Sustainable medical textiles: A way forward

Sustainable medical textiles: A way forward

Development of new waste management strategies for the huge burden of single-use-plastic in medical textiles, with policy guidance at the global level, is a vital need of the hour, says R Radhai, S Sivakumar and E Santhini.

Medical textiles are products designed to be used in the healthcare sector and are categorised as implantables, non-implantables, extracorporeal devices and health and hygiene textiles based on their end application. Medical textiles can be made from both natural and synthetic materials. Eventhough, natural fibres are comfortable, non-allergic and eco-friendly, they are not very durable, have low density, less availability, expensive, absorb moisture and water which makes them easily at the risk of damage.In comparison, synthetic fibres are durable, inexpensive and robust; hence gain much popularity in the development of medical textiles.

The massive increase in use and production of health care textiles using synthetic fibres in recent times could well be attributed to the Covid-19 pandemic. Personal protective equipment made out of these fibres played a key role in controlling the spread of COVID-19. Realising the potential of disposal of PPE in minimising the spread of infection as well as its nature of contact with infectious pathogens, blood and body fluids leaving them not recyclable/reusable and the upfront cost involved in the process of infected materials, health care settings have increased their use of disposable materials for its various operations. This change assisted hospitals / clinics to minimise hospital acquired infection and containing spread of infection. However, the waste generated by these products particularly face masks, surgical gowns, coveralls and drapes are huge. Most of these products are either incinerated or dumped in landscapes which causes a huge threat to the safety of the environment. Approximately 87,000 tonne of personal protective equipment (PPE) were procured between March 2020- November 2021 as a part of joint UN emergency initiative during the pandemic. Almost all the equipment would have got ended up as waste after single use. The global warming potential of a disposable medical mask is 0.02 g CO2-eq. for which the main contributor is the raw materials (40.5 per cent) followed by the packaging (30.0 per cent) and production (15.5 per cent). According to WHO, about 106,478 tonne of CO2 emissions is the carbon footprint estimate of PPE within the first six months of the pandemic.  “COVID 19 has forced the world to reckon with the gaps and neglected aspects of the waste stream and how we produce, use and discard our health care resources, from cradle to grave,” said Dr Maria Neira, Director, Environment, Climate Change and Health at WHO.

Research since the beginning of the current pandemic have thrown more light on the different ways of disinfection of PPE and usage of sustainable materials as an alternate for synthetic fibres.  Many of the disinfection methods such as infusion of hydrogen peroxide vapour, irradiation with ultraviolet or gamma radiations, ethylene oxide gasification, autoclaving, application of disinfectants and infusion of base materials with antimicrobial substances, particularly nanoparticles have been researched extensively by many authors. However most of the methods are in their infancy and material based disinfection methods must be optimised to avoid disinfection process-mediated material degradation so as to ensure their safety and performance for their use by health care personnel during high risk surgeries or when handling patients with contagious infections.
Similar to disinfection methods, there have also been many attempts to develop reusable cloth face masks with organic materials and recycled fabrics as a sustainable option to single-use disposable masks. But the bottle neck in the use of reusable facemask is its efficacy in filtration which ultimately throws questions on the potency of the material. Hence, research on the development of reusable face mask still opens door for the new innovation with an effective filter material which can meet the national and international standards to protect the user as well as the environment.
The growing interest in protecting the environment has led the scientific community to develop totally biodegradable bio-based plastics as it offers an eco-friendly alternative to fossil-based polymers. So far, the polymers such as polylactic acid (PLA), poly hydroxyl alkanoate (PHA), poly caprolactone (PCL), polybutylene adipate terephthalate (PBAT), polybutylene succinate (PBS), bio-polyethylene terephthalate (bio-PET), bio-polyethylene (bio-PE), bio-polypropylene (bio-PP), etc, have been used for the development of bio-plastics. Some of these bio-plastics are found to have degraded in the open air, others with microorganisms or their enzymes in an industrial composting plant. These bioplastics generally mimic the robustness and durability of conventional plastics. Key advantage of using bioplastics is their ability to substitute their oil-based equivalent; and also the capability to be chemically identical to standard industrial medical textile products.

A lot research is carried out for the development of menstrual products using bioplastics with the Centre for Science and Environment estimating that India’s consolidated daily generation of sanitary napkins and baby diaper waste being approximately 925 tonne, which accounts for 0.65 per cent of total solid waste. A sustainable and eco-friendly solution to non-biodegradable sanitary napkins is the use of antimicrobial coated (natural/synthetic), partially degradable (except absorbent core which should befully degradable), flushable, having a removable absorbent core and reusable.  Apart from these sanitary napkins, in recent days, menstrual cup also grow as a new sustainable alternative. Interestingly, menstrual cups are cost effective and do not do any harm to the body and a silicon-made menstrual cup can run for 12 years at a go.

The very crucial and fundamental principle in global health and market for medical textiles is sustainability. The whole earth suffers from the exploitation and draining of its resources. It is high time that we shift to sustainability to safeguard the environment. Recommendations include using,

  • Recyclable or biodegradable materials,
  • Eco-friendly packaging and shipping,
  • Safe and reusable PPE,
  • Venturing in to non-burn waste treatment technologies like autoclaves and
  • Reverse logistics to support the production of value-added products from plastic.

During selection of a material for the development of a medical textile product, features like eco-friendliness, cost-effectiveness, antimicrobial resistance against bacteria, virus, etc., and good breathability without compromising the overall performance of the product should be considered.

In a way, to cater the growing demand of health and hygiene textiles, research and development needs to be kick-started for new sustainable materials that reduce waste generation. Further, development of new waste management strategies for the huge burden of single-use-plastic in medical textiles, with policy guidance at the global level, is a vital need of the hour. This will create opportunities for using alternative bioplastics that are more environment-friendly. To conclude, the medical textiles sector is now focused on functionality, quality and standard compliance. Nevertheless, research on a more sustainable, eco-friendly raw material for medical textiles has to progress to a story whereby the resultant benefits get into humans and become a blessing to the world.

References

  1. Tonne of COVID-19 health care waste expose urgent need to improve waste management systems, WHO news, February 2022.
  2. Udbhav Sharma, Shekhar Kalra, Srishti Gupta, Nirali Seth, Govind Mawari, Naresh Kumar, Mradul Kumar Daga, M. Meghachandra Singh, Tushar Kant Joshi. (2022). The crisis of biomedical wastes associated with the COVID-19 pandemic and management using sustainable technologies for sound management of healthcare waste associated with pandemics: Int J Community Med Public Health, 9(2):1084-1090.
  3. ShailshreeTewari.2022. Sanitary Waste Management In India – Challenges and Agenda, Centre for Science and Environment.
  4. Sustainable Medical Textile, Textile Value Chain, Oct 7, 2020.

About the author:

R Radhai, S Sivakumar and E Santhini, Corresponding author: Senior Scientific Officer-B/Head In charge, Centre of Excellence for Medical Textiles, The South India Textile Research Association.

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