Episode 077 | October 9, 2023 | 34:00
Guest: Rasmus Revsbeck
Published: October 9, 2023
Duration: 34:00
Description
Rasmus Revsbeck, an LCA expert from Region Midtjylland, joins Frederik van Deurs to dive into decarbonizing the healthcare sector. The sector contributes 4-6% of global CO2 emissions. Rasmus shares insights on engaging healthcare professionals in the battle against environmentally harmful single-use products.
Full transcript
About this transcript
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Hello and welcome to the Sustainable Healthcare Podcast, streaming live from the People’s Meeting for the Climate in Middelfart. With me is Rasmus Revsbeck, an LCA expert with the Center for Sustainable Hospitals in Central Denmark Region.
Rasmus: Master’s in environmental management from Aalborg University. Three years at Central Denmark Region. Center for Sustainable Hospitals went from two people two years ago to 12-15 now. Sustainability days bring together 36 people across the region who work with environmental sustainability full-time.
We are a consumer organization — we buy stuff. Public entity with rules and budget. Can’t just buy the most expensive sustainable thing. And we can’t shut hospitals down to figure it out — we mend the fences while running. 30,000 colleagues. We can’t tell clinicians what to do; we ask “is there something you do now that you think is bad?” and work with them on alternatives. It is almost anthropological.
Public enemy number one? No single panacea — we use 150,000+ different object types per year. The biggest things fix maybe 0.5-1% of emissions. But bundling — moving from single-use to multiple-use — saves a lot.
Bronchoscope (lung camera) example: we have multiple-use bronchoscopes that have to be washed weekly, so often people don’t use them and we wash a clean one. If we optimize so we don’t have wastage, the multiple-use case is good. Right now single-use is favored because it optimizes for the efficient use of people not products.
Single-use in an ambulance still makes sense — no clean closet with air, moisture, temperature control on the road. (David Rye from Falck episode covers ambulances.) But the dialogue we are opening is product-as-a-service — vendor takes back the single-use device, harvests the video camera, chips and wires that never touched the patient.
Currently single-use devices go to clinical waste — a yellow plastic bucket of hazardous waste. Denmark has two incinerators allowed to handle it. Ours is south of Copenhagen — Centralised, and they incinerate at 1,800°C with diesel added. So just incinerating clinical waste = bad.
LCA explained: for my coffee cup — materials (rubber, stainless steel, plastics), where it’s produced, energy in, raw materials origin, all the way through to disposal/recycling. Sum the emissions through the life cycle. Standard methods use up to 16 different parameters — acidification of oceans, freshwater ecotoxicity, carcinogenic actions etc. Must define the functional unit (one cup, one use, etc.). LCA is “a bastard between natural science and social science” — the result is a tendency that needs context to interpret. Two numbers are only comparable if calculated the same way.
Common misconception: just latching onto one number. All numbers are made within a system — what gases, what years, what is added in. Biogenic CO2 of my paper cup is not added because the tree grows back — but my cup lasts five minutes and the tree took 40 years.
For procurement: we use the Nordic sustainable packaging criteria — scoring by materials and amounts. For the bronchoscope tender (pulled back) we asked suppliers to fill an Excel of materials, then made an LCA number to compare. Even with EPDs (Environmental Product Declaration), different countries give different numbers because they add in different things. When we get an LCA we are happy — but we ask for the report so we can normalise into our own model.
As a consumer of everything, we need to compare a more sustainable helicopter with a more sustainable syringe. We have to make our own holistic system. Otherwise the calculation that exists determines the policy — “we can calculate syringes, so we work on syringes” while the helicopter might be the bigger problem.
Requirements we set: we don’t want PVC (incineration produces acid-causing emissions; theoretically recyclable but Denmark has no recycler so it has to be sent out — and contaminated PVC must be incinerated anyway). Easier to just exclude. Hard to impose corporate-level requirements in EU public tenders — has to be on the product level. Can’t geographically differentiate (open-market principle), even though it matters whether plastic is made in China or France (energy mix).
Advice for healthcare professionals worldwide: common sense. Nurses become nurses because they care — and they care about the environment. The “this is a quality product, use once and throw out” frustration kicks in when at home they are asked to recycle. That common-sense voice is the go-to. Publicly accessible analyses on our website, the NHS, the Aga Khan Foundation calculation tools. Center for Sustainable Hospitals is releasing a catalog of climate activities already vetted by hygiene staff — easy, doable stuff to start implementing.
Thank you Rasmus. Thanks for listening — please like, subscribe and share.