Abstract
Background
As the US healthcare sector contributes to 5–10% of national CO2 emissions, with a substantial contribution from surgical services, a collective effort is important to minimize the climate footprint of surgery. Solid plastic waste generated from single-use items in operating rooms is a major contributor to greenhouse gas emissions. To address this problem, we implemented a pilot study to replace single-use scrub caps with reusable caps.
Methods
Ninety-two surgical trainees at the Massachusetts General Hospital, Boston, were provided reusable personalized scrub caps. Over 6 months, their use of the reusable cap was compared with corresponding use of disposable single-use caps. We then used the cost of raw materials, fabric and cap manufacturing, transportation, and end-of-life/waste treatment to perform an economic and environmental burden analysis.
Results
After 6 months of reusable scrub cap use, 33 participants (51.6%) reported that due to their use of a reusable scrub cap, their utilization of disposable bouffant or caps had decreased by 76–100%. This was associated with a significant reduction in the use of single-use caps after adjusting for surgical case volume. The carbon footprint of single-use scrub caps was significantly higher than reusable caps during the study period. Reusable scrub cap usage also strongly correlated with substantial reductions in energy consumption and freshwater toxicity.
Conclusions
Reusable personalized cloth scrub caps are cost-effective and can help reduce surgery’s carbon footprint by reducing waste generated from disposable scrub cap use. More programs should consider replacing single-use polypropylene caps with reusable scrub caps for their operating room staff.
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Funding
DA was supported by a grant provided by the Blair and Georgia Sadler Fellowship at Health Care Without Harm, as well as a Center of Expertise: Diversity, Equity, and Inclusion Research Grant from the Mass General Brigham Office of Graduate Medical Education. We thank MedHezz Surgical Designs (Calgary, Canada) for their assistance with manufacturing the reusable scrub caps used in this project. We are also grateful to Charlene Poillucci, Material Supply Supervisor at MGH, for assistance with data acquisition.
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Concept and design: all authors. Acquisition, analysis, or interpretation of data: Agarwal and Slutzman. Drafting of the manuscript: Agarwal, Bharani, and Armand. Critical revision of the manuscript for important intellectual content: Agarwal, Bharani, and Slutzman. Statistical analysis: Agarwal, Slutzman. Administrative, technical, or material support: Armand, Slutzman, and Mullen. Supervision: Mullen.
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Agarwal, D., Bharani, T., Armand, W. et al. Reusable scrub caps are cost-effective and help reduce the climate footprint of surgery. Langenbecks Arch Surg 408, 358 (2023). https://doi.org/10.1007/s00423-023-03107-9
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DOI: https://doi.org/10.1007/s00423-023-03107-9