Environmental impacts: podiatry practice waste

In March 2023 the Intergovernmental Panel on Climate Change (IPCC) released its Sixth Assessment Report. This sobering report highlighted that the findings of previous reports are not being heeded. It presents unequivocal evidence that human activities such as unsustainable energy and land use and land-use change, our lifestyles and patterns of consumption and production are the reason Greenhouse Gas Emissions (GHG_e) continue to rise.^[1]

Across the previous decade, between 2011-2020, the global surface temperature was 1.1^[0]C higher than for the decade 1850-1900.^[1] As GHG_e continue to rise, so do the health impacts of the resultant climate change.^[2] The growing ecological crisis is a global health crisis. Unfortunately, the health care sector is contributing to the problem.^[3] In 2014, the global healthcare sector contributed 4.4% of total global emissions or 2 gigatonnes of CO₂e which is the equivalent of the annual GHG_e from 514 coal-fired power stations.^[4] As the report states, “If the health sector were a country, it would be the fifth largest emitter on the planet.”^{[4][, p.17  ]}In the Health Care Without Harm (HCWH) and ARUP report, ‘Global Roadmap for Healthcare Decarbonization’^[5] Australia’s healthcare sector ranked 12^[th]  for gross emissions and 3^[rd] for emissions/capita out of the 68 countries studied based on 2014 data.^[6]

These data present a very strong argument for the Australian healthcare sector to take urgent action to reduce its emissions. All health professionals, including podiatrists, have a responsibility to play their part in reducing the carbon footprint of their practice.

Some of the areas where podiatrists can reduce the carbon footprint of their practice include the following:

• Energy – reduce energy from fossil-fuels (energy efficiencies) and increase use of clean energy sources such as solar if possible:
  • Turn computers off at wall at night
  • Energy efficient lighting
  • Keep air conditioner at optimal 23^[0]C
• Reduce emissions from transport to and from work, for example walk, cycle, or use public transport
• Participate in community events such as charity walks and running events
• Reduce printing and paper use
• Reduce plastic use
• Staff catering:
  • Refuse plastic cutlery with takeaway food; instead, eat in staff tearoom with metal cutlery or use your own cutlery set. Portable cutlery sets are available in stores such as Biome.
  • Have a food composting pail to collect food waste – ask a staff member with a composting system at home to take this waste daily.
  • Encourage your team to use KeepCups (or equivalent) and reusable water bottles to reduce the volume of disposable coffee cups and plastic water bottles.
  • Reduce the use of food wraps such as clingfilm and other food packaging waste.
  • Make considered purchasing decisions around the purchase of food, staff uniforms and so forth. Consider supply miles, ethical labour and land use.
• Orthotics: the manufacture and disposal of orthotics is a large contributor to podiatry’s carbon footprint. Consider orthotic suppliers who are embedding sustainability into their business practices. One such company is iOrthotics.
• Environmentally responsible waste handling across all waste streams.

Waste

Waste is an area where health professionals can make significant reductions in their practice emissions. By considering the waste hierarchy (Fig. 1) podiatrists can explore opportunities for more sustainable waste handling.

Fig. 1 Waste Hierarchy

Podiatry practice waste streams and their CO₂e

The various waste streams generated in a podiatry clinic are depicted in Table 2 with the CO₂e generated if disposed of in either the clinical waste stream or the general waste stream.

Table 1: Podiatry practice waste streams and CO₂e generated from disposal

Note: CO₂e data obtained from National Greenhouse Accounts Factors: 2022

Many of the podiatry waste streams and their disposal are health sector-wide issues which require a national waste solution strategy (such as single-use stainless steel surgical implements and Kimguard waste). Until such a strategy is in place, some suggestions for alternative disposal are provided in Table 2.

Some of these strategies will not only reduce emissions but reduce waste collection fees. For example, the clinical waste stream is for the disposal of infectious waste – waste that is not contaminated with body fluids could be disposed of in landfill to reduce both emissions and dollars.

Table 2: Suggestions for reducing CO₂e from podiatry waste streams

As health practitioners we may not think that reducing the CO₂e from our practice will make much of a difference to the current global warming crisis. However, if every one of us takes on a sustainability mindset in our health care delivery and makes small changes where possible, the benefits are cumulative. Together, we can all make a difference to the planet.

References

^[1] Intergovernmental Panel on Climate Change (IPCC). IPCC, 2023: Summary for Policymakers. In: Lee H and Romero J, (eds.). Climate Change 2023: Synthesis Report Contribution of Working Groups I, II and III to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change. Geneva, Switzerland: IPCC, 2023, p. 34.
^[2] Romanello M, McGushin A, Di Napoli C, et al. The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future. The Lancet (British edition) 2021; 398: 1619-1662. DOI: 10.1016/S0140-6736(21)01787-6.
^[3] Karliner J, Slotterback S, Boyd R, et al. How the Health Sector Contributes to the Global Climate Crisis and Opportunities for Action. Health Care Without Harm (HCWH) and ARUP 2019.
^[4] Health Care Without Harm (HCWH) and ARUP. HCWH and ARUP Road Map for Health Care Decarbonization – Introduction, https://healthcareclimateaction.org/sites/default/files/2021-04/HCWH%20Road%20Map%20for%20Health%20Care%20Decarbonization%20-%20Introduction.pdf (2019, accessed 15 September 2023).
^[5] Health Care Without Harm (HCWH) and ARUP. Global Road Map for Health Care Decarbonization: A navigational tool for achieving zero emissions with climate resilience and health equity, https://healthcareclimateaction.org/roadmap (2021).
^[6] Health Care without Harm and ARUP. Australia – Health Sector Emissions Fact Sheet. Global Road Map for Health Care Decarbonization. Health Care Without Harm, 2021.