Photo: Pat Sargent
An emergency medicine faculty member and a team of medical students are digging through trash at local emergency departments to study the waste generated, suggest ways to reduce it and improve the health of the community.
Led by Hillary Irons, MD, PhD, associate professor of emergency medicine at UMass Chan Medical School and emergency physician for UMass Memorial Health, the initiative involves auditing trash at five EDs in the UMass Memorial Health system. The project is supported by the UMass Chan Department of Emergency Medicine and Office of Sustainability.
“If we go through the trash and know what we produce, then we can take that data and use it to change things,” said Dr. Irons. “The health care sector contributes approximately 8.5 percent of the emissions in the entire country, which in turn worsens air quality, pollutes water cycles and contributes to weather extremes, which can further exacerbate many medical conditions. So, the waste from the care that we’re providing can make many medical conditions need more treatment. It’s a cyclical problem.”
“The health care sector contributes approximately 8.5 percent of the emissions in the entire country, which in turn worsens air quality, pollutes water cycles and contributes to weather extremes, which can further exacerbate many medical conditions.”
Health care facilities in the United States generate more than 6,600 million tons of waste each year (roughly 14,000 tons per day), according to the American Medical Association. In Massachusetts, landfills are expected to reach capacity by 2030, according to the Massachusetts Department of Environmental Protection.
Third-year T.H. Chan School of Medicine student Alexa Smith, who is spearheading the project with Irons, said sustainability is an important part of her life and, as a future physician, actively participating in making improvements is important.
“I do all I can at home to reduce waste, but it pales in comparison to how much waste the medical system produces,” Smith said. “The audit is a great opportunity to try and change the system or help make improvements in the hospitals that we work in to reduce waste where we can.”
Over the course of nearly two years, a team of medical students, faculty and staff members, and interns measured waste collected in five emergency departments at UMass Memorial Health campuses in Worcester, Leominster, Clinton and Marlborough, to inform decisions on waste reduction and quantify recycling purity.
Smith will present the combined findings of all five hospital audits at the CleanMed conference in St. Louis in May.
Last month, the team spent 24 hours at the UMass Memorial Medical Center emergency department. Volunteers sorted and weighed roughly 1,500 pounds of waste materials, including 121 pounds of personal protective equipment, 82 pounds of recyclables, 37 pounds of unopened and unused medical items (syringes, needles, blood collection tubes, gauze, dressings, IV kits, etc.), and more than 14 pounds of unopened food and drink items.
Third-year medical student Kyle Timmer said the effort aligns with his aspirations to become an advocate and leader in health care sustainability.
“Ultimately, we want to learn how hospitals can continue to provide the utmost care while minimizing the amount of waste generated,” Timmer said. “We found a lot of different items, including single-use pulse oximeters and single use blood pressure cuffs—items that we already have reusable versions of—which can be considered an unnecessary source of waste.”
“Ultimately, we want to learn how hospitals can continue to provide the utmost care while minimizing the amount of waste generated.”
Kortni Wroten, sustainability and energy manager, said, “You can’t manage what you can’t measure. The audit is about finding that measurement so we can use data to inform decisions related to waste reduction. This is our way of getting a more detailed view of the waste that leaves the emergency department.”
According to Riley McLean-Mandell, medical director of green initiatives at UMass Memorial Health, efforts like the audit help inform the sustainability work underway across the UMass Memorial Health system.
"This is one of the best ways to evaluate where to focus our energies. Audits like this have helped UMass Memorial clinicians make changes already, from materials used for draping surgical patients, to switching to reusable devices, but this is the largest, most comprehensive audit that I’m aware of,” McLean-Mandell said. “The students and Dr. Irons have done a great job, and we look forward to collaborating with them on next steps we can all take to create a more sustainable environment across our organizations.”
UMass Memorial Health has also piloted other ways to create a “greener” environment, including evaluating the safety and function of reusable EKG leads, surgical tourniquets, sequential compression devices (blood clot prevention sleeves) and various pieces of surgical equipment.
