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与塑料类一次性使用医疗器械相比,含生物聚合物的一次性使用医疗器械是否能降低外科手术对环境的影响?

Do single-use medical devices containing biopolymers reduce the environmental impacts of surgical procedures compared with their plastic equivalents?

作者信息

Unger Scott R, Hottle Troy A, Hobbs Shakira R, Thiel Cassandra L, Campion Nicole, Bilec Melissa M, Landis Amy E

机构信息

1 Graduate Research Associate, School of Sustainable Engineering and the Built Environment, Arizona State University, USA.

2 Graduate Research Associate, Institute for Sustainability, Glenn Department of Civil Engineering, Clemson University, USA.

出版信息

J Health Serv Res Policy. 2017 Oct;22(4):218-225. doi: 10.1177/1355819617705683. Epub 2017 May 22.

Abstract

Background While petroleum-based plastics are extensively used in health care, recent developments in biopolymer manufacturing have created new opportunities for increased integration of biopolymers into medical products, devices and services. This study compared the environmental impacts of single-use disposable devices with increased biopolymer content versus typically manufactured devices in hysterectomy. Methods A comparative life cycle assessment of single-use disposable medical products containing plastic(s) versus the same single-use medical devices with biopolymers substituted for plastic(s) at Magee-Women's Hospital (Magee) in Pittsburgh, PA and the products used in four types of hysterectomies that contained plastics potentially suitable for biopolymer substitution. Magee is a 360-bed teaching hospital, which performs approximately 1400 hysterectomies annually. Results There are life cycle environmental impact tradeoffs when substituting biopolymers for petroplastics in procedures such as hysterectomies. The substitution of biopolymers for petroleum-based plastics increased smog-related impacts by approximately 900% for laparoscopic and robotic hysterectomies, and increased ozone depletion-related impacts by approximately 125% for laparoscopic and robotic hysterectomies. Conversely, biopolymers reduced life cycle human health impacts, acidification and cumulative energy demand for the four hysterectomy procedures. The integration of biopolymers into medical products is correlated with reductions in carcinogenic impacts, non-carcinogenic impacts and respiratory effects. However, the significant agricultural inputs associated with manufacturing biopolymers exacerbate environmental impacts of products and devices made using biopolymers. Conclusions The integration of biopolymers into medical products is correlated with reductions in carcinogenic impacts, non-carcinogenic impacts and respiratory effects; however, the significant agricultural inputs associated with manufacturing biopolymers exacerbate environmental impacts.

摘要

背景 虽然石油基塑料在医疗保健领域广泛使用,但生物聚合物制造的最新进展为生物聚合物更多地融入医疗产品、设备和服务创造了新机会。本研究比较了生物聚合物含量增加的一次性使用器械与子宫切除术中典型制造器械的环境影响。方法 对宾夕法尼亚州匹兹堡市梅杰妇女医院(Magee)含塑料的一次性使用医疗产品与用生物聚合物替代塑料的相同一次性使用医疗器械,以及四种含可能适合生物聚合物替代的塑料的子宫切除术所使用的产品进行了比较生命周期评估。Magee是一家拥有360张床位的教学医院,每年进行约1400例子宫切除术。结果 在子宫切除术等手术中用生物聚合物替代石化塑料存在生命周期环境影响权衡。在腹腔镜和机器人辅助子宫切除术中,用生物聚合物替代石油基塑料使与烟雾相关的影响增加约900%,与臭氧消耗相关的影响增加约125%。相反,生物聚合物减少了四种子宫切除手术的生命周期人类健康影响、酸化和累积能源需求。将生物聚合物融入医疗产品与致癌影响、非致癌影响和呼吸影响的减少相关。然而,与生物聚合物制造相关的大量农业投入加剧了使用生物聚合物制成的产品和器械的环境影响。结论 将生物聚合物融入医疗产品与致癌影响、非致癌影响和呼吸影响的减少相关;然而,与生物聚合物制造相关的大量农业投入加剧了环境影响。

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