About a month ago, I was running on the treadmill at my local gym when the TV screen in front of me displayed the ad slogan: “30 minutes on a treadmill, forever in a landfill.” I looked over at my plastic bottle of water—guilty as charged.

About a month ago, I was running on the treadmill at my local gym when the TV screen in front of me displayed the ad slogan: “30 minutes on a treadmill, forever in a landfill.” I looked over at my plastic bottle of water—guilty as charged.

Since then, I’ve had waste management on my mind quite a bit. From my own wasteful practices of which I’ve become painfully aware, I have also been doing research, interviews and reading on waste management in the OR and the effect waste has on the environmental footprint of the surgical suite for upcoming “Going Green” editorial in Surgical Products.

In doing this research I found some interesting statistics related to waste management in the United States. According to the Clean Air Council:

  • In the U.S., 4.39 pounds of trash per day and up to 56 tons of trash per year are created by the average person.
  • Only about one-tenth of all solid garbage in the United States gets recycled.
  • Each day the United States throws away enough trash to fill 63,000 garbage trucks.
  • Every year, Americans make enough plastic film to shrink-wrap the state of Texas.
  • Each year, Americans trash enough office paper to build a 12-foot wall from Los Angeles to New York City.

What’s more, an article from Medscape Anesthesiology reports that waste generated by the operating room is even more extreme. “In fact, a routine operation in a hospital often produces more waste than a family of 4 might produce in an entire week,” the article says.

The article cites the need for absolute sterility as a main reason for so much waste in the OR. Sterility of surgical supplies and equipment requires extra packaging, as well as the use of disposable equipment.
Check out these other astounding numbers the article reveals in regards to OR waste:

  • A study nearly 2 decades old performed at a 385-bed private teaching hospital found that 6.6 kg of waste was generated per patient per day, and estimated that 41 tons of operating room waste (compared with 11 tons from the wards) could be saved if reusable alternatives were available [1].
  • The main components of hospital waste include plastics (46 percent), paper (34 percent), liquids (12 percent), glass (7.5 percent), metals (0.4 percent), and anatomic waste (0.1 percent) [2].
  • Anecdotal reports in the U.S. estimate that operating rooms generate 20 percent-33 percent of total hospital waste [3,4], even though the surgical suite represents a proportionally smaller area of the hospital.
  • Surgical waste does not just involve packaging and intentionally disposable supplies, but can also involve more costly medical devices. A study of joint replacement surgery found that the knee or hip implant, each of which may cost thousands of dollars, was wasted in 2 percent of the procedures [5]. Reasons for the waste include improper trialing, failure to check implant size and model before opening the package and dropping the implant.

In recent years, solutions to help the OR reduce waste have advanced tremendously. Paperless surgical information systems allow hospitals to maintain records without using massive amounts of paper. LED lighting provides an energy-efficient lighting solution that also helps reduce waste associated with bulb replacement. More and more surgical equipment can now be reused, thanks to energy-efficient sterilization equipment and solutions. Equipment that cannot be reused is being manufactured with eco-friendly material and packaging from recycled content.

Environmentalism is more than a consumer trend to make the treadmill-runner with the plastic bottle water feel guilty. It’s a serious concern in today’s society and rapidly becoming an important issue in the surgical suite, as well. The sheer amount of waste generated in the surgical suite is costly both financially and environmentally to a hospital and its surgical department. Hospitals must look at the multitude of solutions being developed to help hospital and surgical professionals reduce waste in the OR and move forward in the effort to “go green.”

What is your facility doing to "be green?" Tell me about it at

Study references:

  1. Gilden DJ, Scissors KN, Reuler JB. Disposable products in the hospital waste stream. West J Med. 1992;156:269-272.
  2. Liberti L, Tursi A, Costantino N, et al. Optimization of infectious hospital waste management in Italy. Part I: Waste production and characterization study. Waste Management and Research. 1994;12:373-385.
  3. Goldberg ME, Vekeman D, Torjman MC, et al. Medical waste in the environment: do anesthesia personnel have a role to play? J Clin Anesth. 1996;8:475-479.
  4. Tieszen ME, Gruenberg JC. A quantitative, qualitative, and critical assessment of surgical waste. Surgeons venture through the trash can. JAMA. 1992;267:2765-2768.
  5. Zywiel MG, Ulrich SD, Suda AJ, et al. Incidence and cost of intraoperative waste of hip and knee arthroplasty implants. J Arthroplasty. 2009 May 14.

“Wastage of Supplies and Drugs in the Operating Room.” Roy K. Esaki, MD; Alex Macario, MD, Medscape Anesthesiology.

Clean Air Council,