Healthcare waste: from incineration to pyrolysis: a comparative life cycle assessment of two different healthcare plastic waste management processes.

BACKGROUND

Plastic waste from healthcare is an increasing environmental challenge, particularly in resource-intensive clinical pathways such as dialysis. Peritoneal dialysis (PD) generates large quantities of single-use plastic materials, making its waste stream a priority for sustainable intervention. Conventional disposal through incineration contributes substantially to greenhouse gas emissions (GHG) and produces hazardous ash. Pyrolysis, a chemical recycling process that converts mixed plastic waste into usable outputs, has been proposed as a lower-carbon alternative. This study aimed to estimate the change in GHG emissions and key environmental co impacts if a hospital nephrology service were to switch its PD plastic waste treatment from incineration to pyrolysis.

METHODS

A comparative life cycle assessment (LCA) was conducted for the management of 1 kg of plastic waste from PD. OpenLCA modelling with established life cycle inventory datasets was used to quantify environmental impacts across multiple categories. Two scenarios were assessed: full incineration and a combined system in which pyrolysis was used with a 10% residual fraction sent to incineration. Impact categories included climate change, freshwater ecotoxicity, marine eutrophication, human toxicity, mineral resource use and water consumption. Sensitivity Analysis were also undertaken.

RESULTS

The combined pyrolysis system with 10% residual incineration generated a net climate change impact of -0.230 CO₂e per kg of healthcare plastic waste managed, compared with +1.996 CO₂e per kg under full incineration. Across all sixteen environmental impact categories assessed, the pyrolysis pathway demonstrated lower impacts than conventional incineration. Pyrolysis generated net environmental credits in seven categories, including climate change, non-renewable energy use, freshwater eutrophication and photochemical oxidant formation.

CONCLUSIONS

Pyrolysis shows clear potential as a lower-carbon alternative for managing plastic waste from PD and could support efforts to align clinical waste management with broader sustainability goals. Despite these environmental advantages, economic constraints and differing national regulations currently limit widespread adoption. The findings indicate that pyrolysis may play an important role in reducing the environmental burden of plastic waste in high-volume clinical services. Further work is needed to evaluate the operational feasibility of this approach and to position pyrolysis within a wider set of sustainable waste management strategies.