# Green operating room project in a multidisciplinary Surgical Unit

## TL;DR

This study shows that better waste sorting in operating rooms can reduce biohazardous waste, especially in certain surgical specialties.

## Contribution

The study demonstrates a practical approach to reducing biohazardous waste in a multidisciplinary surgical unit through improved waste segregation.

## Key findings

- A 20 kg reduction in biohazardous waste was achieved over 3 weeks with the same number of surgical procedures.
- Orthopedic procedures generated the most hazardous waste at 9.35 kg per intervention.
- General Surgery, Urology, Otolaryngology, and Orthopedics were the highest contributors to biohazardous waste.

## Abstract

The climate emergency requires effective measures to reduce the environmental impact of the healthcare system. Approximately 20% of medical waste originates from operating rooms. Proper waste segregation, along with adherence to a correct definition of biohazardous waste, are good practice procedures in the operating unit that ensure waste reduction. This study aims to assess the effectiveness of waste segregation in a multispecialty Surgical Unit. During a 3-week observational period, compared with a subsequent 3-week experimental period, counts of paper and plastic bags and the number and weight of biohazardous waste were recorded. The experimental period incorporated heightened waste sorting attention and introduced new criteria for surgical uniform disposal. While no significant differences in paper and plastic bag production were observed between the two periods, there was a non-statistically significant reduction in numbers and weight of biohazardous waste (p = 0.22; p = 0.16 respectively). Multiple regression analysis revealed a statistically significant 20 kg reduction in biohazardous waste over 3 weeks, with the same number of surgical procedures performed (p<0.05), resulting in 3.7 kg of biohazardous waste per surgical procedure. This reduction increased to 24 kg in the second period under the same number and type of interventions (p<0.05). Notably, General Surgery, Urology, Otolaryngology, and Orthopedics were identified as the surgical branches with the highest biohazardous waste production. In particular, orthopedic procedures generated 9.35 kg of hazardous medical waste per intervention, with statistical significance (p = 0.006). A careful separate collection of waste in the operating room, focusing on limiting biohazardous waste production, could be an important tool for reducing environmental impact and fostering economic savings. A good practice involves finding tailored solutions through teamwork as demonstrated by the present study.