Healthcare workers must demand face masks that are better for the environment

Healthcare workers care for patients, not the planet.

(Marcio Jose Sanchez | AP photo) In this photo from April 30, 2020, a person wearing a mask walks past a recently painted fresco with a depiction of the famous “American Gothic” painting by artist Grant Wood, but with the subjects wearing masks in Torrance, California

Every day that I walk on the cardiology floor of the University of Utah hospital, I run into Jeff, who works at the front desk, and ask if I can get a new mask. He opens a box, I take one and then I put mine used in a trash can next to him, among countless others.

This is a simple interaction, but when it’s multiplied by the roughly 5,000 healthcare professionals working in University of Utah hospitals, and then extrapolated to the 6,000 hospitals in the United States, we use and eliminate mountains of masks every day. As healthcare workers, we take care of patients, but we don’t take care of the planet.

Globally, we use over 4 million masks per month, the overwhelming majority of which are disposable plastic microfiber surgical masks. These single-use masks take up to 500 years to degrade.

Healthcare workers deserve and have a right to appropriate protective equipment, with masks being at the heart of occupational risks associated with patient care during the COVID-19 pandemic. Although masks were scarce at the start of the pandemic, they are now readily available in most hospitals and clinics. However, our efforts to protect ourselves must be accompanied by an effort to protect the planet. Every day, 7,200 tonnes of medical waste is generated by healthcare facilities, much of which consists 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.

In healthcare, we expect a clean, comfortable and efficient 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) provided by hospitals and clinics. With this supply now largely satisfied and with the introduction of universal COVID-19 precautions in most medical facilities, this passion and fervor should now be redirected to demanding PPE for healthcare workers that is reusable, or fully biodegradable.

The comfort and performance of face masks depend on the textiles they are made from and the layering techniques used. Studies have shown the potential to use biodegradable polymers as substitutes for traditional biostable textiles used in face masks. Other approaches under study include the development of reusable N95 respirators by creating filters that can be sterilized or discarded after use.

These approaches would require a change in the workflow and services provided by hospitals and clinics. However, those working in healthcare are already expressing their preference and even expecting a centralized supply of scrubs, for example, with cleaning and decontamination being offered by healthcare facilities. Adding the expectation to provide reusable masks and to prove their safety and effectiveness would strengthen the reputation of healthcare establishments by demonstrating their seriousness in protecting patients, providers and the planet.

The cost of creating and providing environmentally friendly masks to healthcare 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 slowing down. As we begin to live with this virus, we must find a way to live with better masks.

John J. Ryan, MD, is Associate Professor in the Department of Medicine and Director of the Pulmonary Hypertension Comprehensive Care Center, University of Utah.

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