Single-use disposable medical devices have rapidly taken over in the US healthcare industry, said Jodi Sherman, MD, associate professor of anesthesiology and epidemiology at Yale School of Medicine and founding director of the Yale Program on Healthcare Environmental Sustainability, New Haven, Connecticut.

A significant portion is made of plastic, which can harm humans and the environment. Production of plastics both uses fossil fuels and releases climate-warming emissions. Then, once they’re disposed of in landfills, plastics break down into tiny particles containing known carcinogens and hormone disruptors.

Todd L. Sack, MD, FACP, clinical associate professor at H. Wertheim College of Medicine, San Francisco, and executive director of the My Green Doctor Foundation, Jacksonville Beach, Florida, recalled when the healthcare industry wasn’t always so reliant on single-use plastics. “When I was a younger doctor, more things were reused,” he said. “Now, everything is thrown away.” The supply chain has redesigned products to be disposable, he explained. 

This is true of all manner of devices and equipment, including blood pressure cuffs, specula, hospital gowns and linens, and surgical instruments. Most egregious waste-wise, in Sack’s opinion, are disposable plastic gloves. Donning a new pair for each patient has become the standard of care, he said.

According to a recent study, gloves are the highest‐volume single‐use disposable product used in healthcare, with approximately 100-124 billion gloves used in exams in the US annually. “It’s wasteful and unnecessary,” said Sack. Instead, “We need to wash our hands; that is all we need to do,” he said.

Single-use plastic equipment is efficient. “People are trying to move fast to take care of patients, so sustainability is often not the number one priority,” said Matthew J. Meyer, MD, anesthesiologist and medical director of sustainability at UVA Health, Charlottesville, Virginia. “Sometimes the deciding factor is, well, that will take 2 minutes, and that will take only 30 seconds.”

Disposable medical supplies are also inexpensive, said Anna L. Goldman, MD, MPH, MPA, primary care physician and medical director of climate and sustainability, Boston Medical Center (BMC) Health System, Boston. Plastic is so cheap that purchasing single-use plastic tools is often more economical and efficient than cleaning and reusing nondisposable alternatives, she explained. Sterilizing tools requires staff, energy, and equipment. “Shifting costs externally, to the environment, does not,” she added.

According to Goldman, extreme caution around patient safety has validated this use of disposables. Especially since the pandemic, institutions have been loath to reuse items, and single-use manufacturers have not allayed these fears, said Sherman. After all, they have a vested interest. “There’s an incentive for equipment manufacturers,” Sherman said. “The more we throw things away, the more they sell.” Earlier this year, negotiations to end an exemption for the healthcare sector from the Global Plastics Treaty failed.

When Goldman began medical school in 2008, she and her colleagues performed Pap smears with reusable metal specula, she recalled. “Now, we use plastic ones. While doing a Pap smear, sometimes they’ll break, and we’ll need to use two. I’ll think about how those big hunks of plastic will sit in the environment for the next thousand years. It’s heartbreaking and happens all over medicine.”

“The harm is so obvious to those of us in healthcare, and we can suffer moral injury every single time we take care of a patient,” said Sherman. “Sometimes, disposables are the right approach,” she acknowledged. But their use has gotten out of control. “We always default to single-use devices being safer because they eliminate the risk of human error.” But that does not need to be — and should not be — the case.

How to Pare Down

Change should start at the top, said Sherman. Currently, the US Environmental Protection Agency does not collect data on medical waste, but federal policy should require healthcare organizations to adopt standardized greenhouse-gas accounting, she said. Reliable data would help prioritize sustainability in healthcare and inform decision-making.

Healthcare organizations and clinics should reduce the unnecessary use of disposable products, transition to reusables, and reprocess single-use devices, said John Ullman, director of supply chain transformation, Health Care Without Harm, Washington, DC. He noted that these topics will be covered at the upcoming CleanMed 2026, Health Care Without Harm’s annual US-based conference on healthcare sustainability.

“Healthcare facilities should review the plastic products they purchase and prioritize them for action,” Ullman said. “Eliminating high-volume single-use items that aren’t essential to care can go a long way to reduce plastic consumption, even before considering alternative products. Transitioning from disposable to reusable products and improving a hospital's single-use device reprocessing program can often lead to significant cost savings and therefore be a very appealing place to start and build momentum for broader waste reduction initiatives.”

Ullman pointed out how Ronald Reagan UCLA Medical Center, Los Angeles, switched back to reusable isolation gowns several years ago, which has cut down on hundreds of tons of landfill waste each year.

By implementing a reprocessing program (with Medline ReNewal and Cardinal Health), Boston Medical Center Health System has saved money both in disposal costs and repurchasing single-use devices (like tourniquets, comfort glides, catheters, and surgical tools) at discounted rates. BMC estimated it reduced purchasing costs by $1.2 million in 2024.

At UVA Health, Meyer found reprocessed supplies generally like new in quality and 50% less expensive. “We’d been throwing out valuable items,” he said. “By purchasing reprocessed items, we’re getting back some of the value from what we were throwing out.”

When hospitals and clinics want single-use items, they can find products made with compostable materials, like sugarcane or cornstarch, rather than plastic. Meyer offered the example of compostable hospital gowns, patient belongings bags, and soiled linen bags from Terraloam. Other companies make biodegradable gloves, face masks, surgical drapes and kits, trays and containers, and patient care items.

Finally, healthcare organizations and clinics can donate unused medical supplies that would otherwise end up in a landfill. The New York-based nonprofit Afya collects and distributes items to communities in need. According to its website, the organization has distributed 13 million pounds of goods (with a market value of $68 million) in the US and 91 other countries. For instance, Afya teamed up with the Greater New York Hospital Association to sort, box, and deliver supplies from 40 hospitals across New York City to health-related organizations in need around the world.

Sherman reported having no conflicts of interest. Goldman reported being supported by a grant from the National Institute of Mental Health (K23MH128639); on the BMC side, she reported leading the project described in the article “Takeda & Boston Medical Center: Tackling Decarbonization in a Healthcare Setting,” which is financially supported by Takeda. Sack reported having no ownership in My Green Doctor Foundation and receiving no income from it. Ullman reported having no conflicts of interest. Meyer reported being the medical director of sustainability at UVA Health University Medical Center. He also reported being the co-inventor of intellectual property focused on reducing unnecessary waste of surgical instruments and supplies but reported having no financial interest in any of the companies mentioned.