Reducing the Environmental Impact of Sterilization Packaging for Surgical Instruments in the Operating Room: A Comparative Life Cycle Assessment of Disposable versus Reusable Systems

The widespread use of single-use polypropylene packaging for sterilization of surgical instruments (blue wrap) results in enormous environmental pollution and plastic waste, estimated at 115 million kilograms on a yearly basis in the United States alone. Rigid sterilization containers (RSCs) are a well-known alternative in terms of quality and price. This paper deals with two research questions investigating the following aspects: (A) the environmental advantage of RCS for high volumes (5000 use cycles) in big hospitals, and (B) the environmental break-even point of use-cycles for small hospitals. An in-depth life cycle assessment was used to benchmark the two sys-tems. As such a benchmark is influenced by the indicator system, three indicator systems were ap-plied: (a) carbon footprint, (b) ReCiPe, and (c) eco-costs. The results are as follows: (1) the analyzed RSC has 85% less environmental impact in carbon footprint, 52% in ReCiPe, and 84.5% in eco-costs; and (2) an ecological advantage already occurs after 98, 228, and 67 out of 5000 use cycles, respec-tively. Given these two alternative packaging systems with comparable costs and quality, our results show that there are potentially large environmental gains to be made when RSC is preferred to blue wrap as a packaging system for sterile surgical instruments on a global scale.