Hergebruik in het ziekenhuis: stappen die duurzame zorg garanderen, nu en in de toekomst
Gebruiken ziekenhuizen echt alles maar één keer? Zelfs na corona?
Je zou denken van wel. Maar dat klopt niet helemaal. Sommige materialen worden wél hergebruikt. En als we de zorg duurzamer willen maken, zou die groep van herbruikbare materialen wel eens flink kunnen groeien. Dat blijkt uit een onderzoek in samenwerking met het Universitair Ziekenhuis Gent.
Veel mensen die in de zorg werken kennen de centrale sterilisatieafdeling in een ziekenhuis, of de ‘pottenwas’ in woonzorgcentra. Dat zijn plekken waar hergebruik al lang gebeurt. Maar hoe zit het met al die andere spullen die na één keer gebruik meteen in de vuilbak belanden, bijvoorbeeld op de vele zorgafdelingen in het ziekenhuis? Gaan patiënten in Vlaanderen ooit samen met het zorgpersoneel worden aangespoord om medicatiepotjes op hun plateau niet weg te gooien.
Genomen door en met permissie van: Christophe Vander Eecken
De Green Deal en de ethiek van wegwerp
De Europese Unie heeft met de Green Deal duidelijke duurzaamheidsdoelen gesteld die ook vertaald zijn naar de zorgsector: minder uitstoot, minder verspilling van grondstoffen en dat zonder de kwaliteit van zorg te verminderen. Zorgpersoneel voelt vaak zelf al aan dat al dat wegwerp niet meer klopt. Het botst met hun ethische waarden. Door de coronapandemie en geopolitieke invloed op fossiele grondstoffen (De Russische federatie, het Midden-Oosten) wordt duidelijk hoe kwetsbaar de toelevering van wegwerpmaterialen kan zijn.
Wegwerp heeft zeker voordelen: minder juridische verantwoordelijkheid, goedkope plastic, geen dure sterilisatie en logistiek gemak. Veel medische gebruiksvoorwerpen zijn in de loop der jaren ‘wegwerp’ geworden, terwijl ze dat oorspronkelijk niet waren.
De ecologische kost van wegwerp
Wegwerpmaterialen belanden wereldwijd in zeeën, oceanen, de bodem en het grondwater met meer dan 25 000 ton extra door ziekenhuisafval tijdens de coronapandemie. In België en Europa wordt ziekenhuisafval wel strikt opgevolgd, maar ook die verwerking kost geld én energie. Wegwerpmaterialen uit het ziekenhuis worden vaak verbrand na één keer gebruik. Dat stoot broeikasgassen uit, bovndien bij productie en transport ervan in grote getallen en steeds opnieuw.
Neem bijvoorbeeld een medicijnpotje dat een patiënt bij het eten op de kamer krijgt. Het lijkt op een klein drinkbekertje, gemaakt van plastic, en bedoeld voor éénmalig gebruik. Maar jij wast je polyester trui toch ook gewoon in de wasmachine? Of je plastic drinkfles in de afwasmachine? Waarom zou dat potje dan niet hergebruikt kunnen worden?
Een alternatief: herbruikbare potjes en de desinfector
Onderzoekers van het UZ Gent en UGent gingen samen op zoek naar een herbruikbaar alternatief voor dat potje. Dat blijkt ook van plastic, maar bestand tegen hoge temperaturen en desinfectiemiddelen. Op twee afdelingen van het ziekenhuis werd een desinfector geïnstalleerd. Je kunt het zien als een soort medische afwasmachine. Daarin kunnen ook andere medische materialen worden gereinigd én ontsmet. Maar hoe beslissen we nu welke materialen te hergebruiken om de milieu impact te verlagen? Levenscyclusanalyse is een aangewezen maar uitvoerige methode die daartoe de internationale standaard volgt.
Genomen door en met permissie van: Christophe Vander Eecken
Wat is een levenscyclusanalyse eigenlijk?
Eerst wordt onderzocht hoe het product gemaakt wordt: welke grondstoffen, hoeveel energie, hoe het vervoerd wordt, en wat er gebeurt aan het einde van zijn leven. Al die gegevens worden in een model gestopt en gekoppeld aan databanken voor grondstof- en energieverbruik. Gespecialiseerde software berekent voor dat model de impact op wel 18 verschillende vlakken qua menselijke gezondheid, ecosysteemkwaliteit en grondstoffen schaarste.
Is hergebruik wel echt duurzamer?
Een logische vraag: kost dat hergebruik niet méér energie en grondstoffen dan gewoon wegwerpen? Uit een levenscyclusanalyse blijkt van niet. Als het potje minstens vijf keer wordt hergebruikt, is het in de meerderheid van milieumaten beter dan het wegwerpmodel. Denk aan:
-Minder bijdrage aan klimaatopwarming
-Minder verzuring van de bodem
-Minder gebruik van fossiele grondstoffen
-Minder fijnstof
En in de praktijk gaan die potjes vaak langer mee dan vijf keer. De kwaliteit blijft gelijk, dus de vraag is nu vooral: is het economisch en logistiek haalbaar?
Andere methodes: natte doekjes vs. desinfector
Naast de desinfector werd ook een andere methode onderzocht: het potje schoonmaken met een nat wegwerpdoekje, zoals babydoekjes maar dan speciaal voor ziekenhuizen. Maar dat bleek geen betere optie dan het wegwerppotje. De doekjes zorgen opnieuw voor wegwerp afval en verlagen de milieu-impact bijgevolg niet.
Recyclage? Nog niet aan de orde
Recyclage van de potjes, herbruikbaar of wegwerp, is momenteel niet voorzien in het ziekenhuisprotocol. Het gaat namelijk niet om verpakkingsmateriaal. En zelfs als het gerecycleerd zou worden, is het onwaarschijnlijk dat het plastic opnieuw in medische producten terechtkomt.
Conclusie: hergebruik is een kans voor duurzame zorg
Het onderzoek toont aan dat hergebruik in ziekenhuizen niet alleen mogelijk is, maar ook milieuvriendelijker kan zijn. Zeker als we slimme keuzes maken over materialen en methodes aan de hand van wetenschappelijk onderbouwde analyses. De desinfector is een goed voorbeeld van hoe technologie kan helpen om de zorg duurzamer te maken, zonder in te boeten op kwaliteit en veiligheid.
Een vooruitblik
Toch is hergebruik niet zomaar vanzelfsprekend. Tijdens het pilootproject gingen nog veel potjes verloren, vaak omdat ze per ongeluk in de vuilbak belandden. Er is nog geen algemene reflex bij zorgpersoneel en patiënten om ze apart te houden. Als het duidelijker wordt dat deze potjes géén wegwerpmateriaal zijn, zal dat waarschijnlijk verbeteren. Maar het roept ook vragen op: in hoeverre kan je van een zieke patiënt verwachten dat die hier bewust mee omgaat? Anderzijds: als we vandaag geen stappen zetten om ons grondstoffenverbruik te beperken, riskeren we dat toekomstige generaties tekorten in de zorg zullen ervaren. Zoals Brundtland het verwoordde: duurzame ontwikkeling betekent dat we in onze eigen behoeften voorzien, zonder die van toekomstige generaties in gevaar te brengen. Hergebruik in de zorg is dus niet alleen een technische of logistieke uitdaging, maar ook een kwestie van waarden en keuzes. Daarom is het project ook ondersteund door Vlaanderen Circulair.
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