A 24-Hour Waste Audit of the Neuro ICU during the COVID-19 Pandemic and Opportunities for Diversion

We conducted a series of 24-hour waste audits in a 20-bed pod of a Neurosciences Intensive Care Unit (Neuro ICU) during the COVID-19 pandemic to 1) determine the unit’s waste generation practices, 2) calculate associated downstream greenhouse gas emissions, and 3) identify opportunities to reduce landfill waste and emissions. We collected and weighed municipal solid waste, regulated medical waste, and mechanical recycling. We then compared the current, “as-is” practices to an ideal, “should-be” model which adds the alternative waste and reprocessing streams of industrial composting, advanced recycling, and sterilization followed by reuse. We found that the unit produced a total of 97.3 kg of waste over 24 hours, or 4.9 kg of waste per patient per day. 96.8% of this waste is currently landfilled. Emissions generated by processing landfill waste totaled 119.7 metric tons per year of CO(2) equivalents. With the should-be sorting model, 24.7% of total waste produced by the unit could be diverted from landfills. Of this potentially divertible waste, 47.9% could undergo post-consumer industrial composting, 28.0% could undergo mechanical recycling, 22.2% could undergo advanced recycling, and 1.9% could undergo sterilization followed by reuse. Emissions from processing landfill waste in the should-be model totaled 110.6 metric tons per year of CO(2) equivalents, representing a 7.7% decrease. These findings highlight the potential utility of alternate waste streams in this setting as well as the urgent need for complementary upstream waste reduction strategies to meaningfully reduce the Neuro ICU’s landfill reliance and greenhouse gas emissions.