Abstract
The University of Virginia (UVA) Health System generates thousands of tons of waste each year. There are currently minimal sustainability efforts within the UVA hospital and healthcare as a whole. In an effort to reduce UVA Health’s environmental impacts from the landfilling of single-use metal instruments, the technical project focused on developing a recycling system within the Emergency Department where such tools are widely used. Connecting this effort to the issue of hospital waste more generally, my STS research examines the problem and discusses a circular economy in healthcare waste management as a potential solution.
The technical portion of my project developed and piloted a recycling system for single-use stainless steel instruments at the UVA Health Emergency Department, aiming to reduce environmental impact and costs while supporting a more sustainable healthcare system. Building on prior life cycle analyses demonstrating the economic and environmental benefits of recycling these instruments, we designed a workflow integrating recycling into existing hospital operations. Through research and interviews with hospital staff and leadership we devised a process for collection, transportation, sterilization, and scrapping. Initial results showed significant projected reductions in global warming potential (GWP) and waste volume. Key design features included the use of sterilizable surgical instrument trays for safe, OSHA-compliant collection and transport, and partnership with a local metal recycler already engaged by UVA Recycling. Our findings emphasize that sustainable healthcare innovation must balance environmental goals with core clinical values like sterility, safety, and availability—principles that, while necessary, often drive waste.
In my STS Research, I explore the reliance on single-use medical products in U.S. healthcare and argue for a systemic transition toward a circular economy model. Through historical analysis, my research traces the evolution of medical waste management from 19th-century sanitation reforms to modern-day infection control practices that prioritize disposables. I identify the environmental, economic, and ethical consequences of single-use dependence, including significant greenhouse gas emissions, financial inefficiencies, and child labor exploitation in global supply chains. The research outlines the structural barriers to circularity, such as cultural perceptions of sterility, manufacturer business models, and regulatory asymmetries favoring disposables. It proposes a framework for systemic change that includes education on the safety and cost-effectiveness of reusables, incentives for manufacturers to adopt service-based models, and regulatory reforms to streamline reprocessing. Ultimately, the paper argues that achieving a sustainable, resilient healthcare system requires coordinated, multi-stakeholder action aligned with circular economy principles.
Through my technical project and STS research, I learned that achieving sustainability in healthcare requires more than technical solutions—it demands addressing ethical issues like environmental impact, labor exploitation, and patient safety. The technical work exposed practical barriers to recycling in clinical settings while establishing technological momentum, and the STS research revealed how historical, regulatory, and economic factors create and sustain wasteful practices. Together, they showed that true progress requires systemic, ethically informed change and that despite many barriers, the path to a sustainable healthcare system does exist.
