Every day that I walk onto the cardiology floor at the University of Utah Hospital, I meet Jeff, who works the front desk, and I ask him if I can have a new mask. He opens a box, I pick one out and then I deposit my used one in a garbage can beside him, among countless others.
It is simple interaction, but when this is multiplied by the approximate 5,000 health care professionals working at University of Utah hospitals, and then extrapolate that to the 6,000 hospitals in the United States, we are using and disposing of mountains of masks every day. As health care workers, we are taking care of patients, but we are not taking care of the planet.
Around the world we are using more than 4 million masks a month, the overwhelming majority of which are disposable surgical masks made from plastic microfibers. These single-use masks take up to 500 years to degrade.
Health care workers deserve and have the right to appropriate, protective equipment, with masks being central to the occupational hazards associated with caring for patients during the COVID-19 pandemic. Although masks were in short supply at the beginning of the pandemic, they are now readily available in most hospitals and clinics. However, our efforts to protect ourselves should be accompanied by an effort to protect the planet. Every day 7,200 tons of medical waste is generated by health care facilities, much of which is comprised of single use surgical masks or N95 respirators. We have neglected our responsibility to protect the environment by not insisting on better and more biodegradable masks.
Within health care, we expect a clean, comfortable and effective mask, at least for every shift. Indeed, at the start of the pandemic, many medical providers were very vocal about the lack of personal protective equipment (PPE) being supplied by hospitals and clinics. With that supply now largely been satisfied, and with universal precautions against COVID-19 being introduced in most medical facilities, that passion and fervor should now be redirected to demanding PPE for health care workers that is either reusable or fully biodegradable.
The comfort and performance of face masks depends on the textiles from which they are comprised, and the layering techniques used. Studies have shown the potential of using biodegradable polymers as substitutes for the traditional biostable textiles used in face masks. Other approaches under investigation include developing reusable N95 respirators by creating filters that can be sterilized or discarded after use.
These approaches would require a change in workflow and services provided by hospitals and clinics. However, those working in health care already express preference for and even expect centralized supplies of scrubs, for example, with cleaning and decontamination being offered by health care facilities. Adding in the expectation of providing reusable masks and proving their safety and efficacy would bolster the reputations of health care institutions by demonstrating their earnestness in protecting patients, providers, and the planet.
The cost of creating and supplying environmentally friendly masks to health care workers will obviously be significant. However, the environmental and medical cost of continuing to fill our streets, waterways and landfills with single use surgical masks will be felt for generations to come. The COVID-19 crisis shows no signs of abating. As we start to live with this virus, we must find a way to live with better masks.
John J. Ryan, M.D.
John J. Ryan, M.D., is an associate professor in the department of medicine, and director of the Pulmonary Hypertension Comprehensive Care Center, at the University of Utah.
