Safety first. In healthcare, saving lives and improving outcomes all center on safety. There is no substituting or subordinating this approach. On the surface, such strict adherence to safety seems to conflict with efforts to keep the environment we live in healthy – including initiatives to be more sustainable in materials management, recyclability, and energy consumption. However, innovation in materials science, combined with the right mindset, can allow us to improve both patient and environmental health without compromise.
 
Healthcare has unique sustainability challenges compared to some other sectors, because its products are both crucial to health and, often, require heightened protection and sterility. Maintaining medicinal efficacy, medical device functionality and sterility are all essential and challenging – a combination that can be difficult to square with eco-friendliness as it is defined in other industries. 
 
We’ve all heard of the “Three R’s” of sustainability. And while aspects of “Reduce, Reuse & Recycle” permeate healthcare, their implementation must take different tacks to meet the uniquely mission-critical importance its medicines and medical devices provide. 
 
What remains is the need to do more for the planet without doing less for patients. As we’ll see, doing so will require a fourth “R” … Resolve.
 
Reduce
 
For reasons we’ll elaborate upon soon, reduction has emerged as the prime focus of the healthcare industry’s sustainability initiatives. 
 
At the facility and supply chain levels, much of this draws direct comparisons to any sector’s manufacturing scenarios. Efforts to mitigate water use, source electricity from renewable resources like wind and solar power, and minimize the amount of scrap produced during production, shipping and warehousing all come into play in healthcare, much like they would elsewhere. 
 
Attempts to reduce raw materials draw other parallels – but with a catch. While healthcare companies are eager to, for example, use thinner materials to protect a medicine or medical device, this type of “down-gauging” has strict guardrails around it. First and foremost, the product must remain protected. That protection may range from a simple closed sterile package to one with additional barriers protecting against moisture, oxygen and/or light for the duration of its stated shelf life. 
 
That said, performance barrier materials can only be minimized as much as the particular pharmaceutical or medical product it contains will permit. The result is a highly customizable, per-product sustainability roadmap;  healthcare and “one size fits all” don’t mix. 
 
Still, there are considerable gains to be made. Like other sectors, the healthcare industry has an affinity for over-designing materials to ensure safety. In many cases, entire levels of packaging could be pared away; for example, doing away with a secondary carton and letting the primary package pull double-duty. Increasingly, common challenges like labeling guidelines and mandatory tamper evidence/child-resistant elements are being conquered, bolstering both the environment and, through diminished materials expenses, bottom lines.  
 
Most recently, the COVID-19 pandemic brought the healthcare sector’s overwrapping issues right into patients’ homes. As self-administration and layman-centric caretaking became the norm, more non-healthcare personnel began handling more medicines and medical devices. Among other complaints, many felt they were handling far too much packaging, resulting in widespread customer calls for materials minimization.
 
Finally, in medical device scenarios there is a decided push for “reduction by subtraction.” Simply put, this entails trying to extend the lifespans of certain medical devices and, in so doing, reducing the number of devices produced over a given timeframe. 
 
In many cases – especially when treating chronic conditions – this approach supports both keeping patients safe and reducing materials. For example, TekniPlex Healthcare has made materials science advancements enabling medical tubing to maintain its stability against strong solvents. Among other benefits, this has allowed patients to use a tubing set delivering insulin in a caustic suspension solution for several days longer, decreasing the amount of tubing required over an extended period. 
 
 
Reuse
 
Admittedly, opportunities to reuse in healthcare are inherently limited by its primary purpose: patient safety through sterility and/or product efficacy. But there are measures being implemented when and where possible – more notably in the upstream manufacturing processes far away from the patient. Such measures include reusing plastic pallets to transfer goods to and from supplier and customer, and utilizing plastic totes instead of single-use cardboard for resin deliveries. These low-risk reusable items not only save money for both suppliers and customers in the long run, but also help reduce landfill waste while keeping manufacturing facilities cleaner. However, as you get closer to the patient, the reuse concept loses some steam.
 
One key factor is healthcare’s outsized need for single-use plastics. Simply put, a higher percentage of the plastics used to protect medicines, and to both produce and protect medical devices, end up discarded for purposes ranging from contamination risk to a simple lack of collection and reuse protocols. 
 
Another obstacle to reuse overlaps with our third “R,” recycling. Understandably, plastics and other packaging materials used for healthcare products must be held to higher standards. Though they may be suitable for cosmetics or other consumer products, recycled plastics historically have not been considered capable of meeting “pharma-or-medical grade” requirements, which has omitted their introduction into the healthcare products production and packaging streams. 
 
In healthcare, then, the vast majority of plastics are “regulated out” of reuse. Promisingly, though, sustainability guidelines being adopted (and mandated) elsewhere are upping the ante on sustainable packaging – a rising tide that will, in time, lift healthcare as well. In fact, chemically recycled resins are starting to gain traction in healthcare applications. Crucially, the final resin produced is identical to that of a resin produced with non-chemically recycled raw materials. 
 
Recycle
 
In the medical, pharma, and diagnostic markets, the majority of recycling still occurs as a closed-loop process – for example, edge trim from a film manufacturing process sent directly back through an extruder, or in-process tubing manufacturing scrap funneled back through extrusion. In other words, materials are literally re-cycled: run through the production process again until they are fully utilized. In a sector where regulations reign, this type of reuse is only permissible because it is in-house, and therefore capable of being conducted without risking contamination all while maintaining raw material traceability. 
 
As mentioned previously, post-consumer recycled materials, or PCRs, have limited to no use in the healthcare space. In fact, materials originators cannot even recycle materials processed downstream from them, regardless of whether they’ve been used by consumers or patients. Notably, though, there are signs of such guidelines becoming slightly more flexible. For instance, in some markets exemption from so-called “plastics taxes“ may require using scrap materials beyond those acquired in-house. This is sensible, as such changes can be undertaken with essentially no effect on product protection (and therefore patient health). 
 
And of course, for healthcare product and packaging manufacturers, recycling avenues abound outside healthcare, where such post-use materials are permissible. As a multi-sector materials provider, TekniPlex Healthcare is accustomed to such scenarios. For example, one of the company’s plants also services a credit card manufacturer. As such, the same polyvinyl chloride (PVC) used to protect your medicines can be repurposed into something used to pay for them.  
 
As hinted at above, advancements in chemical recycling hold the promise of bringing recycled plastics into the healthcare products fold in a much more prominent way. With chemical recycling, plastics are broken down into their building blocks and transformed into valuable secondary raw materials. These materials can then be used to produce new chemicals and plastics. A plastic resin produced with chemical recycled plastics holds the same properties as one produced with traditional manufacturing methods, yielding the potential for a “recycled yet raw” plastics stream in the healthcare sector.
 
This is no small breakthrough – and shows what can be done when smart people tackle longstanding problems. More than anything, it showcases another “R” word that the healthcare industry will need in spades if it hopes to narrow its sustainability gap.
 
 
Resolve
 
Finally, gains in healthcare materials sustainability can be made the old-fashioned way: by innovating our way to them. All eyerolls aside, we know that safety, better outcomes, and the health of the planet are the priorities. Setting our sights on a 100% circular economy while maintaining uncompromising patient safety and health will drive and guide our innovation efforts. 
 
Healthcare sector players have a hard question to ask themselves. Are we hiding behind our industry’s top priority at the expense of another major one? Are we using the ultimate reason – patient health – as an excuse to maintain the sustainability status quo? 
 
Recently, TekniPlex launched an initiative aptly called the “Sustainable Blister Project.” The goal is to take a previously unrecyclable packaging type – plastic blister packages, used to protect everything from tablets and capsules to medical devices and tubing – and… well, recycle them. 
 
It’s a bit complicated, of course, but the idea is to design blister packaging materials compatible with a specific waste stream – and, importantly, to provide these blisters with a baseline set of barrier properties. Previous attempts at recyclable blisters typically didn’t involve protection against oxygen, moisture and humidity – all must-haves for such a sustainable solution to become widely adopted. 
 
It is this type of collaborative, extensive materials research that will help the healthcare sector make sustainability strides. Progress on this front will entail the kinds of incremental gains that, over time, build true breakthroughs. Materials science companies committed to sustainability must invest in research and be unafraid to stumble along the winding road to engineering breakthroughs. Even while we perpetually place patient safety first, the push to improve materials sustainability must include healthcare as we move toward a truly circular economy.