Opportunities for Improving Sustainability in Healthcare Packaging

From disposable plastic syringes and IV bags, to tubes and sterile barrier trays, use of plastics have played a significant role in the evolution of the healthcare industry. In fact, modern healthcare would look much different than it does today without the use of plastics and the wide range of products produced from plastic materials. As the healthcare industry continues to evolve, the versatile nature of plastic materials have allowed products to adapt along with this dynamic industry delivering benefits including sterility, quality, durability, and most importantly, safety for both patients and healthcare workers.

However, despite the many benefits, there are also unintended environmental consequences with single-use plastics in healthcare, namely the waste that they create. The Healthcare Packaging Recycling Council cited that over 32 billion pounds of healthcare plastics were produced globally in 2020, and this number was projected to grow to 48 billion pounds by 2025, most of which is being disposed in landfills or incinerated. However, 80-85% of this material is uncontaminated and non-hazardous, and therefore recyclable in theory. 

Faced with mounting public pressure and increasing environmental concerns regarding single-use plastic waste, stakeholders across the broader packaging industry are setting goals and targets to improve the sustainability of packaging solutions and the healthcare packaging industry is no exception. However, when it comes to healthcare packaging, this becomes a balancing act because while organizations set goals to deliver greater sustainability, product protection and patient safety must always take priority. As a result, the industry has been behind the curve when it comes to sustainability initiatives. But sustainability is no longer a trend and is essential for organizations to consider along with the stringent list of other specifications with patient safety as the top priority.

The challenge then becomes, how do we design healthcare packaging in a way that delivers improved sustainability and recyclability, while continuing to prioritize patient safety and product protection?

The undertaking of implementing sustainable solutions across the healthcare packaging industry is a huge challenge, not just because of the stringent list of application requirements, but because of the industry's dependence on single-use plastic products and the integral role they play in patient safety. While true that these products generate a significant amount of waste, we cannot ignore the extensive list of benefits single-use plastic products provide from a patient safety perspective from reducing the risk of infection, to lowering the chance of cross contamination, and allowing for the delivery of life-saving medicines and medical devices to individuals across the globe. Ultimately, regardless of sustainability goals the packaging cannot fall short of serving its intended purpose or compromise on safety and regulatory expectations.

Choosing the right healthcare packaging material and design is therefore critical to ensuring patient safety, performance, sterility and effectiveness until the point of care - and any changes made in the name of sustainability must adequately balance all of these needs and requirements. Using the Three R's as a starting point, medical device and healthcare packaging organizations can look at several viable strategies to meet sustainability demands without sacrificing critical specifications:

1. Use innovative materials to enhance RECYCLING:

Design & redesign of packaging solutions using recyclable materials is key to delivering sustainable packaging in medical, pharmaceutical & healthcare packaging applications. Of course, this is easier said than done, as there are a list of concerns & specifications regarding safety, regulatory, packaging integrity, performance and compatibility with packaging & sterilization processes that must be addressed. In addition, medical OEMs may be hesitant to consider alternative materials due to the stringent specifications, no-change provisions and arduous qualification and validation process required for healthcare packaging materials.

While certain material solutions such as compostable packaging or glass may not hold up to safety and regulatory requirements for healthcare packaging, alternative plastic materials can provide enhanced sustainability without sacrifice to key requirements. Transitioning to a solution that is recyclable as well as compliant with all requirements & specifications can go a long way in helping organizations achieve their sustainability goals and targets, particularly when you consider that 85% of plastic waste generated from healthcare environments is non-hazardous, and could therefore be recycled if designed appropriately.

Looking at ways to reduce packaging complexity through the use of mono-material solutions can also contribute to improved recyclability. Ultimately, materials used in healthcare packaging were designed to perform a specific function, which sometimes requires the combination of multiple materials to achieve a desired specification that would extend beyond the capabilities of any one material. However, this is often-times in direct conflict with sustainability ambitions because combining materials can often render the packaging non-recyclable. Similarly, use of pigments and colorants can render the packaging non-recyclable depending on the polymer.

While much needs to be done to address the logistics of recycling within the healthcare packaging ecosystem, selecting materials with a favorable recycling outlook within the ever-changing system, as well as avoiding materials labeled as "problematic or unnecessary" for recycling will increase the likelihood that packaging solutions will be recycled in the future. In addition, looking to organizations such as How2Recycle that provide guidance on the recyclability of packaging solutions based on a number of factors will give your packaging the best chance of being recycled at scale moving forward. For example, How2Recycle downgraded rigid PS (including HIPS) to "Not Yet Recyclable" in 2021 following an assessment of the recycling volume in the US, viability of end-use markets and outlook for the material to be recycled at scale. While an excellent material from an efficacy and product protection standpoint, use of HIPS in medical packaging applications moving forward is in direct conflict with packaging sustainability initiatives. Therefore, transitioning healthcare packaging solutions out of HIPS into a material with a more favorable outlook for recyclability in the future including PP or clear PET could be the difference between millions of pounds of packaging being recycled in a closed-loop system versus sent to a landfill. Considering the arduous validation process for medical packaging, maintaining performance requirements of materials at all stages of the packaging manufacturing supply chain to the point of care, while meeting all requirements and specifications in between will be key.

2. Examine ways to REDUCE plastic consumption:

When looking to improve the sustainability of healthcare packaging solutions evaluating ways to reduce overall plastic consumption is important. If you plan to change materials, selecting a polymer with a lighter weight in comparison to alternatives can make a significant impact. Individual materials carry a specified density & weight which directly contributes to the consumption of one material vs another. Polypropylene, for example is the lightest with a density of 0.91, compared to a density of 1.33 for PET/PETG and 1.04 for HIPS. This density reduction can also result in a higher yield (more parts) during thermoforming processes thus contributing to a more efficient use of resources:

Use of a lighter weight material can also contribute to a reduced carbon footprint resulting in less solid waste by weight, less CO2 equivalents by weight, and fewer emissions. However, as previously noted, a switch to a new material cannot be done in a way that compromises essential safety, regulatory and packaging requirements and must go through all of the proper validation controls and testing to ensure specifications.

For OEM or thermoforming companies hesitant to change approved materials or for those looking to make an impact while validating a new material, down-gauging existing rollstock structures or conducting quality control audits to ensure uniform and precise gauge can help optimize your material usage in the short-term. When rollstock is produced at a higher gauge than specified, this leads to a higher quantity by weight, while inversely resulting in less formed parts. At large volumes even a small percentage can go a long way. For example, if your annual purchase quantity for a specific material is 2,000,000 pounds of rollstock per year at a target gauge of .040" Mil, if the thickness of this material increases by as little as +.001" Mil, or 2.5%, this would result in an additional 50,000 pounds of unnecessary material. Working with a supplier that is both well-versed in the requirements for healthcare packaging applications and has demonstrated precise gauge control and monitoring capabilities can therefore make a significant impact in reducing overall plastic consumption, reducing waste, and improving sustainability.

3. Consider potential for RE-USE:

Due to the stringent safety protocols put in place for medical equipment, devices and packaging designed to mitigate risk of infection and  cross contamination, it is unrealistic and unsafe to think that medical packaging will become reusable in the same way that reusable water bottles or containers are used in the food and consumer goods industry. However, reusability is an essential component to achieving industry-wide goals among the plastics industry for reduced waste and a circular economy. 

Since reusable healthcare packaging is not a viable or safe solution, designing packaging solutions using materials with a high potential for reuse in other markets can contribute to this broader goal. While it is estimated that 80-85% of plastic waste generated in a healthcare setting is non-hazardous, many of these materials are not recycled due to lack of infrastructure or incompatibility with recycling systems. Designing solutions using recyclable materials is the first step to ensuring these materials can diverted from landfills for reuse.

In addition, use of Post-Consumer Recycled (PCR) materials are becoming more prevalent among certain industries such as food and consumer goods packaging as a method of waste reduction. Use of these materials have the potential to make a significant environmental impact not just from a waste reduction perspective but also for reducing energy consumption and the extraction of finite resources. While the issue of material traceability, quality and safety poses a challenge for use of PCR materials in healthcare packaging, this doesn't mean that the availability of PCR materials shouldn't be a factor of consideration. When determining what material solution has the best potential for reuse back in the circular economy, following the investments being made to increase the availability of PCR supply will maximize the opportunity for non-hazardous healthcare packaging to be reused in the circular economy. Selecting a polymer at the design (or redesign) phase with a favorable outlook for recycling and investments in PCR solutions can help complete the circular economy "loop" in healthcare packaging when reusability or use of PCR materials may not be feasible.

To account for traceability concerns and regulations, use of post-industrial recycled materials may be a feasible option.  When the material regrinds are returned to the extruder by the medical thermoformer or OEM and kept in a closed-loop system, the post-industrial recycled material can be tracked and traced through lot numbers and re-used back into the rollstock solution up to 40% depending on the application and material solution. 

Check All the Boxes: The Perfect PS Replacement Solution

Finding a viable PS replacement material for thermoformed & form-fill-seal (FFS) healthcare packaging applications will require companies to take into account not just sustainability goals, but critical safety, regulatory and quality standards.

With these considerations in mind, ICPG has developed XPP - a material that is functional, economical & sustainable — and can be implemented as a drop-in replacement for PS utilizing existing equipment:

• Sustainable: Produced from 100% polypropylene materials, our lightweight XPP solutions reduce material consumption, offer compatibility with the Polypropylene recycling stream (RIC #5), and result in a reduced carbon footprint.
  
  
• Functional: Our XPP materials offer advanced product protection and are available in varying degrees of barrier protection. The advanced stiffness of our XPP materials mirrors PS to maintain packaging integrity and product protection.
  
  
• Compatible: XPP is a high stiffness and low-shrink material solution - which means it behaves similar to PS during processing to offer drop-in process compatibility with existing thermoforming & FFS equipment and tooling.
  
  
• Economical: The low density & lightweight nature of our 100% polypropylene solutions means reduced material consumption, increased yield, and an overall reduced cost compared to PS & PET alternatives.

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