Optimizing Proper Waste Management in Pediatric Surgery: An Observational Study.

BACKGROUND

Operating rooms (OR) are responsible for the majority of waste production in hospitals. Proper waste management including recycling is a sustainable initiative with no direct cost increase. We assessed the impact of our current institutional OR recycling program in selected general pediatric surgery procedures and estimated the potential impact of optimizing waste management.

METHODS

A prospective observational study was performed by weighing waste and recycling generated by seven pediatric surgery interventions: inguinal (open/laparoscopic) and umbilical hernia repair, orchiopexy and laparoscopic interventions for undescended testis, laparoscopic appendectomy, and circumcision. Laparoscopic and open approaches were compared using non-parametric testing (p < 0.05 considered significant).

RESULTS

The weight of landfill waste, recycling, and potentially recyclable items generated by 37 interventions was measured. Landfill waste mostly included disposable gowns and drapes. The mean proportion of recycling per procedure was 14.8 % (12.3-21.0). Laparoscopic procedures generated significantly more recycling (p < 0.001), potentially recyclable items (p < 0.001), and landfill waste (p < 0.001). When extrapolated on a yearly basis, our current recycling program generates 384 kg of recycling for selected procedures (n = 947), equivalent to 1076 kg carbon dioxide equivalent (COe) emissions savings from redirected landfill waste. With optimized waste management, 1633 kg COe savings could be estimated annually.

CONCLUSION

Proper waste management redirects significant amounts of waste away from the landfill and could be further increased by optimizing OR recycling practices. Laparoscopy generates more recyclable items than open procedures as it requires more material overall. Recycling must be part of a larger climate-smart initiative to achieve a sustainable pediatric surgery OR.

TYPE OF STUDY

Observational.

LEVEL OF EVIDENCE

III.