6 ways to improve medical device sustainability

1. Use a bio-based plastic for more sustainable
medical device design

Plastic polymers made from biologically-sourced, renewable feedstocks have up to 75% lower carbon footprint compared to traditional fossil-based plastics and are fast becoming a viable option for more sustainable medical device development. There are now a number of companies offering medical grade bio-based plastics, including DuPont, Celanese and Borealis. Alongside being more sustainable, these plastics are typically manufactured using secure supplies of waste biological matter, such as from farms, to avoid having to grow new crops for them.

Bio-based plastic products have also been cleverly designed to ease regulatory approval. The companies offering them now often follow a “mass balance” approach, whereby a certain percentage of bio-based feedstock is mixed with the fossil-based feedstock, which is then supplied to all customers. The result is that it can be argued to regulators that the bio-based and traditional plastics are literally the same product, not merely equivalent in behaviour through physio-chemical tests. In addition, manufacturers have supporting data to demonstrate that the phys-chem properties of plastic made with bio-based feedstock falls within normal batch-to-batch variation for the fossil-based plastic.

In short, medical bio-based plastics are designed to ensure a smooth regulatory approval and bring substantial carbon saving by reducing dependence on fossil-based inputs. By using bio-based, biodegradable or post-consumer recycled plastics to support greater sustainability in medical devices, it may be possible to reduce waste, CO2 emissions, water usage and energy consumption. A Life Cycle Assessment (LCA) would then be a valuable exercise in determining how the choices made might affect the environment.

2. Reduce medical device packaging

Packaging contributes a substantial portion to the carbon footprint of medical devices and also an increased risk of plastic environmental pollution. This includes the manufacture of packing material, shipment to the product assembly sites and the resulting added mass and volume to the final shipped product, all of which add to any product’s overall carbon and waste footprint.

Packaging associated carbon emissions and waste are generated across the whole manufactured product lifecycle but the closer to the final product, the larger the impact.

While product efficacy and patient safety are of course paramount where the transport of medical devices is concerned, there are still numerous options to consider to reduce packaging, while still ensuring the safe delivery of medical components and products.

For example, it may be feasible to reliably ship a component in bulk rather than on a tray. There may also be ways to safely reduce the packaging volume or mass, such as more space-efficient packing within the shipping container. Designing a product that is sufficiently robust to avoid the need for excessive packaging is also hugely beneficial. While adding stronger or additional material to the product will introduce its own carbon cost and waste impact, this could well be outweighed by the benefits of reduced packaging to transport it safely.

Using carbon footprint calculators such as LCA alongside estimations of waste mass may help to better understand the impact of different design and packaging options, enabling more informed decisions that achieve the lowest impact possible to support more sustainable medical device design.

3. Select low emission transport where possible

Transportation is another big contributor to sustainability in medical devices. This includes everything from the transport of raw materials to component suppliers, and components to the assembly site, through to shipment of the product to the user. The latter has a higher potential impact, due to the associated increased packaging, though the actual impact depends on mileage and transport type.

Air freight is associated with the highest carbon cost per mile, followed by road, with sea freight incurring the least. Opting for sea freight and road is generally an effective way to reduce the carbon footprint of your transport. Of course, there may be some occasions when the need to protect a sensitive product will make air freight the better choice.

Transportation overheads can be minimised by seeking to select suppliers local to the manufacturing site, for example in the same country or a neighbouring one. Similarly, placing manufacturing sites for the final product local to the regional market they supply can also help to avoid unnecessary transportation. Where products need cold chain transportation, it is best to minimise the amount of time in transport, for example by filling in or close to the final market and final assembly site.

4. Make your medical product reusable

Product reuse is one of the most effective ways to minimise waste impacts. It can also help reduce carbon emissions, with a carefully designed reuse cycle. Each reuse cycle avoids the manufacturing impacts of another product and can significantly mitigate any associated transportation impacts as well, supporting medical device sustainability.

Reprocessing a product that one user has finished with to make it available to another user, can also help to minimise waste; however, carbon emissions associated with cleaning, sterilisation and transportation also need to be considered. On occasion, the costs of transportation and reprocessing, such as cleaning or sterilisation, can even exceed the benefit of reuse. It is important to therefore select low carbon processes if possible to ensure truly sustainable medical device design.

Gamma sterilisation, for example, emits less carbon than steam/autoclave or Ethylene Oxide (ETO) sterilisation, as these are highly energy intensive. This process does, however, need to be carefully conducted under controlled conditions to protect workers and the local environment, since gamma radiation is carcinogenic (as indeed is ETO). Once again, carbon footprint estimates can help inform decision making, alongside a review of health and safety compliance at a particular site.

Products can be designed with reuse in mind from the outset. Design for reuse means designing a robust product with good longevity, as well as considering modular design to allow replacement of any parts that do not have the same long lifespan, such as containers for drug or reagent.

5. Select commonly recycled materials during medical device development

At present, the rate of recycling for medical devices is low compared to other industries, despite recycling being widely seen as an important means to reduce waste and carbon footprint.

There are many ways to try and improve the recyclability of medical devices, such as implementing a modular design to allow the easy separation of different parts, or avoiding co-moulded parts. By far the most effective route, however, is to select materials that are commonly recycled through municipal waste streams, such as; polypropylene, high density polyethylene film aluminium, steel, drinks bottle grade glass and paper or card. Currently, many glass syringes or vials are made from a high-grade glass that would contaminate recycling streams.

Studies have shown that users often throw their medical device in the domestic recycling bin, in either the belief, or hope, that it can be recycled via that route. Often, this results in problematic contaminants such as engineered plastics entering the recycling streams. Selecting commonly recycled materials when considering sustainable medical device design can help to align with users’ existing beliefs and behaviours. To accommodate this, parts that have made contact with drug or bodily fluids should also be made easily removable by users prior to disposal in the recycling bin.

Other engineering materials such as acrylonitrile butadiene styrene, polycarbonate or acetal, while technically recyclable, most often do not get recycled. This is because the quantities are comparatively small, with the result that collection for reprocessing is not cost-effective.

Setting up bespoke recycling schemes for devices is one option that has been proposed; however, historically these have struggled to achieve the desired impact. GSK’s innovative Complete the Cycle scheme for example, where patients could return any inhaler back to participating pharmacies for recycling free of charge, closed due to limited use. Other similar trials such as PenCycle from Novo Nordisk are still ongoing at the time of writing.

Imposing a specific recycling collection point for each product adds additional burden. Simplifying users’ interactions with the recycling systems therefore gives the best chance of improved recycling rates which, for medical devices, means selecting commonly recycled materials that users can dispose of in their domestic “recycling bin”.

6. Avoid wasteful ‘nice-to-have’ features in your medical device

Engineers feel motivated to design the very best products possible for users. Sometimes this means giving them extra features that are not essential, but that improve the user experience. While this can be beneficial and lead to a better product, adding carbon intensive and high waste features such as connectivity or high-end packaging will lead to a higher carbon footprint.

For example, there is a growing trend to add ‘smart’ chips to devices, to allow them to collect data and interface with an app, often on a user’s phone. Often referred to collectively as ‘The Internet of Things’, these tiny electronic add-ons have a high carbon footprint. They also have a high waste impact, due to the inclusion of materials that are environmental toxins.

It has been argued that adding connectivity to medical devices could improve device usability and patient health outcomes, helping to improve adherence and reduce the need for carbon costly hospitalisations. It is important in this instance to gather data, for example in user studies, to establish whether or not electronic add-ons do improve device usability. In short, any additional ‘nice-to-have’ features, such as connectivity, need to be carefully evaluated in terms of their carbon footprint and actual (not hypothetical) benefits when considering medical device sustainability.

The future of medical device sustainability

As shown in these six examples, there are many practical ways to improve sustainability in the medical device industry, without compromising patient safety. Patients, healthcare professionals and health systems are increasingly demanding that sustainability be taken into consideration, meaning any product intended to be marketed over the next decade or two will likely need to demonstrate this. Clearly, there is a need to start taking positive steps to improve sustainability in medical devices today.

This article was taken from Team Consulting’s Insight magazine. Sign up for your own copy here.