PPE, plastics, and the environment: A cautionary note

The effects of discarded plastics on the environment have been well documented in recent years.

We’ve all seen images of vast rafts of rubbish in our oceans, marine debris in our waterways and litter on our shorelines and streets. Plastic items, made from fossil fuels, has been found in the deepest ocean trenches, within Antarctic ice cores and on our highest mountains. They are found in the agricultural land where our food is grown, in the water we drink and even in the air we breathe.

Before the pandemic, we were learning about this issue and even initiating changes, such as banning single-use plastic bags in supermarkets. But towards the end of 2019, the focus on reducing plastic use was disrupted due to COVID-19.

Single-use plastics and items that contain them, such as PPE, are now in massive demand within the healthcare sector. Production ramped up to enormous levels. Overnight, disposable masks, gowns and gloves become one of our main defences against COVID-19. Soon afterwards, our excessive use of disposable PPE became apparent: it is trashing our planet.

PPE use is one of the most reliable and affordable defences against infection and transmission of the COVID-19 virus. Plastic materials are durable, water-resistant, flexible, and cheap, making them the material of choice for most disposable medical tools, equipment, and packaging. The ability to dispose of medical equipment after just one use reduces infection. Contamination of practical items in health was once common; however, life-saving plastics have revolutionised the medical industry.

Overall, as a tool in our kit bag of pandemic defences, plastics in PPE have allowed us to protect countless millions of people from COVID-19 infection. Plastics have protected nurses, midwives and carers from catching coronaviruses and subsequently has allowed us to continue giving care and assistance to the sick, dependant and vulnerable members of our community.

However, despite the obvious benefits of plastics in PPE during this pandemic, plastic use is a double-edged sword. And the problem is rapidly getting worse.

Prior to the pandemic, plastic pollution was already a global issue. Yet as of August 2021, an estimated EXTRA 8.4 million tonnes of plastic waste have been dumped into the environment rather than being disposed of correctly. Discarded masks are entering waterways, oceans, and other environments. How many discarded masks have you seen on the streets, parks, or sidewalks lately?

There is no place on Earth that plastic debris has not been documented. Those used in PPE can take 400+ years to break down – into smaller bits of plastics. These synthetic polymers do not disappear but break up into smaller and smaller pieces (microplastics and then nanoplastics), making them more available to microscopic animals at the base of the food web. In fact, almost all the plastics ever produced over the decades still exist now: globally, only 9% of all plastic is recycled and just 12% is incinerated.

One significant issue with plastics is that they contain nasty chemicals which can cause a myriad of health effects at minute concentrations. For example, certain plasticisers (which make plastic products less brittle and more user-friendly) are estrogen mimics. One of these, called bisphenol A (BPA), is known to feminise when leached from plastic products. Research has documented the feminisation of some wild animals in contaminated areas to the point that they can no longer reproduce.

We’ve already learned how to reduce our plastic use outside work, including using paper straws and carrying our own bags to the supermarket.

But there are no easy or immediate solutions to how we can reduce our dependence on plastics in healthcare. No current technology or solution exists that can quickly reduce our reliance. Bioplastics, for example, are currently not a long-term solution, as they do not decompose in a landfill, contaminate plastic recycling streams, and still contribute to marine debris. Recycling can help reduce waste overall but is complicated by lack of investment and is often not profitable. Not all plastics are easily recyclable and those that are often require chemical processes that are inherently problematic. And while certain bacteria have been discovered that “eat” plastics, these are currently a scientific curiosity and may even encourage people to litter more.

Plastic materials are obviously indispensable in healthcare and in public health safety. But the pandemic has greatly exacerbated the global environmental threat of plastic pollution through irresponsible disposal. There are no easy solutions. But let’s heed this clarion call and invest the time, research, money, and political will to end this throwaway culture of plastics on our planet.

We are fouling our own nest – let’s clean up our act!

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