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Single-Use PPE: Masking Greater Risks?

In May 2020, CBS and MedSupplyDrive jointly highlighted a study demonstrating that the only mask with proven efficacy against COVID-19 contamination was the FFP3 model, and that the standard surgical facemask was ‘unfit for purpose,’ as it allows unfiltered air in from either side.

Since then, the Confederation have called on Public Health bodies to support the wishes of 95% of the respondents of MedSupplyDrive’s FFP Healthcare Worker Poll, by scrapping the use of disposable surgical masks currently used across the NHS, and taking immediate action to replace them with more sophisticated re-usable and environmentally friendly industrial type masks, which have proven to be more effective, as well as 84% less expensive: an annual savings calculator offered by the manufacturer GVS showed cost savings of approximately £3,484 per frontline worker assuming each person wears 4 disposable masks per day for 1 year.

The research conducted found that in addition to the expense of single-use PPE, some surgeons face conflicting guidance. For example, in instances where trainees are working 50/50 in both academic and clinical environments: while University Campuses require the use of respirators, surgical trainees are expected to wear inadequate masks when working in NHS hospitals – muddying the waters and adding ‘noise’ to an already complex situation.

With recent data in the Lancet demonstrating that despite mass inoculation, it is likely to be a number of years before the COVID-19 virus can be brought under control, it is now not simply a matter of how and when society chooses to determine solutions to many of the environmental challenges associated with healthcare, but that we must now act urgently, in order to protect global health as well as the health of the planet. 

In England alone, 2.3 billion items of single use PPE were distributed to health and social care services between February and July 2020 - the same amount distributed throughout the whole of 2019 - while the global picture reveals an estimated 129 billion face masks and 65 billion gloves have been used every month during the COVID-19 pandemic.

While those with a vested interest in the ongoing mass production and use of single-use PPE (a market estimated to have increased from $800m in 2019 to $166bn in 2020 alone) do not seem to recognise the environmental crisis their products continue to exacerbate, many surgeons have been long raising their voices to decry the impact of single-use plastics on the planet.

Evidence of improper disposal of PPE is highly visible in both urban and rural areas, with plastic masks and gloves amassing in forests, on beaches and in ocean beds, seriously damaging the precarious balance of natural ecosystems and risking entire species.

Against the backdrop of a global pandemic, alterations to the status quo of disposable PPE might be worrisome to some members of the public (who may not be informed on sterilisation in the times before plastics), but surgeons have been raising their voices to offer their insights prior to the pandemic. 

In our January 2020 blog ‘Surgeons Meet the New Decade with 20/20 Vision,’ we noted that many surgeons-cum-environmentalists were already using their personal platforms in order to educate and to reassure the public about alternative materials and their methods of effective sterilisation – a process helping to bridge historic gaps in knowledge that might have previously and unfairly characterised Surgeons as existing in “ivory towers.” 

Not only does the future environmental picture look bleak, but there are other problems imminent in the immediate future, as Consultant Plastic Surgeon and CBS President Mark Henley has recently stated;

“Surgical face masks, gloves, and gowns are commonly manufactured from plastics that break down slowly, such as polypropylene, polyurethane, polyacrylonitrile, polyethylene, and polyethylene terephthalate. A surgical mask made from these materials could take 450 years to fully decompose. These plastics are dispersed globally by wind and ocean currents and may persist as microplastics.

Plastic pollution has substantial adverse environmental effects, including injury to wildlife (through ingestion) and toxicity to ecosystems (through release of additives or adsorbed contaminants and pathogens. The other challenge to waste management is that contaminated PPE could transmit disease.”

As always, we invite you to share your views and comments to our social media platforms @UKsurgeons; and encourage you to spread the word about CBS to encourage awareness and membership to your colleagues. For more information on becoming a CBS member, click here.

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