Climate change and resource scarcity are putting increasing pressure on healthcare systems, making it essential to reduce the sector’s environmental impact. In Dutch hospitals, particularly Intensive Care Units (ICUs), large volumes of unused but contaminated medical consumables are routinely disposed of as a precaution against the transmission of infections. This linear, single-use approach generates significant waste and emissions, challenging long-term sustainability goals. This thesis investigates whether ultraviolet germicidal irradiation (UVGI), specifically using UV-C radiation, can serve as a sustainable alternative to the disposal of unused medical consumables in the ICU of the Leiden University Medical Centre. The research assesses both the applicability and sustainability of UV-C disinfection. Applicability was evaluated through an inventory analysis of ICU bedside carts and a workflow analysis comparing current practices with the implementation of UV-C disinfection. The sustainability was assessed using a Life Cycle Assessment (LCA) to compare the environmental impacts between UV-C disinfection and disposal.
A bedside cart inventory contains medical consumables of which approximately 75% are considered manufacturer-proven or literature-supported suitable for UV-C disinfection with a value of €323. The operational disinfection costs are €23 per bedside cart. Assuming 30-50% inventory levels combined with the patient data of 2023 and 2024 (22 and 33 bedside carts), the total avoided costs are estimated to be between €680-2,000 and €1,670-3,650 respectively, including capital expenditure. The disinfection time of a bedside cart including preparatory steps is estimated to be 65 minutes but may be shortened by, for instance, colour-coding the bedside cart compartments. No previous LCA study on UV-C disinfection of medical consumables had been conducted. The results indicate that UV-C disinfection as an infection prevention method has fewer environmental impacts compared to disposal. Across all assessed impact categories, including climate change, water use, and material use, reductions of 46% to 50% were observed.
Integrating UVGI within hospital settings can reduce environmental burdens and support circularity in healthcare supply chains. UV-C disinfection of medical consumables is best suited for hospitals with large ICU departments, as smaller ICU departments may not generate enough contaminated medical consumables to justify the investments, making financial factors critical to its feasibility. This study contributes to ongoing efforts within the Dutch Green Deal for Sustainable Healthcare and provides actionable insights for hospitals, UV-C device manufacturers, medical consumable manufacturers, and policymakers seeking to improve environmental performance in clinical settings.