and treatment and disposal. The DSC were not recycled nor had recycled content. Chemotherapy DSC were used in both systems. Emission totals were workload-normalized per 100 occupied beds-yr and rate ratio analyzed using Fisher's test with P ≤0.05 and 95% confidence level. With RSC, the hospital reduced its annual GWP by 127 MTCO(2)eq (-83.5%) and diverted 30.9 tons of plastic and 5.0 tons of cardboard from landfill. Using RSC reduced the number of containers manufactured from 34,396 DSC annually to 1844 RSC in year one only. The study indicates sharps containment GWP in US hospitals totals 100,000 MTCO(2)eq and if RSC were used nationally the figure could fall by 64,000 MTCO(2)eq which, whilst only a fraction of total hospital GWP, is a positive, sustainable step.