Is the end of single-use plastic possible in the hospital?

• Several single-use plastic objects have been banned from sale since the start of the year.
• The healthcare community will have to comply with this innovation, with a longer delay. But can it completely do without single-use plastic?
• Finding a solution that offers the same health guarantees, at an equivalent price, seems difficult today.

No more cotton swabs, plates and cups. Since January 1 and the entry into force of the Egalim law, these single-use plastic objects are prohibited for sale. A flexibility of six months is however granted, in order to give traders time to sell stocks. And this is only the beginning: on January 1, 2021, it will be the turn of straws, cutlery and plastic tuilas to disappear from the shelves and from our habits. On this occasion, the free distribution of plastic bottles in establishments open to the public (more than 300 people) will also be prohibited.

Measures that are part of the government's desire to eliminate all single-use plastics by 2040, from all disposable to all reusable. But in the health sector, is this goal achievable?

End of disposable tableware in healthcare facilities

As for individuals, private companies or the public sector, hospitals will have to do without cups, cutlery and towels. With however a longer delay to switch to versions without plastic. Thus, health establishments, as well as penal establishments or the air and maritime transport sector, will have until January 3, 2021 to say their final farewells. In the end, the plastic savings will be colossal. "If a large teaching hospital, which can serve up to 11,000 meals per day, abandons disposable plastic cutlery, this represents a saving of 70 tonnes per year," illustrates Cédric Alliès, sustainable development advisor at Primum Non Nocere, expert agency in CSR / RSO strategy (corporate or corporate social responsibility), a subsidiary of the Sustainable Health Development Committee (C2DS).

The French Blood Establishment (EFS) also contributes to the building. For several months, an experiment has been carried out in several regions (Brittany, Grand-Est, Auvergne Rhône-Alpes, Hauts-de-France, Normandy or even Bourgogne Franche-Comté). On site, the donation houses no longer distribute bottles, while a consumption of 50 cl of water is essential for the safety of the donor. "The EFS has decided to remove them and experiment with more eco-responsible alternatives". Water fountains, glasses, reusable cups (and dishwashers to wash all that): the donation houses are equipped accordingly. What save 600,000 plastic bottles per year. An initiative that "will quickly be generalized to all donation houses", specifies the EFS, which is also considering extending it to mobile collections. Because "each year, with nearly three million donations, so many small bottles are thrown away".

80,000 bottles of water distributed each year in our Donation Centers in Brittany: it was time to act! As of today, they are replaced by fountains, glasses and decanters 👍 #DonDeSang # DéveloppementDurable #Rennes #Brest #Lorient #Quimper #Vannes #StBrieuc pic.twitter.com/bCyXXXJeDg

No plastic zero, but possible reduction

On the other hand, it is impossible for healthcare establishments to switch to zero single-use plastic. Blood bags, syringes, blood transfusion sets ... All these medical devices rely on this material, and are themselves packaged in plastic packaging. “At the moment, there is no alternative for many of these medical devices. Like a catheter, for example, which should be made of flexible material, ”explains Claude Le Pen, health economist and professor at Paris-Dauphine University. Blood bags, solutes, syringes: "creating versions without plastic, in alternative materials for all these care objects used in everyday life, and which have the same guarantees of health security and for an equivalent price, will be complicated in a near future, "he said.

"For the time being, research is focusing more on container / content compatibility, on ways to avoid the presence of endocrine disruptors in the plastics used in the composition of medical devices," says Cédric Alliès. To date, there is no viable substitute for plastic, no material that is as safe in terms of health and as competitive in economic terms, he confirms. Not even bio-plastics or bio-sourced plastics, which do not meet the government's objective of disposing of single-use plastic ”. Each year, 200,000 tonnes of infectious medical waste is produced in France. Treated in dedicated channels, they are not recycled, but incinerated at very high temperatures (over 800 ° C) to avoid any health risk.

But if there are no substitute materials, "we can still reduce the use of plastic at the source," says the specialist in hospital waste management. The C2DS supports healthcare establishments in eco-design of care: in this approach, we establish the carbon footprint of an act and we reflect on how it can be reduced. And one of the ways, for example, is to reduce the plastic overwrapping of medical devices, to optimize more environmentally friendly packaging ”.

Twenty years to change our relationship with plastic

The final end of single-use plastics is scheduled for 2040. A revolution that will first be clearly visible on supermarket shelves and in our closets. So, in twenty years, it will be the end of shampoo bottles, tubes of toothpaste and plastic cans of bleach. Why only in 2040? "It would be a lie to say that getting out of disposable plastic takes less than twenty years," replied Secretary of State Brune Poirson, who wants to give industry time to find alternative materials.

If this objective is for the moment a little too ambitious for the hospital, certain establishments take however initiatives to approach it. "Hospitals can opt, for a given category of products, for one that offers recycling possibilities," emphasizes Cédric Alliès. This is to activate the lever of responsible purchasing by involving their suppliers and providers of waste management. Their purchasing volumes are such that each decision can have a very broad concrete impact. It is not always easy for hospitals, faced with very tight budgets, to undertake this approach, but in the medium term, this often does not represent any additional cost ”. Thus, the Saint-Nicolas Clinic, in Toulouse, opted, in partnership with its linen provider, for the removal of individual single-use plastic covers, in favor of reusable fabric covers for its staff. And from 2013, the maternity hospital of Saint-Maurice (Val-de-Marne) embarked on the recycling of its infants, baby formula baby bottles.

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