10 medical device sustainability terms

1. Sustainability

Definition:

As described in the UN’s 17 Sustainable Development Goals (SDGS), sustainability is widely accepted to cover a broad range of areas. These include not just the climate, but also a variety of emergencies that threaten humanity, from poverty to education and more.

How this applies to the industry:

When considering sustainability in the medical device industry, it can be easy to focus on the issue of climate change and trying to reduce your carbon footprint where possible. While this is of course an important aspect, to address medical device sustainability in full, it’s important to consider the term more holistically. Often, one well-placed decision can help in a variety of ways, for example creating local manufacturing sites around the world could not only help to reduce environmentally costly transport routes, but also create jobs in lower-to-middle-income regions. In short, it’s important to consider all the factors contributing to the sustainability of your development.

2. Greenhouse gas emissions and carbon footprint

Definition:

Greenhouse gas (GHG) emissions and carbon footprint can be considered as interchangeable terms, both relating to the total emissions caused by human activity, from manufacturing and transporting a product, to your company’s office emissions. GHG emissions (or carbon footprint) refers to the total amount of greenhouse gases, however it’s generally expressed as carbon dioxide equivalent, in grams of CO2 equivalent (g CO2-eq).

How this applies to the industry:

For a complex device development, GHG emissions can occur from a variety of sources. To determine the carbon footprint of a single device, we need to consider every source of greenhouse gas, from transport emissions to the energy sources of a manufacturing plant. For example, a printed circuit board (PCB) may be a relatively cheap part for your device, however it will come with a high carbon cost owing to the chemicals used and energy intensive process of manufacturing it.

3. Net-zero carbon targets

Definition:

This refers to a goal that an organisation or other entity can pledge to reach net-zero GHG emissions by a specified date. “Net-zero” is used rather than “zero” as it is impossible to mitigate all emissions entirely. In contrast to “carbon neutrality”, where a company aims to offset its emissions through carbon reduction activities, the aim of net-zero targets is to reduce emissions as a first priority, before counter-acting the remaining emissions through carbon offsetting. This is an important distinction, as it prevents companies from simply continuing along business as usual and then purchasing carbon reduction credits, such as investing in windfarms. According to the UN, net-zero can be achieved by removing from the atmosphere at least the equivalent of the remaining emissions you have produced.

How this applies to the industry:

As with all industries, it is fast becoming relevant for each company to set its own carbon targets and start planning how to reach them. In order to achieve this, it is important to be able to accurately measure your carbon outputs. The Greenhouse Gas (GHG) Protocol is the most widely used accounting framework for quantifying and measuring these emissions when considering medical device sustainability, while tools such as Life Cycle Analysis (detailed later in the article) can also be used throughout your development.

4. Carbon offsetting

Definition:

As mentioned above, the act of carbon offsetting involves removing greenhouse gases to balance against your organisation’s residual GHG emissions. It’s important to note that it is impossible to remove emissions entirely from your company’s operation, which is why carbon offsetting is so important.

There are two key carbon offsetting schemes:

1. Reduction schemes: the aim of these schemes is to reduce (non-proprietary) emissions through renewable energy projects, such as windfarms or solar panel projects. Purchasing credits in reduction schemes results in reducing the need for future emissions elsewhere, but this does not actively remove emissions produced by your organisation.

2. Removal projects: these involve attempts to absorb emissions from the atmosphere, most notably through planting trees or ‘sequestration’.

How this applies to the industry:

Carbon offsetting is a valuable activity, however it can be challenging to determine which approach is best for your company. It may be best to start small, setting net-zero targets to begin with and then planning a roadmap to achieve this.

5. Life Cycle Assessment

Definition:

Life Cycle Assessment (LCA) is a widely recognised (ISO 14040:2006) environmental management framework for assessing the environmental impacts of a product or service. LCA can be utilised for carbon output analysis, considering the carbon footprint of various aspects of a device development, from manufacturing to materials sourcing. An LCA can also be used to assess a wide range of other impact categories, including land use, resource efficiency, water use and more.

How this applies to the industry:

Minimising the environmental impact of a medical device is a complex process. Using tools such as LCA, you can gain accurate quantitative insights into the carbon footprint of your device development. These insights can be used to drive strategic decision making throughout the process, allowing you to weigh the carbon footprint of various suppliers, transport routes, materials and more against costs and the benefits they will bring.

6. Circular economy

Definition:

Developed by the Ellen MacArthur Foundation, circular economy is a methodology for driving system change towards a more sustainable economy. The system aims to address a number of environmental issues, primarily surrounding the depletion of natural resources and excessive waste. It encourages a different approach to product life cycles, embedding recycling, repair, reuse, refurbishing, maintenance and other approaches for a more efficient use of resources and energy, as well as to minimise wastage and pollution.

How this applies to the industry:

Considering the lifecycle of your device from cradle to cradle and identifying where to avoid unnecessary waste is particularly important to consider in relation to single use components and devices. While a circular economy would ideally involve recycling these components or refurbishing them for future use, this is not always a feasible solution in the medical space. Important steps can still be made towards building a circular economy when developing sustainable medical devices however, such as designing out single use components by building in easy-to-clean and/or sterilisable elements to the system.

7. Bioplastics

Definition:

Not to be confused with biodegradable plastics, bioplastics are polymeric materials derived from biomass sources. While bio-sourced, it’s important to note that a bioplastic is not necessarily biodegradable. Alongside being renewable, the carbon footprint of producing biopolymers is also much lower than fossil-based plastics, while the very nature of growing plant-based sources can help to reduce the carbon in the atmosphere. That being said, the benefits of growing plant-based sources for bioplastics could have a negative impact depending on the land used to grow them, for example cutting down a rainforest or replacing a food crop.

How this applies to the industry:

Bioplastics is a fast-growing industry, with a lot of potential for use in medical devices too. Experimentation may be required to ensure reliability and safety, however these materials could contribute to more sustainable medical devices

8. Design for end of life

Definition:

Similar to circular economy, this design practice focuses on reducing the environmental impact of medical waste at the end of a product’s life. This might include aspects such as design for disassembly, recycling, reuse, remanufacture, energy recovery, repair and more.

How this applies to the industry:

Designing for end of life is of increasing importance, particularly at earlier phases of medical device development such as the concept generation phase. What happens to your product at the end of its life should not simply be an afterthought, it should be a part of the full design consideration. As mentioned previously, design for end of life is often more challenging in the medical industry than with consumer products, owing to the nature of medical waste. For example, in most cases biodegradable materials can have little impact for medical device sustainability, as medical waste tends to be incinerated. However, work can be done to understand how contaminants degrade, and whether they can be made safe for landfill, although this would also require education for users to help them to recycle and reprocess appropriately.

9. Waste hierarchy

Definition:

Medical waste is a key cause for concern in the medical industry. Hospitals create over 5 million tons of waste each year, the majority of which is not recyclable and typically disposed of outside of domestic waste streams. Waste hierarchy refers to how we dispose of our products. While the definitions vary, the general underlying principles are as follows:

How this applies to the industry:

It goes without saying that anything we dispose of will need to be replaced. Therefore, the aim of waste hierarchy is to reduce, reuse, recycle and recover as much of the initial product as we can. Waste hierarchy should be considered from the start of the design process and plays an important role in designing for end of life.

10. Supply chain management

Definition:

This refers to managing your suppliers, focusing on local supply where possible, efficient packaging and reducing energy transport.

How this applies to the industry:

Generally, opting for local supply is preferred where possible, to reduce the carbon footprint of transport. While cheaper manufacture can be found abroad, opting for local supply usually comes at a much lower carbon footprint, owing to less transport. If transport is required internationally, sea freight has a much lower carbon footprint than air freight, however the time for delivery must be factored in well in advance. It’s also worth noting that how parts and manufactured products are packaged can also have a significant impact on GHG emissions and therefore overall medical device sustainability. More lightweight, efficient and single material packaging will have a much lower footprint, for example.

What does this all mean for medical device developers?

As set out above, becoming more sustainable as a business involves more than just reducing your carbon footprint, although this of course plays an important role. You must also think laterally about the wider impacts of your device, not just about how much carbon is produced by its development.

For example, diagnostic devices can help to identify conditions early on, while an efficient drug delivery device will help patients to self-medicate, both of which can help avoid an increase in environmentally costly hospital visits. The impacts of this are not negligible either. According to the NHS, approximately 3.5% (9.5 billion miles) of all road travel in England relates to patients, visitors, staff and suppliers to the NHS, contributing around 14% of the system’s total emissions. Though steps are being taken to reduce this impact, these are of course important factors to also consider when planning for sustainability.