Reusing medical equipment is good for the planet. But is it safe?

This kind of single-use medical equipment was first introduced in high-income countries in the 1960s, thanks to advances in plastic manufacturing and a growing emphasis on infection prevention and control.

About 85% of the waste single-use products create is nonhazardous and can be recycled or disposed of without special processing. But a lot of the time it’s not sorted correctly. This means it is often mixed with hazardous waste that has to be incinerated before it is sent to landfill, which increases greenhouse gas emissions.

Our new study tested replacing just one kind of item – single-use absorbent pads, known as “blueys” – with a reusable version in the intensive care unit (ICU).

Blueys are pads made of layered tissue paper, with a plastic waterproof backing. They’re placed under patients to protect bedding and absorb bodily fluids such as blood and urine during patient care and other procedures.

We wanted to know how much waste could be diverted from landfill by replacing these single-use products with reusable linen – and importantly, whether it was safe and hygienic for patients. Here’s what we found.

What our study looked at

Over two years, we examined data from 2,114 ICU patients at a Melbourne hospital – 46% of them (970 patients) before we introduced reusable linen, and 54% (1,114 patients) after.

For the first year (the “before” phase), single-use blueys were used. In the second year (the “after” phase), these were replaced with reusable pads, made from soft cotton with a breathable backing. These had a similar capacity to absorb liquids as the disposable version but – instead of being thrown away – they were washed and reused.

The study compared how many kilograms of waste were generated by single-use blueys in the first year, compared to the reusable linen.

We also explored whether reusable linen increased patients’ risk of pressure injuries, sometimes known as bed sores. These are wounds that develop when patients are immobile and spend a lot of time sitting or lying in one position, causing the skin to break down.

Patients in the ICU have a high risk of developing pressure injuries. These can delay recovery and prolong their stay in hospital.

To evaluate the change, we surveyed nurses who’d used the reusable pads. We also reviewed medical records to compare the prevalence of pressure injuries in the two groups, along with patient demographics such as age, sex and length of hospital stay.

What we found

There was no difference in pressure injuries between the two groups. This means reusable linen did not increase the risk of an ICU patient developing a pressure injury.

But it did save a lot of waste. In the year before introducing reusable pads, 21,554 disposable pads were used in this one hospital ward, generating almost half a tonne of waste from this single-use item alone.

Shifting to reusable linen effectively eliminated this waste, saving about half a tonne (496 kilograms) from going to landfill in one year alone.

Initially, some nurses expressed concerns about whether the reusable linen pads would affect patients’ skin. However, once the reusable pads were introduced and used for a few weeks, staff were highly satisfied. Many noted they were more sustainable and helped reduce waste, and recommended continuing to use them.

While our study didn’t look at infection risk specifically, 50 years of data from the United States and the United Kingdom has previously shown reusable linen does not increase the risk of infections when it is washed and sterilised properly.

For example, Australian laundry standards for infection control require reusable items to be washed at a certain temperature (above 65°C for at least ten minutes, or 71°C for at least three minutes) or treated with a chemical disinfectant when material is heat sensitive.

Why this research matters

Australia’s health-care system produces up to 7% of the country’s total greenhouse gas emissions. Hospitals are the single biggest contributor.

Given this is largely from direct patient care, making day-to-day routines more sustainable can have a big impact.

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Help us advance safer, more sustainable medical practices

At Deakin University, we’re committed to exploring how reusing medical equipment—like enteral nutrition giving sets—can reduce environmental impact without compromising patient safety.

We’ve secured ethics approval for a national point prevalence survey and applied for funding to investigate microbial growth in reused giving sets—an area with little robust evidence. But to move forward, we need your help.

Even small grants of $3,000 will allow us to access and analyse national data that could shape future guidelines and improve both sustainability and safety in healthcare.

If you’re passionate about supporting evidence-based innovation in infection prevention and sustainability, please consider contributing to this vital research.

To learn more or support this work, please contact health-transformation@deakin.edu.au.

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Read the original article published in The Conversation.

Read the research paper titled: Implementation of reusable linen in the intensive care unit: Impact on pressure injury, staff satisfaction, and environmental sustainability

Read more about Professor Rochelle Wynne’s research

Read more about Stacey Matthew’s research