Even the most basic plastic products can yield profound benefits. In Africa, for example, the introduction of a simple plastic bucket relieves substantial hardships for some of the world’s poorest people. Stephen Fenichell in Plastic: The Making of a Synthetic Century, explains:
You cannot survive in the tropics without water; the shortages are always acute. And so water has to be carried long distances, frequently dozens of kilometers. Before the invention of the plastic bucket, water was carried in heavy vats made of clay or stone. The wheel—and vehicles that use it—was not a familiar aspect of African culture; everything was carried on the head including the heavy vats of water. In the division of household labor it was the woman’s task to fetch water. A child would have been unable to lift a vat. Acute poverty meant that few households could afford more than one vat.
The appearance of plastic buckets was a miracle. To start with, it is relatively cheap (although in some households it is the only possession of value), costing around two dollars. And it is light. And it comes in different sizes: Even a small child can carry a few liters. Now it’s the child’s job to fetch water. Flocks of children playing and bantering on the way to a distant well are common. What a relief for the overworked African woman!
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Plastics Are Essential to Modern Medicine. The number of plastic products on which medical professionals rely is vast. Without them, medicine would be less advanced, more expensive, and less accessible to many people. Other materials, including various metals, also play a role, but plastics have become indispensable to medicine. Plastics’ light weight and durable attributes make them particularly valuable for home health applications that rely on portable equipment.[9]
Specifically, plastics compose, or are part of, many vital medical products, including:
Machinery such as magnetic resonance imaging scanners, mammography machines, and X-ray equipment;
Devices used inside or connected to the human body such as pacemakers, stents, and prosthetic limbs; and
Basic yet essential items like tubing, IVs, blood bags, gloves, masks, hospital gowns, catheters, and much more.
Plastics are also critical to many medical breakthroughs, such as 3-D printers that now make it possible for medical institutions to meet essential needs on demand, including the manufacture of custom prosthetics. In his book, Plastics, Norman Finkelstein highlights many other such inventions. He notes, for example,
how blood-clotting plastic bandages quickly halt bleeding in an emergency. These are particularly valuable for soldiers because, in the past, “about 50 percent of those who died on the battlefield” would bleed to death in a matter of minutes. “Today, new blood-clotting plastic bandages save battlefield lives,” he notes.[10] Finkelstein also highlights a product known as the Plasti-Bone that can replace and help regenerate bones lost to injury. It is a porous material through which the attached bone will grow and eat through, until a new natural bone takes the Plasti-Bone’s place.[11]
Plastics also help make medicine more affordable and accessible to a larger share of the population by allowing for considerable cost savings. And plastics, thanks to their flexible nature, allow for innovation in product design and manufacturing. They can be easily and affordably molded into many complex instruments, devices, and components of medical equipment. As Bayer Materials Engineering Manager Mark Yeager explains in Design News:
Injection molding can economically produce millions of identical parts with complex geometries. For this reason, plastics have already displaced metal in a wide array of applications in which the high cost of metal fabrication is prohibitive.[12]
Yet, environmental activists continue to push for regulations and advocate the elimination of many medical-related plastic products. Worse, they routinely second-guess the expertise of medical professionals regarding the value of such products, claiming that plastics use is excessive, and they target single-use plastics in particular.
For example, just a few months before the world learned about COVID-19, activist Gary Cohen downplayed the value of sanitary single-use medical supplies. Cohen, the president of Green Practice Health, a left-of-center group designed to pressure medical facilities to reduce the use of plastics, once called the trend toward single-use devices an “overreaction” to the AIDS crisis.[13]
Patients whose lives are at risk from hospital-acquired infections might not consider it excessive to rely on some single-use sanitary products as part of their treatment.
Hospitals are chock full of infectious agents because, after all, they are places where sick people congregate. “If you’re sick, then the hospital is often the last place you want to be,” notes reporter Jon Evans in Plastics Engineering. Disposable products are a critically important tool in reducing the spread of such infections.[14]
According to the U.S. Centers for Disease Control and Prevention (CDC): “On any given day, about one in 31 hospital patients has at least one healthcare-associated infection.”[15] Similarly, the European Center for Disease Prevention and Control estimates that 25,000 people die annually in Europe as a result of hospital acquired infections, while 100,000 Americans die from such infections in the United States.[16]
The risks of hospital-acquired infections may also substantially contribute to deaths during pandemics because of higher admissions, overworked staff, and supply shortages. One research report published in April 2021 found a high number of intensive care unit-acquired infections among a large sample of critically ill COVID-19 patients in Italy. The authors noted:
The incidence of infectious complications was very high, with almost half of the patients experiencing at least one infectious episode during the ICU stay. Specifically,
14 days after ICU admission, the probability of having an infection was more than 40%.[17]
In addition, COVID itself became a hospital-acquired infection for patients admitted with other ailments. The scope of the problem in the United States is not clear because the
CDC has not released data related to hospital-acquired COVID infections, and U.S. nursing facilities are not required to report such data.[18] However, there are indicators that the problem is substantial.
Medical researchers estimated in January 2021 that reports from several different hospitals, around the world and in the United States, indicated that “the hospital-acquired SARS-CoV-2 infection rate is 12–15%.”[19] According to data from Britain’s National Health Service, as reported in The Guardian, 40,000 people contracted COVID in British hospitals during just the months between August 1, 2020 and February 21, 2021.[20]
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Similarly, “conservation strategies”—such as reuse of personal protective equipment because of supply shortages during the COVID-19 outbreak—may have contributed to the doubling of Candia auris infections in Southern California hospitals during May and June of 2020.[26]
Despite these realities, activists actually use the pandemic as an excuse to advocate elimination of single-use plastics in hospitals because of increased waste related to masks and other single-use products. They ignore the value that such single-use materials provide, and they second-guess the decisions of medical professionals who are closer to the situation and have a better understanding of the implications. The fact that shortages—and inappropriate reuse of certain supplies—contributed to COVID transmission underscores the reality that single-use products are essential to reducing the hospital-acquired infections.
For example, something as simple as a single-use syringe has proven critically important to public health, which is why the CDC says syringes should never be reused.[27] Cases where misguided medical professionals have reused syringes have transmitted deadly diseases like Hepatitis C[28] and AIDS,[29] as well as other illnesses. As USA Today reported in 2012:
Since 2001, more than 150,000 patients nationwide have been victims of unsafe injection practices, and two-thirds of those risky shots were administered in just the past four years, according to data from the U.S. Centers for Disease Control and Prevention. The errors led to at least 49 disease outbreaks, a USA TODAY examination shows, and a trail of victims suffering with potentially life-threatening bacterial infections, such as MRSA, and sometimes fatal viruses, such as hepatitis.[30]
Those 150,000 cases could have been avoided had medical personnel used a new syringe every time.
While few people might openly advocate for reusable syringes, the all-out assault on plastics could eventually undermine the availability and affordability of disposable syringes. In fact,
provisions of the proposed Break Free from Plastics Act could shut down U.S. plastics facilities and produce serious medical supply shortages that would force hospitals to reuse syringes.[31] Disposable syringes also underscore the value that disposable products play in preventing unnecessary illnesses in hospitals.
Rather than curb the use of plastics, particularly single-use ones, medical institutions should seek to expand their use. “Growing concerns about hospital-acquired infections make single-use instruments increasingly attractive,” notes a materials science expert with Bayer. “
When you consider the high cost of treating infections, switching from reusable metal instruments to pre-sterilized plastic versions can actually reduce costs by eliminating one potential source of cross-infections,” he notes.[32]
Something as simple as more frequent use of plastic sheeting to cover certain instruments can help make them safer. For example, in 2015 a metal endoscope exposed 200 patients to an antibiotic-resistant bug, leaving two people dead, yet a simple disposable plastic sheath could have been used to prevent those infections.[33]
Similarly, infection risks can be reduced by increased reliance on single-use tourniquets—the plastic bands that wrap around a patient’s arm to make veins more visible for taking blood or administering intravenous medicines.
A 2012 study sampled reusable hospital tourniquets and found that 36 percent were contaminated with Staphylococcus aureusand 12 percent contained MRSA. They concluded: “The introduction of disposable tourniquets to clinical practice should be an adjunct to current measures for MRSA prevention.”[34]
Even component parts of reusable equipment can be outfitted with disposable elements to help reduce disease transmission. One study points out that the lead wires that are attached to patients during electrocardiograms cannot be sufficiently sterilized. The authors recommend disposable wires to “eliminate risk of infection through these pathways” and “decrease infection rates in acute health care facilities.”[35]
Blue wrap—another product activists advocate replacing with reusables—offers another example of single-use plastics’ valuable role in medicine.[36] Blue wrap is a plastic wrap that keeps medical tools and equipment sterile during transportation and storage that has proven to be highly effective at preventing dangerous contamination.
One study comparing rigid, reusable containers and blue wrap found that blue wrap performs substantially better at controlling pathogenic contamination. It notes:
Of 111 rigid containers tested, 97 (87%) demonstrated bacterial ingress into the container. Of 161 wrapped trays, 0 (0%) demonstrated bacterial ingress into the tray. Contamination rates of rigid containers increased significantly with increasing duration of use. … In this study using a dynamic bacterial aerosol challenge, sterilized wrapped trays demonstrated significantly greater protection than sterilized rigid containers against the ingress of airborne bacteria.[37]
Phillip Van Gorp, a sterile processing manager for the Clinics and Surgery Center at the University of Minnesota Medical Center, explained additional difficulties associated with the reusable equipment storage containers. They take up much more space and they create a “decontamination backlog” because medical staff must disassemble and sterilize them between uses. Then staff must reassemble and inspect the containers before they can store instruments. After all that effort, “the better part of an hour has gone by,” while the wrap takes three or so minutes to wrap instruments. But in the final analysis, he notes, “the real argument is one of safety.”[38]
In addition, some single-use and reusable plastics are now being made with antimicrobial attributes that resist the spread of diseases.[39] For example,
one company has developed a plastic coating for medical instruments that eliminates microorganisms that come into contact with the instrument before they can infect a patient.[40]
Clearly, plastics are essential to modern medicine.
Environmental activists’ attempts to ban or limit their use present a serious threat to public health. Pandemic-related shortages were bad enough; the reckless elimination of such single-use and other plastic products for political reasons would actively facilitate the spread of deadly hospital-acquired infections.