Operating Theatre Waste Generation and Segregation in a Tertiary Hospital: A Prospective Waste Audit

Healthcare is a major contributor to greenhouse gas emissions, with operating theatres recognised as some of the most carbon-intensive areas of hospitals. Waste disposal practices substantially contribute to this footprint. Accurate quantification of operating theatre waste streams is essential to inform targeted sustainability interventions.

A prospective waste audit was conducted over 10 weekdays in April-May 2024 at a 400-bed tertiary hospital in Melbourne, Australia. Solid waste generated from 386 operations was intercepted and categorised into general, clinical, and recyclable streams. Waste generation was analysed overall, per operation, and by surgical specialty using descriptive statistics.

A total of 2309 kg of solid operating theatre waste was generated, equating to 231 kg/day or 5.98 kg per operation. Clinical waste comprised the largest proportion (46%, 1055 kg), followed by general waste (40%, 923 kg) and recyclable waste (14%, 330 kg). Polypropylene, cardboard, and sterilisation wrap accounted for the majority of recycled materials. General Surgery, Orthopaedics and Plastic Surgery generated the highest total waste volumes. Adjusted for case numbers, Orthopaedics produced the greatest waste per case (7.15 kg). The clinical-to-general waste ratio varied substantially by specialty, with Vascular, Obstetric, and Orthopaedic surgery producing the highest proportions of clinical waste.

This audit demonstrated a predominance of carbon-intensive clinical waste and low rates of recycling within operating theatres, with marked variation between surgical specialties. These findings highlight significant opportunities for improved waste segregation, targeted education, and specialty-specific sustainability interventions to reduce the environmental impact of surgical care.