The Environmental Impact of Wheel Life

By |2018-09-01T08:57:01+00:00September 1st, 2018|
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Illustration by Mark Weber

As a wheelchair user, it can be easy to feel guilty about the waste and impact generated by the large quantity of medical supplies we often need. But there are ways to reduce our impact through smart shopping and conscientious use of our supplies. Eco-conscious wheelers have partners in this fight, as medical supply companies are working to lower their environmental footprint and to reduce waste by donating unsold supplies to nonprofits. Here’s a look at how we can reuse, reduce and recycle to minimize our environmental impact.

Reuse

Sarah Thomas has spina bifida and, like many wheelers, relies on catheters to use the bathroom. Whether latex, silicone or plastic, in order to ensure sterility, every catheter is intended for one use. Once used and thrown away, the catheter joins the rest of the nation’s trash in landfills. On average, Thomas uses about six catheters a day. Multiply that by 30 days in a month, and she would be going through 180 catheters per month — or over 2,000 per year.

Except, she doesn’t use 2,000 per year. Not even close.

“I reuse my single-use catheters, sterilize them myself, and use them over and over until they start to look grungy,” says Thomas. “It probably enables them to be reused hundreds of times. I boil them vigorously in a sauce pan for 20 minutes because my urologist told me this is the standard time to sterilize anything.” The whole process takes time but saves her from wasting those supplies: “I pour out the water in the pan, let it cool, wash my hands thoroughly, splash rubbing alcohol on my hands and gently pry about 20 catheters into a brand-new Ziploc snack bag.” Of course, they don’t last forever, so she opens a new set every couple of weeks — but that’s still almost a 93 percent reduction. When you consider how much less waste that is, there’s no doubt Thomas is making a difference.

Nils Jorgenson, a C5-7 quad, grew up in a family that prioritized reducing, reusing and recycling long before it became a catch phrase. “With my mother, anything that was reusable, she would reuse it,” says Jorgenson. “I grew up in that culture.”

Jorgensen carried on his family’s habits when he became an adult, especially when it came to his medical care. He has set up his medical routine to use as few gloves as possible while still protecting himself and his personal attendants. He reuses disposable items if they aren’t dirty. And he keeps supplies clean so they will stay functional as long as possible.

He applies the same approach to his durable medical equipment. He has kept his Bounder power chair running for 12 years thanks to spare parts he found online. Conserving supplies and making them last is a way of life that’s worked well for decades, and one he plans to continue in the future. “It takes planning and organization,” says Jorgenson, “but it can be done.”

Gregor Wolbring, associate professor of community rehabilitation and disability studies at the University of Calgary, stresses that wheelers should not beat themselves up over the increased profile of their environmental impact as long as they are aware and working towards a more sustainable lifestyle. “Disabled people are part of society, they are citizens and have obligations [around conservation],” Wolbring says.  As far as living sustainably goes, “Disabled people should do as much as anyone else. Then it will become a habit that also goes to medical supplies as well.”

Reduce

Wolbring believes that company choices should be prioritized above consumer actions when it comes to the environment. “I think it [sustainability] should be done much more on the producer level,” he says. “There should be a system that makes this as pain-free as possible for consumers.” Thankfully, many medical supply companies are doing just that and taking steps to reduce their environmental footprint — from the sourcing of raw materials all the way through production and shipping.

For example, Coloplast, one of the largest producers of urinary and ostomy supplies worldwide, has committed to minimizing its environmental impact during production, shipping and disposal of its products. A recent improvement in Coloplast’s SpeediCath reduced the amount of aluminum in its packaging by 50 percent compared to previous products, dropping total use by the equivalent of 150 soft drink cans per user per year. Thanks to an increased focus on efficiency, Coloplast reduced its carbon footprint by 7 percent between 2010-2014 despite 12 percent growth in production. Hollister, another catheter and ostomy manufacturer, has taken actions ranging from increasing its recycling rate to reducing the energy and water use at its manufacturing facilities. A representative says that “as a manufacturing operation, Hollister is very conscious of its place in the community and its obligation to protect the environment in which it operates.”

Cure Medical, a leading manufacturer of prescription intermittent catheters and closed systems, is working to make a difference by reducing packaging, providing pre-lubricated catheters, and eliminating certain chemicals such as DEHP, which can harm consumers as well as the environment. Lisa Wells, vice president of marketing at Cure Medical, explains the company’s thinking: “We feel the conscious decision to avoid scary chemicals and to offer reduced packaging options is a reflection of our commitment to serving our customers and community in an ethical, responsible way.” This includes practicing smart inventory management that takes product expiration dates into account. “Cure does donate any excess inventory to a charitable organization, Globus Relief, to avoid throwing away product unnecessarily,” says Wells.  “Globus Relief works to improve the delivery of healthcare worldwide by gathering, processing and distributing surplus medical and health supplies to charities in the U.S. and abroad.”

By practicing sustainability, medical supply companies make it easier for wheelers to live environmentally-friendly lives. Now that companies such as Coloplast, Hollister and Cure are acting more sustainably, wheelers have an opportunity to applaud them and push other companies to take similar steps. Part of that is communication and advocacy — and part of it is just “voting with our wallets.” The more that consumers support companies that act sustainably, the more likely other companies are to take the same path.

Recycle

On the flip side of conserving can be the equally vexing problem of what to do with unneeded supplies. Even with the best of plans, a closet full of extra medical supplies like catheters, leg bags, ostomy supplies, or bed pads can be hard to avoid. Doctors prescribe how many of any given supply you need, then insurance pays for and ships a set amount for a given period. For someone who uses disposable catheters, that might be the equivalent of five per day, and somebody with a suprapubic might receive enough to change their cath and bags twice per month. Even if you only end up using four catheters per day, or only switch out an indwelling cath once every three weeks instead of once every two, extra supplies add up quickly.

Calling the supplier and asking them to hold off on the next shipment might seem like a simple solution, but there is always the question looming: What will insurance think? Will they send fewer goods in the future, even if our routines change so we need the original amount?  It’s an anxiety-causing conundrum, which leads us back to the same cycle — you use less than you get, the piles build up and you clean house after a while with a bunch of latex and plastic going straight to the landfill.

The best way to address this problem is to establish and maintain a good, personal relationship with all the members of your medical team: insurer, doctor and provider. With trust and a deeper understanding of your medical situation, doctors are likely to be more comfortable changing prescribed quantities, raising your chances for a hassle-free encounter with insurance.

Another great option is to simply donate medical supplies that haven’t yet expired, either to a nonprofit or a community program. Many nonprofits have recently sprouted up to deal with the massive medical waste in the U.S. hospital system, where unused supplies get thrown away when a patient leaves the room, or only a few goods are used out of a pack. Partners for World Health was founded by Elizabeth McLellan, a nurse who saw the need after visiting hospitals abroad and seeing how many didn’t have enough supplies.

She started Partners for World Health in 2007, and in one year she collected 11,000 pounds of single-use supplies, biomedical goods and durable medical equipment from hospitals and nursing homes. Partners in World Health obtained nonprofit status in 2009 and now has six warehouses across the Northeast, with McLellan expecting nearly 1 million pounds of donated goods in 2018 alone.

The majority of resources donated to Partners for World Health come from hospitals and nursing homes, but the organization also accepts donations from individuals — single-use supplies as long as they are not expired and durable medical equipment if it is in good condition.  “Everyone is grateful that there’s an organization that takes the supplies because they don’t want it to end up in landfills,” says McLellan.  Donating is simple, and just takes getting in touch and paying for shipping. “Anyone’s who’s interested in donating can call us and tell us what they have, or go to our website (partnersforworldhealth.org) and see what we need.” Of course, running six warehouses, shipping supplies and sending medical missions abroad costs money, so financial support is always appreciated.

There are plenty of other opportunities to pass off unused supplies at the local, national and international levels. Some other nonprofits that accept medical goods include the Global Surgical and Medical Support Group, and Project C.U.R.E.

As director of United Spinal’s Resource Center, Bill Fertig has fielded hundreds of calls from people looking to donate extra supplies, and he encourages callers to connect locally, either with local United Spinal chapters, support groups or centers for independent living. “Many of the 400-plus centers for independent living may have loan closets for single-use and durable medical equipment so check with one in your area,” he suggests. Online communities such as Care Cure Forums sometimes have members in need — for example, individuals with limited health insurance — who may be looking for affordable goods from others with disabilities. Even if one person has to cover shipping, it’s worth it, considering the price of disposable goods. “You can probably put in a box supplies that comprise $1,000 of retail costs,” Fertig notes, “and ship it across the country for less than a hundred bucks.” And even more, it will be putting them to good use instead of going straight to the garbage dump.

A Smaller Wheelprint

Let’s face it, living with a disability requires us to use the medical system. Living with zero medical waste is not a realistic option for most of us and, even if we’d like to, we can’t just move into a forest commune disconnected from society. Jorgensen provides some good perspective, comparing his earlier years and current life. He used to live an especially low-impact lifestyle, but now needing regular wound care, he uses bandages daily. “It’s hard with a disability to survive [without waste],” he reflects. “Some people are good at one area of conservation, but you can give yourself a break about another side.”

Still, every little bit counts — and if we all make the effort, it can add up to a lot.

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