Environmental and economic comparison of reusable and disposable blood pressure cuffs in multiple clinical settings

Objective: To assess the environmental and economic impacts of reusable and disposable blood pressure cuffs. Setting: Out-patient clinic and ambulatory procedure rooms, and five-day in-patient regular ward and intensive care unit (ICU) health care encounters. Methods: Environmental modeling using life cycle assessment was employed to estimate greenhouse gas (GHG) emissions and other environmental impacts, from cuff manufacturing, packaging, transportation, use, cleaning, and landfill or incineration waste management. Cuff, cleaning, and packaging materials were identified and weighed directly. Both per-encounter and per-day low-level disinfection scenarios were performed. Life cycle costs were determined with hospital data, including procurement, labor (time-motion observations), and waste disposal. Results: For all use and cleaning scenarios, the reusable cuff was environmentally preferable in terms of GHG emissions and other impact categories, in some cases by a factor of 40. Disposable cuff emissions are dominated by materials manufacturing, while reusable cuff emissions are dominated by production of disinfection wipes. Reusable cuffs are far cheaper than disposables in the out-patient settings. Disposable cuffs are slightly lower cost in the in-patient setting where reusable BP cuffs are shared among patients and therefore require frequent cleaning. However, reusable cuffs are also more economical in the in-patient settings when patients have dedicated personal equipment (i.e., stays with them during their entire health care encounter) whether cleaned daily or at the end of their stay. Conclusion: Life cycle assessment and costing highlight environmental and financial trade-offs between manufacturing and cleaning when comparing reusable and disposable BP cuffs.