Interventions to reduce greenhouse gas emissions from health-system solid waste: a systematic review

When considering the entire lifecycle of products, including manufacturing, distribution, use, and end-of-life disposal, health-system solid waste contributes substantially to health-system greenhouse gas emissions, making the issue an important target for sustainability and decarbonisation action. In this systematic review, we examined sustainability principles and interventions that have been implemented in Australia and other high-income countries to reduce the greenhouse gas emission footprint of solid waste in the health-care and aged-care sectors, considering the waste hierarchy for the efficient use of resources. We identified 107 primary research articles and systematic reviews. A range of waste-management interventions were described, including a transition to electronic health records; removal of rarely used single-use items from preprepared sterile surgical packs; reuse of personal protective equipment, surgical textiles, procedural instruments, and non-invasive medical devices; introduction of recycling streams and recycling surgical blue wrap; and training staff on appropriate waste segregation. 54 of the 57 studies that reported economic costs found cost savings associated with interventions aimed at reducing waste and emissions. Although the scale, type, and reported effect of interventions vary considerably, the evidence gathered in this Review prioritises interventions further up the waste hierarchy, namely reduce, reuse, reprocess, and refurbish interventions.