Wasting away
Following our clinic’s latest routine audit by our provincial College of Physicians and Surgeons I was surprised and disappointed to learn that we are now being asked to increase our use of disposable, single use and individually wrapped items.
In this era of growing awareness of the serious health threat facing the planet as a consequence of our wasteful consumer society, I would have expected the medical profession and our professional bodies to be at the forefront of change. At the same time the clinical literature is providing us with evidence of the safety of performing most ambulatory procedures using “clean” instead of traditional “sterile” techniques.
It was difficult to follow the references in the College guidelines back to identify the original studies demonstrating the need for double wrapping single instruments like nail clippers in paper or plastic (as opposed to re-useable cloth) for sterilization or any data about the infections likely to result from airborne pathogens that might inadvertently land on metal specula during the brief interval that the sterile boat is opened to extract the speculum prior to inserting it into a (very unsterile) vagina. I understand the need for care to be taken to reduce iatrogenic infections and realize that this has been one of the biggest public health advances of modern times. However, if we are invoking the precautionary principle to justify these measures instead of using evidence we must also consider the environmental harms inherent in doing so.
Other jurisdictions in the US and Europe are working hard to resist the pressures from the medical industrial complex which, for obvious reasons, are delighted to have us move toward more and more single use items. As a profession, instead of submitting to these players and their nebulous threats of potential harms, we should be standing up and, if anything, banning single use devices and demanding that manufacturers create better, more durable products that can withstand long term use.
Dr. Ilona Hale is a Clinical Assistant Professor in the Department of Family Medicine at the University of British Columbia.
