A framework for assessing the circularity and technological maturity of plastic waste management strategies in hospitals

Consumer single-use plastic waste has received much attention from the public, policy-makers and researchers. However, the management of such waste in medical settings has been less well examined. This article reviews existing evidence on waste management strategies within hospitals, with a particular focus on single-use plastics. The article develops the ‘Waste Hierarchy-Technology Readiness Levels’ framework and assesses each waste management strategy against it, indicating the maturity of the technology and the strategy’s position in the Waste Hierarchy, in addition to its relative adherence to circular economy principles. Findings show that currently dominant waste management strategies include disposal to landfill, incineration and recycling, while alternative strategies include reduction, reuse, bioremediation and chemical recycling. Most strategies reviewed are at a high level of technology readiness and at a low level on the Waste Hierarchy, demonstrating that hospital waste management strategies tend to be based on mature technologies and suggesting a need for more innovative, circular economy solutions. Exceptions, which are at a high level on the Waste Hierarchy but at an early stage of development, include bioremediation using microbial action and chemical recycling using hydrophilic solvents. This review highlights a disparity between the levels of alignment with the circular economy principles in waste management strategies of developed and developing nations, suggesting a need for both international collaboration and strategies sensitive to specific regional contexts.