Sustainability Within Ophthalmology: How Can We Reduce Cost & Environmental Impact Associated With Inappropriate Waste Disposal?

1) To assess the compliance and appropriateness of clinical waste disposal in ophthalmic theatre | 2) To promote environmental sustainability and to encourage cost-effectiveness without compromising patient safety.

Ophthalmology theatres in East Lancashire Hospital NHS Trust (a university teaching hospital) in the United Kingdom

The amount (kilograms) of clinical waste from two ophthalmic operating theatres was collated. Procedure-specific equipment was analysed and evaluated to identify inappropriate waste, including unnecessary clinical waste and recyclable items associated with its use.

Thirty-eight operations were investigated. 28 (74%) were cataract surgeries, and 10 (26%) were oculoplastic operations, including six major and four minor operations. The average weight of clinical waste generated from each cataract procedure was 1.20kg, of which 0.83kg was inappropriate. This amounts to 30.7kg over one week, equivalent to £13.94. Comparatively, minor and major oculoplastic operations generated 0.15kg and 0.40kg of clinical waste respectively, of which 0.05kg and 0.11kg were inappropriate. This amounts to 1.09kg over one week, equivalent to £0.42. Among the inappropriate waste found in the clinical waste, the majority was from consumables such as intraocular lens packaging, of which 3.10kg are potentially recyclable items.

There was a significant difference in the weight of inappropriate clinical waste (0.72 kg) when comparing one cataract surgery with one major oculoplastic surgery. This is attributed to the excessive plastics used in a custom cataract pack. In contrast, most instruments used in oculoplastic surgery are reusable after sterilization. This study found more than half of the clinical waste is potentially recyclable. Replacing disposable with reusable equipment and appropriate waste disposal would significantly reduce carbon footprint and promote sustainability. Incorporating awareness of appropriate waste disposal and reducing the carbon footprint into surgical training will be the future of promoting sustainability in healthcare.