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Recycling Glass and Metal in the Anaesthetic Room

Last post 16 Nov 2011, 12:55 PM by Pencheon David. 1 replies.
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  •  01 Nov 2011, 3:26 PM 962

    Recycling Glass and Metal in the Anaesthetic Room

    Anaesthesia contributes significantly to the environmental impact of healthcare [1]. It is therefore incumbent on us to reduce the pollution we create. Recycling has potential to reduce our carbon footprint and the amount sent to landfill. In addition to this, the cost of waste disposal can be reduced: an attractive prospect in a time of austerity. In particular, metallic waste is of increasing significance; the use of disposable laryngoscope blades and the introduction of volatile agents supplied in aluminium bottles combined with the rising value of metal presents a growing opportunity for recycling.

    We audited the waste produced by anaesthetic practice at Macclesfield District General Hospital over a two-month period. Our results indicated 41% of anaesthetic waste was recyclable (glass 28%, paper 6%, plastics 4%, stainless steel 2.4%, aluminium 0.6%).  Mean waste production was 0.52 kg per case, of which 61% by mass is incinerated at a cost of £470 per tonne. The remaining 39% is sent to landfill at a cost of £110 per tonne. The cost of anaesthetic waste disposal is therefore £173.26 per thousand cases at the time of writing. 

    Given the large proportion of glass waste and the high cost and carbon-intensity of metal production, combined with the ease of sorting glass and metal, we
    conducted a literature-based study to determine if recycling glass and metal could be beneficial.

    Glass production is a carbon-intensive process; each tonne of recycled glass saves 314kg of carbon emissions compared to production from virgin materials [2]. The price paid for glass by recycling agents at the time of writing was up to £31 per tonne [3]. Therefore, recycling glass waste can potentially save £501 per tonne compared to incineration.

    A report by Imperial College London concluded that recycling one tonne of steel saved 970 kg of carbon emissions, whereas recycling one tonne of aluminium saved 3.54 tonnes [4]. Therefore, based on our ratio of 20% aluminium to 80% steel, recycling one tonne of anaesthetic metal waste equates to 1.48 tonnes of carbon savings. The scrap value of metals is rather volatile; however there has been an upward trend over the last decade. At the time of writing, the price paid for stainless steel was £1300 per tonne, and the price for aluminium was £650 per tonne [5]. It may therefore be possible to save £1130 per tonne of metallic waste.

    The recycling of anaesthetic waste would therefore be beneficial in terms of both carbon and finance. Simply recycling metal and glass could reduce the total cost of waste disposal by 66%, and save 147kg of carbon emission per thousand cases. In 2009-2010, 9.7 million surgical interventions or procedures were performed; extrapolating our figures gives a sense of the annual potential for savings nationwide: approximately £1 million and 1,350 tonnes of carbon [6].

    The results of our audit were received enthusiastically by local recycling companies. However, the Department of Health document ‘Safe Management of Healthcare Waste’ states that waste must be incinerated if it contains residual quantities of medicines, which prevents the recycling of our glass waste and volatile bottles. The regulations regarding laryngoscope blades appear unclear, and their only reference in the document states that they must undergo incineration or ‘non-burn’ alternative treatment; recycling is not discussed [7]. Whilst we appreciate the potential safety issues of contaminated waste we feel a more rational approach is warranted. Healthcare providers and the recycling industry must work together to find ways to safely recycle these high-carbon, high-value materials, and specific guidance on anaesthetic waste is required to support practitioners who wish to reduce their environmental impact.

    CL Shelton

    M Abou-Samra

    Anaesthetic Trainees

    Mersey Deanery.

    MP Rothwell

    Consultant Anaesthetist

    Macclesfield District General Hospital

    Email: cliff.shelton@nhs.net

    No external funding and no competing interests declared. 


    1. Sneyd JR, Montgomery H, Pencheon D. The anaesthetist and the environment. Anaesthesia 2010; 65: 425-437.

    2. Flanagan J, Davies M. Glass recycling – life cycle carbon dioxide emissions. Sheffield: British Glass, 2003.

    3. Environment Media Group Ltd. Glass, 2011. http://www.letsrecycle.com/prices/glass (accessed 30/05/2011)

    4. Grimes S, Donaldson J, Gomez GC. Report on the environmental benefits of recycling. Brussels: Bureau of International Recycling, 2008.

    5. Environment Media Group Ltd. Metal, 2011. http://www.letsrecycle.com/prices/metal (accessed 30/05/2011)

    6. The NHS Information Centre for Health and Social Care. A decade in view, 2010. http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937&categoryID=451 (accessed 30/05/2011)

    7. Department of Health Gateway Review, Estates & Facilities Division. Safe Management of Healthcare Waste, version 1.0. London: Department of Health, 2011.


  •  16 Nov 2011, 12:55 PM 978 in reply to 962

    Re: Recycling Glass and Metal in the Anaesthetic Room

    This is a really good example of how busy clinicians can take an active, measurable and generalisable contribution to one of the biggest health threats we face.  Paradoxically, it is also one of the biggest opportunties we face too as the pressure to behave sustainably also accelerates our attitudes and actions towards a more humane health system where we weave this sort of approach into core business.  Well done Cliff and Mick and well done Anaesthesia..More at http://blogs.bmj.com/bmj/2011/11/15/david-pencheon-what-is-it-about-large-scale-change-that-makes-anaesthetists-act/

    D. Pencheon


    NHS Sustainable Development Unit


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