The reuse of breathing systems in anesthesia

The cheap manufacture of plastics compared with the relatively expensive labor-intensive cost of decontaminating medical equipment encourages the use of disposable single-use equipment. Although the manufacture and disposal of single-use equipment superficially would seem to have more environmental impact than reusable equipment, the processes of cleaning and decontaminating reusable items may impose an even greater cost on the environment. In a recent study at two United States hospitals, anesthetic tubing accounted for less than 10% of medical waste, about half the amount of the plastic waste generated by the cafeterias at the same two hospitals [34]. There may be a higher cost to the organization by using single-use breathing systems. One United States institution has estimated that changing from single-use to re-usable breathing systems, with a new filter for each patient, resulted in savings in initial cost and waste disposal of more than Dollars 100,000 per year [20]. In the light of current knowledge concerning infective agents, reusing breathing systems for up to 1 week with a new appropriate filter for each new patient seems to be safe practice, provided the manufacturer of the breathing system recommends such use, and the breathing system is carefully checked before each new patient.