Dumpster Diving in the Emergency Department
Introduction: Healthcare contributes 10% of greenhouse gases in the United States and generates two milion tons of waste each year. Reducing healthcare waste can reduce the environmental impact of healthcare and lower hospitals’ waste disposal costs. However, no literature to date has examined US em...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2020-08-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/1p78w8s6 |
| _version_ | 1828775216813178880 |
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| author | Sarah Hsu Cassandra L. Thiel Michael J. Mello Jonathan E. Slutzman |
| author_facet | Sarah Hsu Cassandra L. Thiel Michael J. Mello Jonathan E. Slutzman |
| author_sort | Sarah Hsu |
| collection | DOAJ |
| description | Introduction: Healthcare contributes 10% of greenhouse gases in the United States and generates two milion tons of waste each year. Reducing healthcare waste can reduce the environmental impact of healthcare and lower hospitals’ waste disposal costs. However, no literature to date has examined US emergency department (ED) waste management. The purpose of this study was to quantify and describe the amount of waste generated by an ED, identify deviations from waste policy, and explore areas for waste reduction. Methods: We conducted a 24-hour (weekday) ED waste audit in an urban, tertiary-care academic medical center. All waste generated in the ED during the study period was collected, manually sorted into separate categories based on its predominant material, and weighed. We tracked deviations from hospital waste policy using the hospital’s Infection Control Manual, state regulations, and Health Insurance Portability and Accountability Act standards. Lastly, we calculated direct pollutant emissions from ED waste disposal activities using the M+WasteCare Calculator. Results: The ED generated 671.8 kilograms (kg) total waste during a 24-hour collection period. On a per-patient basis, the ED generated 1.99 kg of total waste per encounter. The majority was plastic (64.6%), with paper-derived products (18.4%) the next largest category. Only 14.9% of waste disposed of in red bags met the criteria for regulated medical waste. We identified several deviations from waste policy, including loose sharps not placed in sharps containers, as well as re-processable items and protected health information thrown in medical and solid waste. We also identified over 200 unused items. Pollutant emissions resulting per day from ED waste disposal include 3110 kg carbon dioxide equivalent and 576 grams of other criteria pollutants, heavy metals, and toxins. Conclusion: The ED generates significant amounts of waste. Current ED waste disposal practices reveal several opportunities to reduce total waste generated, increase adherence to waste policy, and reduce environmental impact. While our results will likely be similar to other urban tertiary EDs that serve as Level I trauma centers, future studies are needed to compare results across EDs with different patient volumes or waste generation rates. |
| first_indexed | 2024-12-11T15:36:19Z |
| format | Article |
| id | doaj.art-010be6f805a94276a3cae91b72501b48 |
| institution | Directory Open Access Journal |
| issn | 1936-9018 |
| language | English |
| last_indexed | 2024-12-11T15:36:19Z |
| publishDate | 2020-08-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-010be6f805a94276a3cae91b72501b482022-12-22T00:59:56ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182020-08-0121510.5811/westjem.2020.6.47900wjem-21-1211Dumpster Diving in the Emergency DepartmentSarah Hsu0Cassandra L. Thiel1Michael J. Mello2Jonathan E. Slutzman3Warren Alpert Medical School of Brown University, Providence, Rhode IslandNew York University Grossman School of Medicine, Department of Population Health, New York, New YorkWarren Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode IslandMassachusetts General Hospital and Harvard Medical School, Department of Emergency Medicine, Boston, MassachusettsIntroduction: Healthcare contributes 10% of greenhouse gases in the United States and generates two milion tons of waste each year. Reducing healthcare waste can reduce the environmental impact of healthcare and lower hospitals’ waste disposal costs. However, no literature to date has examined US emergency department (ED) waste management. The purpose of this study was to quantify and describe the amount of waste generated by an ED, identify deviations from waste policy, and explore areas for waste reduction. Methods: We conducted a 24-hour (weekday) ED waste audit in an urban, tertiary-care academic medical center. All waste generated in the ED during the study period was collected, manually sorted into separate categories based on its predominant material, and weighed. We tracked deviations from hospital waste policy using the hospital’s Infection Control Manual, state regulations, and Health Insurance Portability and Accountability Act standards. Lastly, we calculated direct pollutant emissions from ED waste disposal activities using the M+WasteCare Calculator. Results: The ED generated 671.8 kilograms (kg) total waste during a 24-hour collection period. On a per-patient basis, the ED generated 1.99 kg of total waste per encounter. The majority was plastic (64.6%), with paper-derived products (18.4%) the next largest category. Only 14.9% of waste disposed of in red bags met the criteria for regulated medical waste. We identified several deviations from waste policy, including loose sharps not placed in sharps containers, as well as re-processable items and protected health information thrown in medical and solid waste. We also identified over 200 unused items. Pollutant emissions resulting per day from ED waste disposal include 3110 kg carbon dioxide equivalent and 576 grams of other criteria pollutants, heavy metals, and toxins. Conclusion: The ED generates significant amounts of waste. Current ED waste disposal practices reveal several opportunities to reduce total waste generated, increase adherence to waste policy, and reduce environmental impact. While our results will likely be similar to other urban tertiary EDs that serve as Level I trauma centers, future studies are needed to compare results across EDs with different patient volumes or waste generation rates.https://escholarship.org/uc/item/1p78w8s6 |
| spellingShingle | Sarah Hsu Cassandra L. Thiel Michael J. Mello Jonathan E. Slutzman Dumpster Diving in the Emergency Department Western Journal of Emergency Medicine |
| title | Dumpster Diving in the Emergency Department |
| title_full | Dumpster Diving in the Emergency Department |
| title_fullStr | Dumpster Diving in the Emergency Department |
| title_full_unstemmed | Dumpster Diving in the Emergency Department |
| title_short | Dumpster Diving in the Emergency Department |
| title_sort | dumpster diving in the emergency department |
| url | https://escholarship.org/uc/item/1p78w8s6 |
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