Regulatory requirements can impede sustainable progress in the health care sector. But some companies and engineers are up to the challenge.

The health care system makes up a substantial portion of Australia’s carbon footprint, accounting for seven per cent of the nation’s total emissions.

The challenging task of cutting health care waste  While the lion’s share of the sector’s emissions are generated through supply chains, single-use plastics – ranging from personal protective equipment and hospital gowns to medicine cups, IV bags and catheters – are a prevalent problem.

Plastics, making up a third of hospital waste generated in Australia, are largely relegated to landfill.

In the pursuit of a more circular health care economy, create takes a look at some local and international innovations that could help to make an impact.

Pharmaceutical packing bottles from recycled resin

Earlier this year, Canadian-based plastic upcycling company Loop Industries unveiled a new pharmaceutical packaging bottle made with 100 per cent recycled virgin quality PET resin, developed in collaboration with pharmaceutical packaging and medical devices leader Bormioli Pharma.

Loop-branded PET resin has met the rigorous regulatory standards for pharmaceutical packaging in both the US (USP <661.1>, Plastic Materials of Construction) and Europe (Ph.Eur. 3.1.15, Polyethylene Terephthalate for Containers for Preparations not for Parenteral Uses), designed to uphold the integrity, safety and quality of medical products.

“Loop PET resin creates circularity for low-value waste while reducing greenhouse gas emissions and can save up to 360,000 t of CO2 per year compared to virgin PET made from fossil fuels,” said Adel Essaddam, Vice-President of Science and Innovation at Loop.

Biopolymers to replace petroleum-based plastics

To address the large levels of material waste generated by the health care sector, a team of local mechanical, manufacturing and chemical engineers from the University of New South Wales have joined forces with biotechnology company Ecopha Biotech to develop biodegradable plastic packaging products.

The Innovative Development of Biodegradable Healthcare Packaging Products initiative, powered by a $3 million grant over three years by the Cooperative Research Centres Projects, aims to develop a new generation of health care packaging products using biodegradable polymer polyhydroxyalkanoates (PHAs).

The PHA-based packing will replace petroleum-based plastics, offering safety, high performance and sustainability.

“IT CAN ALSO BE FERMENTED FROM DIFFERENT BIO RESOURCES SUCH AS CANOLA OIL, STARCH AND OTHER PLANTS, MAKING IT EASIER TO PRODUCE ON A LARGE SCALE.”
Associate Professor Jin Zhang
 

With health care plastic waste amounting to 1.25 million t per year, there was a “strong drive” to develop a biodegradable polymer, said Australian Research Council Future Fellow Associate Professor Jin Zhang, from UNSW Mechanical and Manufacturing Engineering.

“There are more than 150 types of PHA monomers that present a wide range of mechanical and physiochemical properties,” she said. “Because of this versatility, PHAs are widely considered as one of the main candidates to replace conventional plastics.”

Due to their flexible properties, PHAs can eventually replace polypropylene, polyethylene (PE) and polystyrene (PS), the main polymers of today’s global polymer market.

“PHAs are 100 per cent bio-based and biodegradable,” Zhang said. “They can be made using plant feedstocks such as vegetable oils, sugars or starches by bacteria fermentation.”

With millions of tons of plastics ending up in marine environments every year, PHA has another property that sets it apart, ARC Laureate Fellow Professor Cyrille Boyer from UNSW Chemical Engineering told create.

“PHAs can biodegrade in seawater, which is not the case for many polymers classified as biodegradable,” he said.

There are several challenges that come with focusing on sustainable health care packaging.

“For example, if a plastic has to be used directly in contact with patients, it should not release toxic compounds, according to the regulations,” Boyer explained.

PHA biocompatibility is an important advantage, Zhang said.

“Due to the fact that PHAs are non-toxic, and they occur naturally in human tissues and blood, they have been used in medical applications,” she said.

But there are commercial considerations, too. Because biopolymers are more expensive to produce than petroleum-based polymers, health care packaging – also more expensive than other forms such as food packaging – seemed to fit the bill.

“We will therefore have a smaller margin to meet to [ensure there is a] business benefit,” Zhang said.

Reusable soft mist inhalers

Around 2.5 million, or 11 per cent, of Australians have asthma. But pressurised metered-dose inhalers (pMDIs), commonly used for asthma and chronic obstructive pulmonary disease, are a significant hidden contributor to greenhouse gas emissions.

In fact, the gas in a salbutamol pMDI has the same impact on global warming as the tailpipe exhaust from a 300 km car trip.

To reduce the carbon footprint of inhalers, pharmaceutical company Boehringer Ingelheim developed a soft mist, propellant-free inhaler. With carbon dioxide emissions 20 times lower than its pMDI counterparts, using the company’s Respimat inhaler is the equivalent of switching out a petrol car for a hybrid in terms of annual carbon footprint reduction.

“WE HAVEN’T SEEN MUCH EVOLUTION TOWARDS MORE ENVIRONMENTAL ASTHMA DEVICES UNTIL NOW.”
Michele Goldman
 

The Respimat device can also be re-used for up to six months, as opposed to non-reusable inhalers that last a month.

According to Asthma Australia, the “new-generation” inhaler, listed on the Pharmaceutical Benefits Scheme in 2021, could usher in a sustainable approach to asthma.

“We haven’t seen much evolution towards more environmental asthma devices until now,” said CEO of Asthma Australia Michele Goldman.

There are also plenty of dry powder devices available in Australia which don’t contain hydrofluorocarbon propellant gases, including Turbuhaler, Accuhaler, Ellipta, Spiromax, Handihaler, Breezhaler, Zonda and Genuair.

Everyday heroes

Everyone can help to make a difference to reduce health care waste, both in and outside the lab. Expired and unused medicines can be returned to pharmacies for environmentally safe disposal through the Return Unwanted Medicines (RUM) project.

Returning unused antibiotics also helps to prevent antimicrobial resistance by reducing the development of resistant strains of bacteria from antibiotics leaching into the environment.

These days, even finished medicine packs are worth returning, with more and more pharmacies launching blister pack recycling programs.

Packaging for thought.