Stewardship for Sharps and Reusable Sharps Containers - Business Case Considerations December 2020
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Stewardship for Sharps and Reusable Sharps Containers Business Case Considerations December 2020 1 Stewardship for Reusable Sharps Containers – Business Case Considerations
CONTENTS Glossary i Executive Summary ii Introduction 01 Product Stewardship and EPR 02 The Need for Sharps Stewardship 03 Additional Issues for Sharps Stewardship 04 Conclusions 09 References 10 GLOSSARY Background Paper Stewardship for Sharps and Reusable Sharps Containers – Background and Issues Paper DASTRI (France) EPR system for home-generated sharps DfE Design for Environment DSC Disposable Sharps Container EPR Extended Producer Responsibility GHG Greenhouse Gas GlobalPSC Global Product Stewardship Council IPR Inevitable Policy Response OECD Organisation for Economic Co-operation and Development RSC Reusable Sharps Container WHO World Health Organization i Stewardship for Reusable Sharps Containers – Business Case Considerations
EXECUTIVE SUMMARY
THIS REPORT IS INTENDED TO SHARPS PROGRAM Redesign, reuse and recycling
ASSESS CURRENT BUSINESS are not viable options for sharps
OVERVIEW
CASE CONSIDERATIONS themselves at this stage, given
FOR REUSABLE SHARPS specific medical and regulatory
Increased demand for home
STEWARDSHIP MODELS FOR requirements, but represent
healthcare, underscored by the
THE HOME HEALTHCARE significant potential opportunities
COVID-19 pandemic, will continue
INDUSTRY, AND BUILDS UPON for growth in these areas as part
to drive the increased generation
THE ACCOMPANYING GLOBAL of reducing risks while meeting
of household-generated sharps
PRODUCT STEWARDSHIP growing demand. Regulatory
such as used needles, lancets and
COUNCIL (GLOBALPSC) REPORT, frameworks, including product
similar devices, with the resultant
STEWARDSHIP FOR SHARPS AND stewardship / EPR programs,
need for the safe collection and
REUSABLE SHARPS CONTAINERS should allow for flexibility as
management of sharps.
– BACKGROUND AND ISSUES technology and program design
PAPER (BACKGROUND evolve. Although this is an area
RSCs are used in Australia, USA,
PAPER). THE BACKGROUND for further development, EPR
UK, New Zealand, South Africa,
PAPER COMPARES REUSABLE programs should consider the use
Canada, South America, and by
SHARPS CONTAINERS (RSCS) of RSCs more closely as a viable
the World Health Organization
TO DISPOSABLE SHARPS option to reducing the waste
(WHO) and Medecins Sans
CONTAINERS (DSCS) FOR associated with sharps disposal
Frontieres. However, current RSC
HOME HEALTHCARE USE, AND and its carbon impact.
usage is predominantly in hospital
HIGHLIGHTS OPPORTUNITIES TO
and clinical settings; examples of
INTEGRATE RSCS IN PRODUCT
the use of RSCs in the home and
RISKS OF SHARPS
STEWARDSHIP AND EXTENDED
residential care settings have not WASTE
PRODUCER RESPONSIBILITY
been identified outside of those
(EPR) APPROACHES. Perceived risks to waste
being initiated by HealthBeacon.
management and recycling
FOR BOTH REPORTS, workers are often cited for
All existing programs for home
HEALTHBEACON COMMISSIONED introducing sharps product
healthcare sharps focus on
THIS GLOBALPSC RESEARCH stewardship / EPR. However, as
ensuring proper management
TO UPDATE THE GLOBALPSC’s detailed in the Background Paper,
and disposal through autoclaving
2016 REPORT FOR THE US research shows that actual risks
(steam sterilization), incineration
HEALTHCARE INDUSTRY ON to these workers of infectious
or landfilling in the interests
PRODUCT STEWARDSHIP AND disease transmission are quite
of consumer safety and the
EPR PROGRAMS FOR SHARPS. low. The greater risks, however
environment.
appear to lie with family members
of sharps users. An approach
specifically addressing household
sharps users and their caretakers
could therefore provide greater
safety if made convenient and
accessible.
Stewardship for Reusable Sharps Containers – Business Case Considerations ii
EXECUTIVE SUMMARY
LIFE-CYCLE BENEFITS OF RSCs
Both DSCs and RSCs are essential in healthcare. Sharps users lacking appropriate education frequently
Although life-cycle data on home healthcare for RSCs dispose of sharps loosely in the household trash or
is not currently available, peer-reviewed studies on into toilets.
RSC use in hospitals show that RSCs may help to
eliminate almost all sharps plastic that is currently Where they exist, product stewardship and EPR
landfilled, greatly reduce greenhouse gas emissions, approaches for sharps in home healthcare do not fully
significantly reduce sharps injuries and reduce labour. consider the potential roles of RSCs. However, viable
reuse systems should be rolled out in cooperation
These benefits are possible while still keeping risks to with the introduction of products onto the market, as
public health and safety low, as both DSCs and RSCs part of individual producers’ responsibility under these
are designed, manufactured and tested to the same approaches.
high standards. Expanding use of RSCs into home
healthcare would therefore be consistent with circular To date, waste in the medical industry has typically
economy and sustainability principles if part of robust, been incinerated, but as carbon budgets tighten
managed collection, processing and reuse initiatives and the clear effects of climate change force action,
coupled with appropriate education and outreach to this will no longer be considered a long-term viable
patients and carers. Indeed, patient management of solution. A move to reuse and recycling will become of
sharps is highly dependent on the level of education paramount importance.
they receive.
iii Stewardship for Reusable Sharps Containers – Business Case Considerations
INTRODUCTION
This report is intended to highlight Comparison of reusable sharps HealthBeacon’s FDA-cleared Smart
business case considerations containers (RSCs) against Sharps Bin tracks patient injection
for reusable sharps stewardship disposable sharps containers history, provides personalized
models for the home healthcare (DSCs) and opportunities to interactive reminders and safely
industry, and builds upon the integrate RSCs into product stores used injections. With the
accompanying Global Product stewardship and EPR approaches intervention of HealthBeacon’s
Stewardship Council (GlobalPSC) are specific areas of focus for the Smart Sharps Technology, patients’
report Stewardship for Sharps Background Paper. persistence and adherence
and Reusable Sharps Containers increased by 25-30% within twelve
– Background and Issues Paper ABOUT THE GLOBALPSC months of initiating therapy.
(Background Paper). HealthBeacon’s integrated model
connects a patient’s routine and
The GlobalPSC is an independent,
HealthBeacon1 has funded this the prescribing clinician’s workflow.
not-for-profit organization
report to update the GlobalPSC’s This technology has been adopted
dedicated to facilitating the
2016 background research (2016 across 13 countries with >400,000
development of effective product
Report or GlobalPSC 2016) on injections tracked since launch in
stewardship and EPR schemes
global product stewardship and 2014, and a patient acceptance
globally. The GlobalPSC has
Extended Producer Responsibility rate of 80-90%.
members operating worldwide
(EPR) programs for sharps
that span producers, product
and unwanted or out-of-date, HealthBeacon follows the EPR
recovery organizations,
medicines. The 2016 Report model as a part of its fundamental
reprocessors, NGOs, universities
was funded by Eli Lilly and business model, embracing end to
and governments at federal, state
Company in support of facilitated end product stewardship. Earlier
and local levels.
discussions between the US this year, HealthBeacon launched
pharmaceutical industry and key its innovative Green Labs initiative
stakeholders. ABOUT HEALTHBEACON for sustainable waste management.
AND THE HB GREEN The labs which HealthBeacon have
The Background Paper addresses LABS built will allow for the sterilisation
adoption and significance of and reuse of sharps bins and
public health and safety concerns, recovery of injection waste for
HealthBeacon is a medication
the circular economy and reuse more sustainable processing.
adherence technology company
for sharps. which develops smart tools for
managing medication.
1 Disclosure:
1
Stewardship for Reusable Sharps Containers HealthBeacon
– Business (www.healthbeacon.com) is a GlobalPSC Corporate member.
Case Considerations 1
PRODUCT STEWARDSHIP AND EPR
PRODUCT STEWARDSHIP IS AN ENVIRONMENTAL IMPACTS ON DFE AND SUPPLY CHAINS
MANAGEMENT STRATEGY TO PROMOTE INCREASED
RESPONSIBILITY FOR THOSE WHO DESIGN,
While EPR has delivered a variety of benefits across
PRODUCE, SELL OR USE A PRODUCT, TO MINIMIZE
product types, its direct impact on a primary objective,
THAT PRODUCT’S ENVIRONMENTAL IMPACT.
DfE, has been quite limited overall and focused mainly
MOST MODELS AIM TO SHIFT SOME PHYSICAL
on packaging design considerations. Design for
AND/OR FINANCIAL RESPONSIBILITY FROM STATE
environment is also more viable in consumer products
AND LOCAL GOVERNMENTS TO PRODUCERS
with more rapid design turnover, such as packaging
AND CONSUMERS OF SPECIFIC PRODUCTS
and e-waste. (OECD 2016)
(TRADITIONALLY FOR PACKAGING AND E-WASTE
BUT INCREASINGLY APPLIED TO A WIDE RANGE OF
Various product stewardship and EPR programs are
PRODUCTS).
working to integrate more of a circular economy
approach in which the value of products, materials and
The Organisation for Economic Co-operation and
resources is maintained in the economy for as long as
Development (OECD) defines EPR as (OECD 2014):
possible, and the generation of waste is minimized.
Broader circular economy approaches, such as the EU
“...an environmental policy approach in which action plan for the circular economy and the French
a producer’s responsibility for a product is Roadmap for the Circular Economy, increasingly
extended to the post-consumer stage of a integrate stewardship and EPR. (European Commission
product’s life cycle.” 2015) (OECD 2016) (Republic of France 2018)
The home healthcare industry has opportunities to
Shifting responsibility through EPR is intended to drive
develop circular economy models that provide both
improvements in design for environment (DfE), an
significant life-cycle and circular economy benefits
approach that attempts to reduce a product’s overall
overall, while potentially reducing supply chain risks,
impacts on human health and the environment.
and disruptions, and addressing potential resource
scarcity through resource management and control.
Responsibility is invariably shared across a range of
stakeholders, including consumers. Program costs,
however, are generally incorporated into purchase
prices so that consumers are not charged when they
return items at end-of-life.
2 Stewardship for Reusable Sharps Containers – Business Case ConsiderationsTHE NEED FOR SHARPS STEWARDSHIP
With sharps used in the treatment Although ‘needle-free’ insulin challenges accessing medications
and management of various delivery methods are under and healthcare providers. Some
conditions, including one of the development, such approaches patients deemed ‘high-risk’, taking
leading causes of morbidity are not likely to be available for medications which suppress their
worldwide, diabetes, there is the foreseeable future (Diabetes. immune system, may have been
significant need for enhanced co.uk, 2020). Diabetes-related instructed to pause their treatment
sharps stewardship. Against the products account for 80-90% of during this pandemic, with the
background of the COVID-19 the materials recovered through resultant impact on their adherence.
pandemic, with remote care the French sharps EPR program, The extremely valuable data that
in the home setting growing, DASTRI2. HealthBeacon provides enables
such stewardship is becoming targeted intervention programs and
increasingly necessary. IMPACTS OF THE an additional level of support for
COVID-19 PANDEMIC these high-risk patients.
SIGNIFICANCE OF SHARPS MANAGEMENT
DIABETES As the full impact of the COVID-19
pandemic comes to light, it AND DISPOSAL PRACTICES
is clear that its impact on the
According to the World Health
home healthcare industry will Most references show high
Organization (WHO), globally
be significant. Factors such rates of direct sharps disposal
around 422 million adults were
as increased home isolation into household trash, although
living with diabetes in 2014, a
and minimization of travel and information on whether the sharps
significant increase from the
exposure at medical facilities were contained prior to this disposal
108 million living with diabetes
may have lasting effects on is limited.
in 1980. The age-standardized
healthcare as we know it, and
global prevalence of diabetes has
increase the burden on remote Four US states (California,
nearly doubled in adults, rising
patient care. The collection, Massachusetts, Oregon and
from 4.7% in 1980 to 8.5% in 2014.
transport and handling of sharps Wisconsin) and the Canadian
Over the past decade, diabetes
from home healthcare will also province of Ontario allow medical
prevalence has risen faster in low-
likely be impacted as a result. waste generators such as
and middle-income countries than
However, these conditions hospitals and other institutions
in high-income countries. (WHO
could also generate commercial to dispose of sharps as general
2016)
opportunities. solid waste in landfills if treated to
be non-infectious/non-hazardous
The WHO estimates that diabetes
HealthBeacon’s Smart Sharps (autoclaving is common practice);
caused 1.5 million deaths in 2012,
Bin has been implemented this provides for no additional risk
with higher-than-optimal blood
across 13 markets including the of exposure. Apart from Oregon
glucose causing an additional
USA, Canada, Germany, Italy, allowing a de minimus 50 pounds
2.2 million deaths, with 43% of
Belgium, Netherlands, Ireland, per month exemption from prior
these 3.7 million deaths occurring
Portugal, Israel, South Africa, treatment requirements, these
before 70 years of age. (WHO
Luxembourg, Latvia and Lithuania. jurisdictions do not allow for
2016)
With thousands of active users landfilling of sharps containers
across different continents, many without prior treatment. This raises
This high burden of disease
of these patients on injectable the question as to the need for
comes with a high demand for
medications are considered high- treatment of home-generated
treatment, resulting in significant
risk if they contract the COVID-19 sharps where infectious disease
use of insulin needles. Diabetes
virus. From their digital-enabled transmission is different, as
however is not the only disease
Sharps Bin, HealthBeacon has discussed further in the Background
for which patients take injectable
been able to detect a trend Report.
therapy in the home setting.
towards higher rates of non-
Indeed, an estimated 9 million
adherence in some injectable
people in the US use sharps at
medications in 2020 compared to
home, resulting in more than
previous years. The reasons for
3 billion disposable needles
this are varied and may include
and syringes and 900 million
delays to treatment start dates,
lancets each year being disposed
postponed hospital appointments,
(safeneedledisposal.org, 2020).
DASTRI-related information is based on personal communication with Laurence Bouret, Déléguée Générale for DASTRI from 2016 to 2020, unless
3 3
2
otherwise indicated.
Stewardship for Reusable Sharps Containers – Business Case ConsiderationsADDITIONAL ISSUES FOR SHARPS STEWARDSHIP
REUSABLE VS USE OF REUSABLE ENVIRONMENTAL
DISPOSABLE SHARPS SHARPS CONTAINERS IMPACT OF RSCS
CONTAINERS
Commercial RSCs were first Both DSCs and RSCs are essential
ALTHOUGH RSCS ARE A used in US and Australian in healthcare. Although life-cycle
MORE SUSTAINABLE OPTION hospitals in 1986, and now data on home healthcare for RSCs
COMPARED TO DSCS, THEIR represent approximately 50% is not currently available, peer-
USE INVOLVES A NUMBER and 75%, respectively, of the reviewed studies on RSC use in
OF KEY CONSIDERATIONS, IN sharps containers used in these hospitals show that RSCs may
PARTICULAR RELATING TO countries. Since 1999, RSCs have (Grimmond, 2019):
POTENTIAL PUBLIC HEALTH been increasingly used in Canada,
RISKS. UK, Ireland, New Zealand, South
Africa and South America. RSCs 99%
IN RESEARCH AND are also used by the WHO Eliminate 99% of sharps plastic
CONSULTATIONS FOR THIS and Medecins Sans Frontieres. landfilled;
REPORT, THE GLOBALPSC (Grimmond, 2019) (McPherson et
COULD NOT CONFIRM THE
ADOPTION OF RSCS FOR
al, 2019)
65-84%
HOME HEALTHCARE USE TESTING OF RSCS Eliminate 65-84% of Greenhouse
OUTSIDE OF THE SYSTEM Gas (GHG) emissions;
BEING IMPLEMENTED BY RSCs can be reused many
HEALTHBEACON. EVEN times per year and may be in
DATA ON RSC USAGE WITHIN use for several decades with
HEALTHCARE FACILITIES IS appropriate manufacture, usage Significantly reduce sharps
QUITE LIMITED. ADDITIONAL and maintenance. The US FDA injuries;
RESEARCH WILL THEREFORE requires both RSCs and DSCs
BE NECESSARY TO DETERMINE to pass identical performance
ATTRIBUTES SPECIFIC TO HOME tests and design requirements
HEALTHCARE USE. NOTE, ALL under relevant standards. Prior Reduce labour.
LIFE-CYCLE INFORMATION to this testing, the US FDA also
ON RSCS THAT FOLLOWS These benefits are possible while
requires ‘‘lifespan simulation’’
IS BASED IN HOSPITAL still keeping risks to public health
of RSCs, which includes filling
OR SIMILAR HEALTHCARE and safety low.
and processing for the number
SETTINGS INSTEAD OF HOME of lifespan uses stated by the
HEALTHCARE, DUE TO THE manufacturer (e.g., 500 times)
LIMITED INDEPENDENT, PEER- and transport vibration tests
REVIEWED DATA AVAILABLE. such as the US Department of
Transport Packaging Vibration
Standard to ensure robustness
during transit. The Canadian
sharps container standard
involves similar requirements.
(McPherson et al, 2019)
4 Stewardship for Reusable Sharps Containers – Business Case ConsiderationsADDITIONAL ISSUES FOR SHARPS STEWARDSHIP
FIT WITHIN CIRCULAR
ECONOMY PRINCIPLES
While various healthcare facilities The 2019 study examined the Under circular economy
adopted RSCs for sustainability impact on GHG of nation-wide principles, the value of products,
reasons, quantitative studies transport distances when a large materials and resources is
for this are rare. While limited US teaching hospital system maintained in the economy
quantitative data is available, converted from DSCs to RSCs. for as long as possible, the
recent life-cycle analysis The RSCs in the study were generation of waste is minimized
comparing RSCs and DSCs in a US certified for 500 uses and reused and landfilling is avoided, where
hospital (McPherson et al, 2019) an average of 12 times/year, possible. Higher-value uses are
found that: for a theoretical ‘‘end-of-life’’ regularly sought, rather than
lifespan of 41.7 years. However, downcycling and disposal. Rather
- RSCs achieved significant GHG a ‘‘worst-case’’ lifespan scenario than an end-of-life perspective
reductions over DSCs, even where of 26.4 years based on the most and a focus on material recovery,
large RSC transport distances frequently used RSC still in service circular economy takes a life-
lessen the GHG differential in the US was assumed for the cycle perspective and spans
between the two systems study. The study confirmed entire supply and recovery chains.
that large transport distances Many newer circular economy
- Transport and electricity between polymer manufacturer, initiatives also seek to minimize
cleanliness (e.g., renewables container manufacturer, user the manufacture of, or maximize
vs coal) are key factors in GHG and processing facilities, can the reuse of, plastics and
emissions for RSC systems significantly impact the carbon integrate product stewardship
footprint of sharps containment and EPR. (European Commission
- The lifespan of RSCs has minimal systems. (McPherson et al, 2019) 2015) (OECD 2016) (Republic of
effect when comparing carbon France 2018)
footprint between the two Converting to RSCs, the hospital
systems system examined reduced its Given the benefits of RSCs
annual GHG by 162.4 tonnes shown earlier, expanding the use
- Purchasing decisions can CO2-eq, a 65.3% reduction. They of RSCs into home healthcare
significantly contribute to GHG also had an annual elimination of would therefore be consistent
reduction strategies. 50.2 tonnes of plastic DSC and with circular economy and
8.1 tonnes of cardboard from the sustainability principles if part
- Institution-wide adoption of sharps waste stream. Of the DSC of robust, managed collection,
RSCs can reduce GHG with plastic eliminated, 31.8 tonnes processing and reuse initiatives
minimal staff behavior-change. were diverted from landfill and coupled with appropriate
18.4 tonnes were diverted from education and outreach to
incineration. (McPherson et al, patients and carers.
Annual GHG emissions by life 2019)
stage (with DSCs normalized to
Adjusted Patient Days) are shown
in Figure 1.
A previous study had found that
converting from DSCs to RSCs
reduced sharps waste stream
GHG by 84%. However, the 2019
study confirmed that transport
distances impacted significantly
on GHG outcomes.
Figure 1: Annual GHG emissions by life stage
(McPherson et al, 2019)
Stewardship for Reusable Sharps Containers – Business Case Considerations 5ADDITIONAL ISSUES FOR SHARPS STEWARDSHIP
PUBLIC HEALTH AND SAFETY INTEGRATION WITH PRODUCT
STEWARDSHIP AND EPR
Most of the public health and safety considerations
around sharps containers revolve around increasing Where they exist, product stewardship and EPR
the appropriate use and management of approved approaches for sharps from home healthcare do not
sharps containers through access, convenience fully consider the potential roles of RSCs. However,
and education, regardless of whether the sharps viable reuse systems should be considered and
containers are disposable or reusable. Both RCSs rolled out in cooperation with product manufacturers
and DSCs are made to perform to the same high as individual producer responsibility under these
standards, and reuse systems are designed to approaches.
minimize human contact. Various studies have
confirmed that RSCs represent no greater risk than Determining collection data for sharps can pose
DSCs. (Grimmond, 2019) difficulties, as highlighted for Ontario and DASTRI
in the Background Paper. While material collections
from a given jurisdiction can ultimately be determined,
the amount of product sales into a given jurisdiction
(especially at a state or local level) can be difficult to
determine given existing distribution networks. The
durability and tracking possible for RSCs should help
avoid many of these problems experienced by product
stewardship and EPR programs, as long as the process
and tracking are explained clearly.
6 Stewardship for Reusable Sharps Containers – Business Case ConsiderationsADDITIONAL ISSUES FOR SHARPS STEWARDSHIP
OTHER CONSIDERATIONS – THE
INEVITABLE POLICY RESPONSE
The landscape for stewardship of sharps and sharps Waste in the medical industry has typically been
containers is chaotic and fragmented at the moment, incinerated, but as carbon budgets tighten and the
but governments around the world are coming to clear effects of climate change force action, this will
the realization that waste will need to be tackled and no longer be considered a long-term viable solution. A
legislated in a more cohesive and globalized manner. move to reuse and recycling will become of paramount
importance.
The medical industry is not escaping scrutiny, and
as it becomes clear that the pandemic has greatly Along with the tightening of financial regulations will
increased single use plastics and medical waste, the come the scrutiny of supply chains and the inevitable
risk of a strong policy response is becoming inevitable. tightening of regulations around waste. It is therefore
advantageous for those who are aware of these
In financial circles, this phenomenon, known as the coming changes to get ahead of the curve, make
inevitable policy response (IPR), predicts a sharp and the necessary changes in an orderly fashion, and
disruptive government response to the climate crisis position themselves as leaders in the new circular and
the closer we get to 2025. sustainable economy.
“Government action to tackle climate change has so far been highly insufficient
to achieve the commitments made under the Paris Agreement, and the
market’s default assumption appears to be that no further climate-related
policies are coming in the near-term. Yet as the realities of climate change
become increasingly apparent, it is inevitable that governments will be forced
to act more decisively than they have so far.
The question for investors now is not if governments will act, but when they
will do so, what policies they will use and where the impact will be felt. The
IPR project forecasts a response by 2025 that will be forceful, abrupt, and
disorderly because of the delay.” (UNPRI 2020)
Stewardship for Reusable Sharps Containers – Business Case Considerations 7ADDITIONAL ISSUES FOR SHARPS STEWARDSHIP
AREAS FOR FURTHER EXPLORATION
GIVEN THE SCARCITY OF DATA ON REUSABLE
SHARPS SYSTEMS FOR HOME HEALTHCARE, THE
GLOBALPSC RECOMMENDS THAT THE FOLLOWING
AREAS BE EXAMINED TO BETTER DEFINE THE
BUSINESS CASE FOR THESE SYSTEMS:
1. Define collection and transport models for RSCs 6. The healthcare sector is heavily regulated and
used in home healthcare, including ground and air scrutinized by governments at all levels. Therefore,
transport, and including mailback options specifically. the development of a government relationship road
map plan would inform a better understanding of
2. Life-cycle analysis of processing and government departments that influence the sector.
decontamination systems such as HealthBeacon’s From this, a sphere of influence and targeted
Green Labs, factoring in specific collection and relationship-building exercise between the home
transport models. healthcare sector and government departments can
begin e.g. Dept. Health and Human Services, EPAs,
3. Extent to which collection and transport methods Local Government Associations and Departments of
affect classification of sharps and RSCs (e.g., Environment, Social Services Commission etc.
Dangerous Goods, Clinical and Sharps Waste and
Special Waste) and resulting transport, storage and 7. Support the Business Case with a high-level financial
management costs. assessment that scopes out the cost / benefit analysis
and return on investment period for RSCs versus DSCs.
4. Opportunities for further reuse and recycling
initiatives, including of the sharps themselves. 8. Scope and map current home RSC disposal options
for specific and strategic geographical locations
5. Benchmarking and verified public reporting to identified by key stakeholders.
provide transparency and increase government and
public trust in the sector. 9. Develop an RSC marketing and communications
plan to support the Business Case and test the
marcomm plan with key stakeholders in specific and
strategic geographical locations e.g. pharmacies,
medical centres and doctors’ surgeries.
8 Stewardship for Reusable Sharps Containers – Business Case ConsiderationsCONCLUSIONS
This report, building upon previous GlobalPSC This report has demonstrated that expanding the use
research, highlights the key considerations for of RSCs into home healthcare would be consistent
reusable sharps stewardship. Compared to DSCs, with circular economy models and sustainability
RSCs provide a viable option to tackle several of the principles. Indeed, with an ever-increasing importance
main challenges facing medical waste in the home on environmentally friendly practices and as carbon
setting today, while integrating product stewardship budgets tighten with the effects of climate change
and EPR approaches for producers. becoming more obvious, mass incineration of sharps
waste will likely no longer be acceptable.
As redesign, reuse and recycling are not yet viable
options for sharps themselves, an innovative A shift towards reuse and recycling will be of greater
approach to the challenge of sharps waste is importance. On the back of the COVID-19 pandemic,
needed and regulatory frameworks, including and with the move towards increasingly remote
product stewardship and EPR programs, should patient care and its associated challenges, the use
allow for flexibility to meet the safety, storage and of RSCs in the home setting can become part of the
sustainability needs in the home healthcare sharps solution.
domain.
9 Stewardship for Reusable Sharps Containers
Stewardship
– Business
forCase
Reusable
Considerations
Sharps Containers – Business Case Considerations 9REFERENCES
1. European Commission 2015, Closing the loop - An EU action plan
for the Circular Economy. Available at https://eur-lex.europa.eu/
legal-content/EN/TXT/?uri=CELEX:52015DC0614, accessed April
2020.
2. GlobalPSC 2016, Product Stewardship for Sharps and Unwanted
Medicines – Background and Issues Paper.
3. Grimmond 2019, Reusable Sharps Containers: Safety, Sustainability
and Standards. Presented at International Stewardship Forum,
Paris, 2 July 2019.
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carbon footprint of converting from disposable to reusable sharps
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manufacturing and processing facilities. PeerJ. 2019.
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https://www.oecd.org/environment/waste/Global%20Forum%20
Tokyo%20Issues%20Paper%2030-5-2014.pdf, accessed October
2020.
6. OECD 2016, Extended Producer Responsibility – Updated
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7. Republic of France 2018, Roadmap for the Circular Economy.
8. UNPRI 2020, What is the Inevitable Policy Response?, available
at https://www.unpri.org/what-is-the-inevitable-policy-
response/4787.article, accessed October 2020.
9. WHO 2016, Global Report on Diabetes, available at https://www.
who.int/diabetes/global-report/en/, accessed April 2020.
10 Stewardship for Reusable Sharps Containers – Business Case Considerations11 Stewardship for Reusable Sharps Containers – Business Case Considerations
Prepared for Prepared by HealthBeacon Global Product Stewardship Council Unit 20, Naas Road Business Park, Muirfield PO Box 755 Turramurra NSW 2074 Australia Drive, Dublin 12 Phone: +61 417 445 644 D12WD85 admin@globalpsc.net Phone: +353 1 450 8480 @GlobalPSC on Twitter www.healthbeacon.com www.globalpsc.net
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