Developing a Circular Economy for Medical Testing Plastics

随着政府和消费者对减少塑料废物的兴趣不断增加，全球医疗保健行业估计使用了1500万吨塑料，这带来了一些独特的挑战。在英国，NHS已经计划减少不必要的塑料废物，作为“实现净零NHS”的一部分，需要新的实践和技术来实现这一目标。在医疗保健行业使用的塑料中，与临床环境内外的医学测试中使用的塑料相关的废物代表了大量的塑料，为循环提供了独特的机会。这些废物目前大多通过焚烧或填埋处理，或者更糟的是，直接在环境中处理，从而导致环境污染。这些塑料的循环使用将大大减少塑料废物，并为NHS等组织节省大量成本。医疗测试塑料通常可以分为两种非常不同的方式。用于诊所/实验室的试剂盒，以及用于个人和家庭检测的床旁（POC）快速诊断试剂盒。这些不同的使用环境提出了非常不同的挑战，本提案将解决这些问题。尽管随着COVID-19大流行的减弱，个人/家庭医疗检测减少，但由于POC检测广泛用于结核病、疟疾和艾滋病等疾病的诊断，以及家庭妊娠测试和糖尿病血液测试，全球每年的POC检测超过4亿次。此外，随着我们扩大其他疾病的低成本检测范围（特别是在低收入到中等收入国家），面对新的流行病和大流行病（即禽流感或猴痘），以及将医疗服务的提供改变为患者和医疗保健从业者之间的虚拟互动，POC检测的使用预计将增长，伴随着家庭疾病检测的日益正常化。同样，在NHS等临床环境中产生的塑料废物越来越令人担忧，新技术和治疗方法备受追捧。仅在英国NHS，诊断测试在2022年就达到了创纪录的水平，再次有力地证明了对这些塑料的处理需求。考虑到基于实验室的环境，与公众在远离临床环境的情况下使用的个人诊断检测试剂盒相比，这些塑料可以促进不同的，也许更简单的循环途径。 为此，该提案的重点是解决在临床环境（即医院，实验室等）以及远离诊所，家庭和其他地方创建医疗测试废物循环经济的挑战。该研究不仅将创造基于开创性的新基础科学和工程的新解决方案，而且还将采取一种整体系统方法，结合对经济，社会和环境挑战的探索，这对于为医疗测试塑料创造可持续的循环经济至关重要。

Amid an ever-increasing government and consumer interest in reducing plastic waste, the estimated global use of 15 million tonnes of plastic in the healthcare sector presents some unique challenges. While in the UK, the NHS already has plans to reduce unnecessary plastic waste as part of 'Delivering a Net Zero NHS', new practices and technologies will be required to achieve that target. Among the plastics used in the healthcare sector, the waste associated with plastic used in medical testing within both clinical settings and beyond, represents a large volume of plastic that presents unique opportunities for circularisation. This waste is currently mostly disposed of by incineration or disposal into landfill or, worse, directly in the environment, thus leading to environmental pollution. Circularisation of these plastics would result in significant reduction in plastic wastes, as well as providing large cost savings to organisations, such as the NHS. Medical testing plastics can be typically characterised into two very different ways. Those used in the clinic/laboratory, and the point of care (POC) rapid diagnostic kits used in personal and home tests. These different usage environments present very different challenges, that this proposal will address. Despite the reduction of personal/home medical testing as the COVID-19 pandemic abates, POC testing exceeds 400 million tests worldwide each year on account of their widespread use for diagnosis of diseases such as tuberculosis, malaria and AIDS, as well as for home pregnancy tests and diabetic blood tests. Moreover, the use of POC tests is predicted to grow as we expand the range of low-cost testing for other diseases (especially in low to middle income countries), face new epidemics and pandemics (i.e. bird flu or monkey pox) and change the delivery of medical services towards virtual interactions between patients and healthcare practitioners, accompanied by increasing normalisation of home testing for illness. Similarly, the plastic waste generated in clinical settings, such as in the NHS, presents a growing concern, with new technologies and treatments highly sought after. In NHS England alone, diagnostic testing has reached record levels in 2022, again, strongly evidencing the need for treatment of these plastics. Given the lab-based setting though, these plastics may facilitate a different, perhaps simpler, route to circularity compared to personal diagnostic testing kits which are used by the public away from the clinical settings. To this end, this proposal is focussed on addressing the challenge of creating a circular economy for medical testing waste, both in clinical settings (i.e. hospitals, labs, etc) and away from the clinic, in homes and elsewhere. The research will not only create new solutions that are based on pioneering, novel fundamental science and engineering but it will also take a whole systems approach that incorporates an exploration of the economic, social and environmental challenges that it will be essential to address in order to create a sustainable circular economy for medical testing plastics.