Opinion

Taking out the Trash in a Pandemic

PhD researcher Babet de Groot reports on the increasing demand for personal protective equipment in Australia and why incorrect waste management and disposal is potentially just as much a threat to our health as the virus itself.

Image via Unsplash, by Barthelemy de Mazenod

Until recently, the curbside collection, management and disposal of municipal solid waste was a rather unremarkable aspect of daily life. Since the government advised Australians to stay home to curb the spread of COVID-19, however, our weekly #BinIsolationOuting is more important than ever.1 For some, it has become the highlight of the week, but taking out the trash is now especially important for other reasons – to minimise the secondary impacts of infected and non-infected medical waste on human health and the environment.

The pandemic response effort has increased the need for gloves, medical masks, goggles, face shields, gowns, aprons and other personal protective equipment (PPE). PPE is an essential resource for the protection of frontline respondents to the COVID-19 pandemic, specifically healthcare and support staff, and other hospital patients. Use has increased among essential workers employed in supermarkets, pharmacies, shipping and public transport. PPE demand has also increased as the result of panic buying, hoarding or misuse.2

The World Health Organisation (WHO) advised governments and industry to increase PPE manufacturing by 40% to meet rising global demand.3 In Australia, more than 130 companies responded to the federal government’s call to boost PPE production after reports that medical staff were going to extraordinary lengths to conserve stocks.While governments and industry focus on meeting the growing demand for PPE, little thought has gone into the responsible management and disposal of infected and noninfected waste. Biomedical and healthcare waste, known as clinical waste in Australia, requires appropriate collection, separation, transportation, treatment and disposal by specialised workers with the appropriate disinfection, protection and training.It cannot simply be thrown in the trash.

“While governments and industry focus on meeting growing demand for PPE, little thought has gone into responsible management and disposal […]. Biomedical and healthcare waste cannot simply be thrown in the trash.”

The appropriate disposal of medical waste is paramount to minimise the risk of secondary impacts on human health and the environment. Medical waste can cause secondary infection in hospital patients, health workers and the general public. Treatment of this waste also has inherent risks, such as toxic exposure to pharmaceutical products or chemicals used in sterilisation and air pollution from incineration. The mismanagement of medical waste can result in the contamination of waterways used for drinking and aquaculture by leachate (a mineral-rich solution resulting from the percolation of water through landfill).6 These chemical substances may bioaccumulate up the food chain with severe spill-over effects in humans ranging from antibiotic resistance to toxicity.7

Further issues arise as a result of PPE consisting predominately of single-use plastic. While plastic’s cost, flexibility and durability are key to its utility for healthcare and combatting the COVID-19 pandemic, these qualities also pose environmental challenges. Plastic is virtually indestructible and persists in the environment indefinitely. It ends up in the ocean, with 80% of the estimated 60.4 million tonnes of debris discharged annually stemming from land-based sources.Plastics pose a hazard to marine biodiversity. Animals risk entanglement in or ingestion of plastic marine debris, in the latter case resulting in distress from the obstruction of the digestive tract and eventual starvation.Over time, marine plastic debris photodegrades into smaller particulates that are ingested by sea life and end up as an unexpected, undetectable ingredient in your lunchtime sushi.10

While the COVID-19 pandemic is prevalent across the globe, the adverse impacts of mismanaged waste may not be distributed evenly. The Basel Convention on the Control of Transboundary Movements of Hazardous Waste and their Disposal is a comprehensive intergovernmental environmental agreement that arose from public resistance to hazardous waste disposal – ‘Not in My Back Yard’ syndrome – in the 80s.11 It reminds us that waste management and disposal is an environmental justice issue that may have disproportionate implications based on race, colour, national origin or income. The Basel Convention advises against the disposal of PPE in household waste streams, stating that medical waste resulting from COVID-19 must be stored separately and collected by specialist municipality or waste management operators.12

Appropriate waste management and disposal is especially important during the COVID-19 pandemic. High-income countries generate an average of 0.5kg of hazardous waste per hospital bed per day.13 Increasingly, less severe cases of COVID-19 are being treated through outpatient care where the specialised knowledge of medical waste management is not as widely available. UN Environment has urged governments to treat waste management, including household, medical and other hazardous waste, as an urgent and essential public service.14 This is essential to minimise the possible secondary impacts on human health and the environment. Despite waste management being a virtually invisible service beyond our weekly #BinIsolationOutings, we must take a moment to reconcile that the safe handling and final disposal of PPE and other medical wastes is a vital element in our pandemic emergency response.

References
1.Butler, J. and Donaldson, A. (2020). ‘Aussies dressing up for bin night is the most exciting time of the week’. April 15. 
2. WHO. (2020). Shortage of personal protective equipment endangering health workers worldwide [Press release]. World Health Organization. March 3.
3. WHO. (2020).
4. Knaus, C. (2020). ‘More than 130 Australian companies ready to boost PPE stock of coronavirus masks, gowns and gloves’. The Guardian. March 23. 
5. WHO. (2020b). Health-care waste. World Health Organization.
6. Allaby, M. (2013). Leachate [Reference Entry]. In A Dictionary of Geology and Earth Sciences. (4 Ed). Oxford University Press.
7. WHO. (2020). Health-care waste. World Health Organization.
8. UNEP (2005). Marine Litter: An Analytical Overview. United Nations Environment Programme.
9. Andrady, A. L. (2015). Plastics in the oceans. In Plastics and environmental sustainability. John Wiley & Sons, Incorporated. 
10. Andrady (2015); Watts, J. and Harvey, F. (2018). ‘Microplastics found in human stools for the first time’. The Guardian. October 23. 
11. Basel Convention, Secretariat. (2011). Overview. Basel Convention.
12. UNEP. (2020). Waste management an essential public service in the fight to beat COVID-19 [Press release]. United Nations Environment Programme.
13. WHO. (2020).
14. UNEP. (2020).


Babet de Groot is a PhD Candidate in the Department of Government and International Relations at the University of Sydney. Her current research focus relates to ocean governance and waste management, specifically marine plastic debris accumulated in ocean gyres, such as the Great Pacific Garbage Patch


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