Single-use vs. reusable products for six respiratory procedures in an intensive care unit: A retrospective evaluation of plastic waste implications

Objective: Intensive care units (ICUs) are recognised as carbon "hotspots" within hospitals due to their reliance on resource-intensive technologies. This study aimed to compare reusable and disposable products used for six common respiratory procedures in an Italian ICU to determine the potential for reducing plastic waste generation and the carbon footprint associated with plastic waste incineration. Methods: We performed a retrospective evaluation in a 10-bed ICU over 12 months. The comparison between reusable and single-use devices was based on theoretical calculations: each device was weighed with a precision scale, and annual totals were estimated by multiplying individual device weights by the number of procedures recorded in the clinical information system. CO2e emissions were calculated using the European Environment Agency emission factor of 2.9 kg CO2e per kg of plastic waste incinerated. Results: Reusable or low-waste products generated an estimated 143.50 kg of plastic waste, compared with 501.64 kg from single-use devices. Using reusable strategies could have potentially reduced plastic waste by 358.14 kg and avoided approximately 1038.60 kg CO2e over one year of respiratory procedures, equivalent to approximately 4258 km driven by an average gasoline-powered passenger vehicle. Conclusion: Reusable and low-waste alternatives can substantially reduce plastic waste and the carbon footprint associated with incinerating plastic from disposable ICU respiratory care products. Critical care nurses are well positioned to integrate these sustainable strategies into everyday clinical practice. Implications for clinical practice: Implementing reusable equipment and low-waste alternatives can become part of standard care pathways, aligning clinical excellence with environmental sustainability. These findings support the integration of sustainability into everyday nursing decisions and institutional policies in critical care settings in the future.