Ophthalmology Operating Room Waste Segregation And Recycling: Analysis Of Practice Habits And Barriers To Sustainable Waste Management

Cataract surgery is one of the most performed surgeries worldwide and is known to be associated with significant medical waste production. However literature on waste segregation and recycling were scarce. This study aimed to assess the quality of operating room (OR) waste segregation, quantity of recyclable waste and associated carbon emissions after cataract surgery. It aimed to also analyse the practice habits of OR staff members towards medical waste segregation and recycling and to explore the barriers to an accurate, sustainable waste management.

A dedicated ophthalmology OR facility in a tertiary teaching hospital.

Outputs of waste streams were quantified through bag counts and approximations of weight, and quality of waste segregation were assessed randomly at different time points. The presence and type of non-conforming waste was recorded. Equivalent waste-related carbon emissions per cataract surgery were calculated based on disposal methods for each waste stream, and the total carbon emissions per week were calculated and compared to benchmark values. A questionnaire was distributed to all OR staff members. The survey assessed awareness and behaviours of waste segregation and recycling in the OR, followed by testing of knowledge on the environmental impact of cataract surgery. Thematic analysis of the barriers was performed.

For one cataract surgery, an average of 1.44kg of waste was produced, and over one week of cataract surgery (120 surgeries), this equated to total carbon emissions of 33.5 kg CO₂e. Carbon emissions from non-recyclable waste exceeded those from dry mixed recycling (DMR) by 5.68 times. Quality of waste segregation was poor with only 43.4% of DMR waste correctly segregated. Common non-conforming items included sterile fabric wrap, soft plastics and wipes. Through testing, knowledge of waste streams and environmental impact were low with an average score of 54.4% and 57.8% respectively. The leading barriers to good waste segregation were a lack of knowledge, accessibility of required bins and time pressures.

Our study showed a significant carbon footprint associated with cataract surgery and therefore improved waste segregation is crucial in reducing its environmental impact. The disparity in emissions between non-recyclable waste and dry mixed recycling highlights the need for better recycling practices. Waste segregation and recycling are still poorly understood and practiced by OR staff members in our facility. Given the identified key barriers to sustainable waste management, interventions including targeted education, well-placed waste disposal systems, and workflow adjustments were rolled out. Improved waste segregation and recycling efficiency could significantly reduce carbon emissions while maintaining high standards of patient care.