title: Auditing an intensive care unit recycling program.
abstract: BACKGROUND
  The provision of health care has significant direct environmental effects such as energy and water use and waste production, and indirect effects, including manufacturing and transport of drugs and equipment. Recycling of hospital waste is one strategy to reduce waste disposed of as landfill, preserve resources, reduce greenhouse gas emissions, and potentially remain fiscally responsible. We began an intensive care unit recycling program, because a significant proportion of ICU waste was known to be recyclable.
  
  
  OBJECTIVE
  To determine the weight and proportion of ICU waste recycled, the proportion of incorrect waste disposal (including infectious waste contamination), the opportunity for further recycling and the financial effects of the recycling program.
  
  
  METHODS
  We weighed all waste and recyclables from an 11-bed ICU in an Australian metropolitan hospital for 7 non-consecutive days. As part of routine care, ICU waste was separated into general, infectious and recycling streams. Recycling streams were paper and cardboard, three plastics streams (polypropylene, mixed plastics and polyvinylchloride [PVC]) and commingled waste (steel, aluminium and some plastics). ICU waste from the waste and recycling bins was sorted into those five recycling streams, general waste and infectious waste. After sorting, the waste was weighed and examined. Recycling was classified as achieved (actual), potential and total. Potential recycling was defined as being acceptable to hospital protocol and local recycling programs. Direct and indirect financial costs, excluding labour, were examined.
  
  
  RESULTS
  During the 7-day period, the total ICU waste was 505 kg: general waste, 222 kg (44%); infectious waste, 138 kg (27%); potentially recyclable waste, 145 kg (28%). Of the potentially recyclable waste, 70 kg (49%) was actually recycled (14% of the total ICU waste). In the infectious waste bins, 82% was truly infectious. There was no infectious contamination of the recycling streams. The PVC waste was 37% contaminated (primarily by other plastics), but there was less than 1% contamination of other recycling streams. The estimated cost of the recycling program was about an additional $1000/year.
  
  
  CONCLUSIONS
  In our 11-bed ICU, we recycled 14% of the total waste produced over 7-days, which was nearly half of the potentially recyclable waste. There was no infectious contamination of recyclables and minimal contamination with other waste streams, except for the PVC plastic. The estimated annual cost of the recycling program was $1000, reflecting the greater cost of disposal of some recyclables (paper and cardboard v most plastic types).
authors.affiliation: Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia. mark.kubicki@mh.org.au.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Kubicki
authors.affiliation: Departments of Anaesthesia and Intensive Care, Western Hospital, Melbourne, VIC, Australia.
authors.forename: Forbes
authors.initials: F
authors.lastname: McGain
authors.affiliation: Environmental Services, Western Health, Melbourne, VIC, Australia.
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: O'Shea
authors.affiliation: Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia.
authors.forename: Samantha
authors.initials: S
authors.lastname: Bates
mesh_terms: D001315:Australia; D003365:Costs and Cost Analysis; D006801:Humans; D007362:Intensive Care Units; D008485:Medical Audit; D059027:Recycling / Q000191:economics*; D018505:Waste Management / Q000191:economics*; D014866:Waste Products
chemical_list: D014866:Waste Products