AB258. SOH26AB_0423. A sustainability and feasibility assessment of reusable surgical headgear implementation in an orthopaedic hospital

Background: Healthcare is an evolving industry that has led to an insidious increase in Healthcare Facility Waste (HFW). Orthopaedic operating theatres are major producers of CO₂ equivalents (CO₂e). Seeing how disposable surgical caps are purchased and discarded in high volumes, one potential strategy to improve sustainability is the implementation of reusable surgical headwear. This study aimed to present a sustainability and feasibility assessment of reusable surgical headgear in the National Orthopaedic Hospital Cappagh, Dublin, Ireland.

Methods: We conducted a cradle-to-grave life cycle assessment (LCA) comparing disposable polypropylene caps with reusable cotton caps, following ISO 14040/14044 guidelines. The functional unit was one operating room (OR) worker supplied with a scrub cap daily for 1 year (18,000 disposable vs. 60 reusable caps, assuming a 300-wash lifespan). Real-world procurement, transport, laundry, and waste data were combined with assumptions and modelled. A cost comparison was performed using hospital procurement data.

Results: For reusable caps, laundry was the main contributor to most impact categories, while polypropylene production dominated impacts for disposable caps. Over 1-year, reusable caps reduced climate change impact by 30% (≈91 kg CO₂e) and improved categories by up to 51%, but had higher impacts in land and water use and eutrophication. For 60 OR workers, switching to reusable caps yielded an estimated annual saving of €5,105.

Conclusions: Reusable surgical caps are environmentally beneficial and cost-effective compared to disposable caps. A pilot implementation with real-world usage, laundry tracking, and microbiological monitoring is recommended to validate these findings and support wider sustainable change in operating theatres.

Keywords: Orthopaedic; surgical headgear; life cycle assessment; sustainability; carbon emission