The February 2023 report issued by the U.N. Intergovernmental Panel on Climate Change stated that if human-caused global warming isn’t slowed to a couple tenths of a degree, deadly heat, drought, fires, and floods could impact the planet in “potentially irreversible” ways. Putting off cuts in mitigating carbon emissions, the report warns, “will miss a brief and rapidly closing window of opportunity to secure a livable and sustainable future for all” (

Doing nothing is not an option. The impact has already begun, and it’s measurable.

In 2020, a team of researchers led by Northeastern University’s Matthew Eckelman looked solely at the impact of hospitals and health services on climate change. Our hospitals, the cornerstone of community health, are a major emitter of greenhouse gases. Climate change derived solely from greenhouse gas emissions caused by hospitals results in Americans losing approximately 388,000 “daily adjusted life years,” or years of living in good health. Greenhouse gas emissions from U.S. hospitals account for around 6% of all U.S. emissions, making hospitals some of the largest generators of climate-changing emissions (

Digging deeper, the research team found that over 80% of these hospital-derived emissions come from the supply chain. Hospitals are massive consumers, and many of the items purchased are used once and tossed.

Human-derived climate change has caused a rise in incidents of heart disease and respiratory illnesses, as per the Centers for Disease Control and Prevention ( Hospitals, because of the greenhouse gas emissions they cause, appear to create a rising cycle of illness that likely results in an unfortunate increase in hospitalizations. Health care workers are committed to the Hippocratic Oath to “do no harm,” and have an obligation to stop this cycle generated by their place of employment. The work is beginning. At least 50 countries, including the U.S., have committed to reaching net zero emissions at their hospitals or to achieve low carbon, sustainable health systems (Health Aff 2020;39:2071-9).

The FDA has found that diagnostic ultrasound cardiac catheters can be commercially reprocessed and reused, lowering costs, waste, and cutting greenhouse gas emissions roughly in half. Photo courtesy of

So, what can be done? The search is on for “low-hanging fruit,” or relatively easy changes that can reduce emissions, particularly from the supply chain. Regulated reprocessing of certain single-use medical devices is a proven example of a sustainability solution in the health care industry already in use. By turning over used medical devices labeled for single use but found by the U.S. Food and Drug Administration (FDA) to be reprocessable, health care providers are partnering with commercial reprocessing companies to extend the service lives of millions of devices. The practice slashes greenhouse gas emissions and saves tens of millions of dollars in the health care industry every year (Sustainability 2021;13:898;

Despite this, recently published research from Yale University identified several barriers to more widespread adoption of reprocessing – chief among these being the anti-competitive, anti-consumer business practices of some medical device manufacturers (BMJ 2021;375:n2734; PLoS One 2022;17:e0279808). The research team, headed by Drs. Jodi Sherman, Emily Goddard, and Rachel Hennein, conducted interviews with physicians and staff throughout a major regional health system to assess their perspectives on facilitators of and barriers to reprocessing (;; They found that, on the positive side, health care staff were supportive of reprocessing overall. Common themes included a desire for greater training for staff on how to handle reprocessed devices, and even support for dedicated project managers whose primary function is to oversee and develop reprocessing programs at their facilities. The interviews reflect continued interest in reprocessing among health care providers. While there is always more that can and should be done to promote and expand the abundant body of existing research supporting the safety and efficacy of reprocessed devices, most health care workers at all levels seem to grasp the intuitive environmental, cost-saving, and logistical advantages of the reprocessing industry. Another longstanding ailment in the health care sector under the spotlight: the concerted efforts of device manufacturers to sabotage the growth of reprocessing out of their own self-interest. Respondents described contracts with manufacturers that include language prohibiting reprocessing, even if the device is approved for such by the FDA. Moreover, they described instances of ”forced obsolescence” wherein – both at the hardware and software levels – manufacturers design their products to make reprocessing impossible. The paper concludes by, among other things, calling on federal and state authorities to enact legislation that would prevent manufacturers from engaging in these sorts of practices. We at the Association of Medical Device Reprocessors, or AMDR, support this suggestion wholeheartedly, having campaigned against these behaviors for over 20 years.

To prohibit reprocessing through contract language or to deliberately design obsolescence into one’s own device so it stops working after a single use can only be rationalized through a lens of profit maximization. By pursuing such a narrow agenda, some device manufacturers are part of the problem, contributing to a cycle of greenhouse gas emissions caused by a wasteful health care supply chain. As some manufacturers enrich themselves by strong-arming providers, the rest are left to deal with supply shortages and soaring costs. Regulatory authorities and health care providers must unite to put a stop to this situation. The Biden-Harris administration has set ambitious climate objectives and has made consistent efforts to include the health care sector as part of the solution.

If we are to meet these objectives, it is imperative that we make every effort to scale up “circular economy” solutions in this industry. That is, practices wherein products and resources are conserved and reused throughout the economy, rather than simply used once and needlessly disposed of. The right-to-repair movement, an idea once confined to the “fringes” of environmentalism, has exploded into the mainstream conversation of environmental-economic transformation, including the medical device industry.

Pulse oximeter cables, pictured here, are one of the most commonly reprocessed devices, helping to generate about 2,000 green jobs. Photo courtesy of

Hospital executives, surgical teams, nurses – and indeed all staff – have the ability to demand the shift from a “take-make-waste” linear approach to that of a circular economy that reduces emissions. If health care workers are fighting the good fight to reduce climate-changing emissions, their ability to choose FDA-regulated, reprocessed single-use devices is the front line of the battle. Though just one example of sustainable practices hospitals can and should conduct, growing reprocessing programs to reduce the health sector’s carbon footprint should be an easy step. Identifying and eliminating roadblocks is urgently needed to help our planet and all people.