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NUH leads in landmark move to recycle used IV fluid bags


Breaking new ground in sustainable healthcare, the NUH spearheads a first-of-its-kind recycling initiative by repurposing used IV fluid bags to create everyday items.
Issue 1 | June 2023

NUH leads in landmark move to recycle used IV fluid bags

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While swapping out plastic bags for reusable ones in grocery shopping seems like a straightforward step, minimising single-use plastic in healthcare is more challenging - especially given its role in infection prevention and control.

Over 25 per cent of general hospital waste is derived from plastics, posing a considerable environmental burden. Nonetheless, there is a silver lining to this - the very prevalence of single-use plastics suggests ample opportunities for recycling.

Drawing on her experience working in hospitals in Australia, Dr Andrea Yap, a consultant in the Department of Anaesthesia at the National University Hospital (NUH), suggested that the hospital could start by recycling its intravenous (IV) fluid bags, which produce roughly 24 tonnes of waste each year.

These IV fluid bags are common single-use plastic items in healthcare, used for keeping patients hydrated, managing their blood pressure, and administering necessary medication or nutrients. They are primarily composed of polyvinyl chloride (PVC), one of the most widely used plastic material that is also fully recyclable.

Determined to make a change

Though her idea was first met with scepticism, Dr Yap was driven by her commitment to sustainable healthcare. She reached out to various recycling companies, providing them with samples and aiming to demonstrate that IV fluid bags can be recycled.

"It's important for us to rethink how we use and dispose of our plastic waste both in the hospital and at home. Most of the waste in Singapore is incinerated, and Semakau Landfill is estimated to reach capacity by 2035," says Dr Yap. "We have started exploring ways to reduce, reuse and recycle our plastic waste in NUH to maintain sustainability in the healthcare system, without compromising on patient care."

Her steadfast efforts finally paid off in October 2022 when a local recycling company confirmed that the hospital's IV fluid bags were indeed recyclable. The company agreed to ship the used bags to Vietnam for recycling, due to lower labour and processing costs in the country. It was a landmark moment in the pursuit of sustainable healthcare.

A pilot was started in the operating theatres in November 2022 before expanding to all of the wards in NUH by February 2023. Since November, NUH has recycled almost 600 kg of PVC waste, saving a total of 7,179 kg of CO2 emissions - equivalent to driving 37,392 km by car! The used bags will be transformed into everyday items such as plastic bags, cable covers and garden hoses.

Recycle used IV fluid bags
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While the objective is to recycle as many used bags as possible, approximately 20 per cent are not suitable due to potential contamination with infectious or biohazardous material. This cautious approach is crucial to maintaining the sterility of medical equipment.

"Safety is always our number one priority - IV fluid bags earmarked for recycling must be free from contamination," says Dr Bryan Ng, head and senior consultant at the Department of Anaesthesia at NUH.

Team effort to drive progress

The NUH team championing the recycling drive also recognises the importance of engaging hospital staff, particularly nurses, in this sustainability effort. Ms Charmaine Ng, a nurse at the hospital who is part of the team spearheading the initiative, says, "Nurses have a high workload, so we've incorporated a standard operating procedure for recycling to encourage them to place used IV fluid bags into designated recycling bins."

Once the initiative was successfully implemented in NUH, the team worked closely with other hospitals in the National University Health System (NUHS) to assist them with their PVC recycling process. Both Alexandra Hospital and Ng Teng Fong General Hospital have started this effort in May 2023.

"We have expanded our PVC recycling initiative to include face masks, oxygen tubings and nasal prongs in our operating theatres, and this will be started on the wards in the near future. We are currently exploring the recycling of non-PVC plastic as well as blister packs to reduce our plastic waste in hospital." shares Dr Yap, shedding light on the team's forward-thinking plans.

NUH is proactively launching a variety of initiatives in support of Singapore's Green Plan 2023. From implementing rainwater-harvesting systems and installing energy-efficient LED lights, to setting up EV charging stations and going paperless with its OneNUHS App, NUH is championing a more sustainable future for healthcare, while maintaining its unwavering commitment to delivering world-class patient care.

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National University Health System
  • National University Hospital
  • Ng Teng Fong General Hospital
  • Alexandra Hospital
  • Jurong Community Hospital
  • National University Polyclinics
  • Jurong Medical Centre
  • National University Cancer Institute, Singapore
  • National University Heart Centre, Singapore
  • National University Centre for Oral Health, Singapore
  • NUHS Diagnostics
  • NUHS Pharmacy
  • Yong Loo Lin School of Medicine
  • Faculty of Dentistry
  • Saw Swee Hock School of Public Health
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