scholarly journals Environmental impact of personal protective equipment distributed for use by health and social care services in England in the first six months of the COVID-19 pandemic

2021 ◽  
pp. 014107682110015
Author(s):  
Chantelle Rizan ◽  
Malcolm Reed ◽  
Mahmood F Bhutta
Keyword(s):  
Environmental Impact ◽  
Carbon Footprint ◽  
Personal Protective Equipment ◽  
Social Care ◽  
Resource Depletion ◽  
Protective Equipment ◽  
Life Years ◽  
Health And Social Care ◽  
Scenario Modelling ◽  
Base Scenario

Objective To quantify the environmental impact of personal protective equipment (PPE) distributed for use by the health and social care system to control the spread of SARS-CoV-2 in England, and model strategies for mitigating the environmental impact. Design Life cycle assessment was used to determine environmental impacts of PPE distributed to health and social care in England during the first six months of the COVID-19 pandemic. The base scenario assumed all products were single-use and disposed of via clinical waste. Scenario modelling was used to determine the effect of environmental mitigation strategies: (1) eliminating international travel during supply; (2) eliminating glove use; (3) reusing gowns and face shields; and (4) maximal recycling. Setting Royal Sussex County Hospital, Brighton, UK. Main outcome measures The carbon footprint of PPE distributed during the study period totalled 106,478 tonnes CO2e, with greatest contributions from gloves, aprons, face shields and Type IIR surgical masks. The estimated damage to human health was 239 DALYs (disability-adjusted life years), impact on ecosystems was 0.47 species.year (loss of local species per year), and impact on resource depletion was costed at US $12.7m (GBP £9.3m). Scenario modelling indicated UK manufacture would have reduced the carbon footprint by 12%, eliminating gloves by 45%, reusing gowns and gloves by 10% and maximal recycling by 35%. Results A combination of strategies may have reduced the carbon footprint by 75% compared with the base scenario, and saved an estimated 183 DALYS, 0.34 species.year and US $7.4m (GBP £5.4m) due to resource depletion. Conclusion The environmental impact of PPE is large and could be reduced through domestic manufacture, rationalising glove use, using reusables where possible and optimising waste management.

scholarly journals Environmental impact of Personal Protective Equipment supplied to health and social care services in England in the first six months of the COVID-19 pandemic

2020 ◽  
Author(s):  
Chantelle Rizan ◽  
Malcolm Reed ◽  
Mahmood F Bhutta
Keyword(s):  
Environmental Impact ◽  
Carbon Footprint ◽  
Personal Protective Equipment ◽  
Social Care ◽  
Resource Depletion ◽  
Protective Equipment ◽  
Life Years ◽  
Health And Social Care ◽  
Scenario Modelling ◽  
Base Scenario

ABSTRACTObjectivesUse of Personal Protective Equipment (PPE) has been central to controlling spread of SARS-CoV2. Here we quantify the environmental impact of PPE supplied to the health and social care system in England, and model strategies for its mitigation.MethodsLife cycle assessment was used to determine environmental impacts of PPE supplied to health and social care in England during the first six months of the COVID-19 pandemic. The base scenario assumed all products were single-use and disposed of via clinical waste. Scenario modelling was used to determine the effect of mitigation strategies; 1) eliminating international travel during supply, 2) eliminating glove use 3) reusing gowns and face shields, 4) maximal recycling.ResultsThe carbon footprint of PPE supplied during the study period totalled 106,478 tonnes CO2e, with greatest contributions from gloves, aprons, face shields, and Type IIR surgical masks. The estimated damage to human health was 239 DALYs (disability adjusted life years), impact on ecosystems was 0.47 species.year (loss of local species per year), and impact on resource depletion costed at US $ 12.7 million.Scenario modelling indicated UK manufacture would have reduced the carbon footprint by 12%, eliminating gloves by 45%, reusing gowns and gloves by 10%, and maximal recycling by 35%. A combination of strategies would have reduced carbon footprint by 75% compared with the base scenario, and saved an estimated 183 DALYS, 0.34 species.year, and US $ 7.4 million due to resource depletion.ConclusionsThe environmental impact of PPE is large and could be reduced through domestic manufacture, rationalising glove use, using reusables where possible, and optimising waste management.

Ensuring the quality and quantity of personal protective equipment (PPE) by enhancing the procurement process in Northern Ireland during the coronavirus disease 2019 pandemic: Challenges in the procurement process for PPE in NI

2021 ◽  
pp. 251604352110573
Author(s):  
Kathryn Burnett ◽  
Suzanne Martin ◽  
Catherine Goudy ◽  
John Barron ◽  
Linda O’Hare ◽  
...  
Keyword(s):  
Northern Ireland ◽  
Personal Protective Equipment ◽  
Social Care ◽  
Protective Equipment ◽  
Business Services ◽  
Procurement Process ◽  
Goods And Services ◽  
Logistics Service ◽  
Health And Social Care ◽  
Medicines Optimisation

This article outlines the purchasing process for personal protective equipment that was established for Health and Social Care in Northern Ireland in response to the outbreak of coronavirus disease 2019. The Business Services Organisation Procurement and Logistics Service, who are the sole provider of goods and services for Health and Social Care organisations, was faced with an unprecedented demand for personal protective equipment in response to the coronavirus disease 2019 pandemic. The usual procurement process was further complicated by changing messages within guidelines which resulted in confusion and anxiety when determining whether or not a product would meet the required safety guidance and was therefore suitable for purchase. In order to address these issues in a rapidly changing and escalating scenario the Department of Health asked the Business Services Organisation Procurement and Logistics Service to work with the Medicines Optimisation Innovation Centre to maximise the availability of personal protective equipment whilst ensuring that it met all requisite quality and standards. A process was implemented whereby the Medicines Optimisation Innovation Centre validated all pertinent essential documentation relating to products to ensure that all applicable standards were met, with the Business Services Organisation Procurement and Logistics Service completing all procurement due diligence tasks in line with both normal and coronavirus disease 2019 emergency derogations. It is evident from the data presented that whilst there were a significant number of potential options for supply, a large proportion of these were rejected due to failure to meet the quality assurance criteria. Thus, by the process that was put in place, a large number of unsuitable products were not purchased and only those that met extant standards were approved.

scholarly journals COVID-19 Pandemic, Javanese Rituals, and Social Solidarity

2021 ◽  
Vol 317 ◽  
pp. 01045
Author(s):  
Dhanang Respati Puguh ◽  
Rabith Jihan Amaruli ◽  
Mahendra Pudji Utama
Keyword(s):  
Cultural Capital ◽  
Personal Protective Equipment ◽  
Large Scale ◽  
Social Care ◽  
Cultural Practices ◽  
Health Workers ◽  
Social Solidarity ◽  
Protective Equipment ◽  
Literature Study ◽  
Indonesian Government

The COVID-19 Pandemic has been going on for more than a year in Indonesia. The Indonesian government has been struggling to manage this Pandemic in various ways by implementing health protocols, Large-Scale Social Restrictions (PSBB), and vaccinations. This article discusses the efforts made by the Javanese people in coping with the COVID-19 Pandemic by using literature study methods and observations of the realities that occurred during the Pandemic in Semarang. The discussion focused on cultural practices carried out by Semarang society to overcome the COVID-19 Pandemic, such as the ritual of repelling logs, social care for affected communities, and cooperation in providing personal protective equipment for health workers. Based on this reality, it can be stated that socio-cultural capital is used to cope with the COVID-19 Pandemic.

scholarly journals COVID-19 Disposable Face Masks: a Precursor for Synthesis of Valuable Bioproducts

2021 ◽  
Author(s):  
Oluwatosin Oginni
Keyword(s):  
Environmental Impact ◽  
Environmental Pollution ◽  
Personal Protective Equipment ◽  
Face Mask ◽  
Protective Equipment ◽  
Thermoplastic Polymers ◽  
Secondary Transmission

Abstract Disposable face mask has become a mandatory personal protective equipment in order to prevent contracting COVID-19. With the significant surge in its usage, its adverse environmental impact is becoming a source of concern. Disposable face masks are made from thermoplastic polymers and therefore they can be safely converted into valuable bioproducts. This paper discussed the possibility of converting waste/contaminated face masks into valuable bioproducts, which will essentially eliminate secondary transmission of the coronavirus and the concerns of environmental pollution.

scholarly journals Environmental impact and life cycle financial cost of hybrid (reusable/ single-use) instruments versus single-use equivalents in laparoscopic cholecystectomy

2021 ◽  
Author(s):  
Chantelle Rizan ◽  
Mahmood F Bhutta
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Life Cycle ◽  
Environmental Impact ◽  
Environmental Impacts ◽  
Carbon Footprint ◽  
Surgical Instruments ◽  
Laparoscopic Instruments ◽  
Life Years ◽  
Single Use ◽  
Hybrid Instruments

ABSTRACTBackgroundHybrid surgical instruments contain both single-use and reusable components, potentially bringing together advantages from both approaches.MethodsWe used Life Cycle Assessment to evaluate environmental impact of hybrid laparoscopic clip appliers, scissors and ports used for a laparoscopic cholecystectomy, comparing these with single-use equivalents. We modelled this using SimaPro to determine 18 midpoint environmental impacts including the carbon footprint, and three aggregated endpoint impacts. We also conducted life cycle cost analysis, taking into account unit cost, decontamination, and disposal costs.FindingsThe environmental impact of using hybrid instruments for a laparoscopic cholecystectomy was lower than single-use equivalents across 17 midpoint environmental impacts, with mean average reductions of 60%, and costing less than half that of single-use equivalents (GBP £131 versus £282). The carbon footprint of using hybrid versions of all three instruments was around one-quarter of single-use equivalents (1,756 g versus 7,194 g CO2e per operation), and saved an estimated 1.13 e-5 DALYs (disability associated life years, 74% reduction), 2.37 e-8 species.year (loss of local species per year, 76% reduction), and US $ 0.6 in impact on resource depletion (78% reduction). Scenario modelling indicated environmental performance of hybrid instruments was better even given low number of reuses of instruments, decontamination with separate packaging of certain instruments, decontamination using fossil-fuel rich energy sources, or changing carbon intensity of instrument transportation.InterpretationAdoption of hybrid laparoscopic instruments could play an important role in meeting carbon reduction targets for surgery, whilst saving money.FundingThis work was funded by Surgical Innovations Ltd who manufacture hybrid laparoscopic instruments.

scholarly journals What is the best approach to adopt for identifying the domains for a new measure of health, social care and carer-related quality of life to measure quality-adjusted life years? Application to the development of the EQ-HWB?

2021 ◽  
Author(s):  
Tessa Peasgood ◽  
Clara Mukuria ◽  
Jill Carlton ◽  
Janice Connell ◽  
Nancy Devlin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Care ◽  
Domain Identification ◽  
Life Years ◽  
Health And Social Care ◽  
Related Quality ◽  
Health Related ◽  
Informal Carers ◽  
The Impact

AbstractEconomic evaluation combines costs and benefits to support decision-making when assessing new interventions using preference-based measures to measure and value benefits in health or health-related quality of life. These health-focused instruments have limited ability to capture wider impacts on informal carers or outcomes in other sectors such as social care. Sector-specific instruments can be used but this is problematic when the impact of an intervention straddles different sectors.An alternative approach is to develop a generic preference-based measure that is sufficiently broad to capture important cross-sector outcomes. We consider the options for the selection of domains for a cross-sector generic measure including how to identify domains, who should provide information on the domains and how this should be framed. Beyond domain identification, considerations of criteria and stakeholder needs are also identified.This paper sets out the case for an approach that relies on the voice of patients, social care users and informal carers as the main source of domains and describes how the approach was operationalised in the ‘Extending the QALY’ project which developed the new measure, the EQ-HWB (EQ health and wellbeing instrument). We conclude by discussing the strengths and limitations of this approach. The new measure should be sufficiently generic to be used to consistently evaluate health and social care interventions, yet also sensitive enough to pick up important changes in quality of life in patients, social care users and carers.

scholarly journals Sustainable oral healthcare and the environment: challenges

Dental Update ◽  
2021 ◽  
Vol 48 (6) ◽  
pp. 493-501
Author(s):  
Steven Mulligan ◽  
Lucy Smith ◽  
Nicolas Martin
Keyword(s):  
Climate Change ◽  
Supply Chain ◽  
Environmental Impact ◽  
Patient Care ◽  
Carbon Emissions ◽  
Personal Protective Equipment ◽  
Clinical Relevance ◽  
Direct Patient Care ◽  
Protective Equipment ◽  
Single Use

Oral healthcare has an environmental impact that is specific to the profession and is currently unsustainable. This impact results in unwanted and difficult-to-manage waste, carbon emissions and other environmental impacts that contribute to climate change. Contributions to this pollution come from the supply chain that provides the required materials and sundries, patient and staff commuting/travelling, direct patient care, the use and end-of-life management of restorative materials and single-use plastics (SUPs) such as personal protective equipment (PPE). This article explores these various contributors to pollution arising from oral healthcare. CPD/Clinical Relevance: The provision of oral healthcare has an environmental impact that requires consideration and action in order to become sustainable.

scholarly journals Assistive technology and telecare to maintain independent living at home for people with dementia: the ATTILA RCT

2021 ◽  
Vol 25 (19) ◽  
pp. 1-156
Author(s):  
Rebecca Gathercole ◽  
Rosie Bradley ◽  
Emma Harper ◽  
Lucy Davies ◽  
Lynn Pank ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Assistive Technology ◽  
Social Care ◽  
Intervention Group ◽  
Control Group ◽  
Quality Adjusted Life Years ◽  
People With Dementia ◽  
Life Years ◽  
Health And Social Care ◽  
Quality Adjusted Life

Background Assistive technology and telecare have been promoted to manage the risks associated with independent living for people with dementia, but there is limited evidence of their effectiveness. Objectives This trial aimed to establish whether or not assistive technology and telecare assessments and interventions extend the time that people with dementia can continue to live independently at home and whether or not they are cost-effective. Caregiver burden, the quality of life of caregivers and of people with dementia and whether or not assistive technology and telecare reduce safety risks were also investigated. Design This was a pragmatic, randomised controlled trial. Blinding was not undertaken as it was not feasible to do so. All consenting participants were included in an intention-to-treat analysis. Setting This trial was set in 12 councils in England with adult social services responsibilities. Participants Participants were people with dementia living in the community who had an identified need that might benefit from assistive technology and telecare. Interventions Participants were randomly assigned to receive either assistive technology and telecare recommended by a health or social care professional to meet their assessed needs (a full assistive technology and telecare package) or a pendant alarm, non-monitored smoke and carbon monoxide detectors and a key safe (a basic assistive technology and telecare package). Main outcome measures The primary outcomes were time to admission to care and cost-effectiveness. Secondary outcomes assessed caregivers using the 10-item Center for Epidemiological Studies Depression Scale, the State–Trait Anxiety Inventory 6-item scale and the Zarit Burden Interview. Results Of 495 participants, 248 were randomised to receive full assistive technology and telecare and 247 received the limited control. Comparing the assistive technology and telecare group with the control group, the hazard ratio for institutionalisation was 0.76 (95% confidence interval 0.58 to 1.01; p = 0.054). After adjusting for an imbalance in the baseline activities of daily living score between trial arms, the hazard ratio was 0.84 (95% confidence interval 0.63 to 1.12; p = 0.20). At 104 weeks, there were no significant differences between groups in health and social care resource use costs (intervention group – control group difference: mean –£909, 95% confidence interval –£5336 to £3345) or in societal costs (intervention group – control group difference: mean –£3545; 95% confidence interval –£13,914 to £6581). At 104 weeks, based on quality-adjusted life-years derived from the participant-rated EuroQol-5 Dimensions questionnaire, the intervention group had 0.105 (95% confidence interval –0.204 to –0.007) fewer quality-adjusted life-years than the control group. The number of quality-adjusted life-years derived from the proxy-rated EuroQol-5 Dimensions questionnaire did not differ between groups. Caregiver outcomes did not differ between groups over 24 weeks. Limitations Compliance with the assigned trial arm was variable, as was the quality of assistive technology and telecare needs assessments. Attrition from assessments led to data loss additional to that attributable to care home admission and censoring events. Conclusions A full package of assistive technology and telecare did not increase the length of time that participants with dementia remained in the community, and nor did it decrease caregiver burden, depression or anxiety, relative to a basic package of assistive technology and telecare. Use of the full assistive technology and telecare package did not increase participants’ health and social care or societal costs. Quality-adjusted life-years based on participants’ EuroQol-5 Dimensions questionnaire responses were reduced in the intervention group compared with the control group; groups did not differ in the number of quality-adjusted life-years based on the proxy-rated EuroQol-5 Dimensions questionnaire. Future work Future work could examine whether or not improved assessment that is more personalised to an individual is beneficial. Trial registration Current Controlled Trials ISRCTN86537017. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 19. See the NIHR Journals Library website for further project information.

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