Environmental Impact of Personal Protective Equipment in Dental Services During COVID-19: A Life Cycle Assessment Approach

Abstract

Objectives: COVID-19 has significantly influenced Personal Protective Equipment (PPE) use in dental services. This study quantifies the environmental impact of different PPE types used at Dublin Dental University Hospital (DDUH). Methods: A life cycle assessment was conducted to evaluate PPE used at DDUH in 2020/2021. PPE were categorized as: 1. Body protection: Disposable and reusable gowns. 2. Eye protection: Visor with a disposable face shield and reusable visor. 3. Respiratory protection: FP2SLw respirator, FFP2 respirator, and surgical mask. An environmental impact assessment was performed using OpenLCA (version 1.10.3) with the ecoinvent_37_cutoff database. Processes included manufacturing, packaging, transportation, and disposal, with an additional washing step for reusable gowns. The functional unit was one PPE product used for a single clinical visit. Results: Body protection PPE had the highest environmental impact, with reusable gowns consuming more water (4.74E-07 DALY) than disposable gowns (9.47E-08 DALY). However, climate change impact was greater for disposable gowns (3.99E-07 DALY vs. 1.99E-07 DALY). In eye protection, visors with disposable face shields had a higher impact than reusable visors, emitting five times more CO2-equivalent and consuming four times more water. Climate change-related damage was also higher (3.03E-07 vs. 5.89E-08 DALY). For respiratory protection, the FP2SLw respirator had the highest burden, followed by the FFP2 respirator and surgical mask. Global warming impact was highest for the FP2SLw respirator (7.92E-08 DALY), while water consumption impact was greatest for the FP2SLw (1.65E-08 DALY) and lowest for the surgical mask (3.84E-09 DALY). Conclusions: Reducing PPE's environmental impact requires prioritizing locally made, reusable, and recyclable materials. Disposable gowns were preferable to reusable gowns due to their lower environmental burden, but a lightweight polyester alternative could be more sustainable. Reusable visors outperformed disposable face shield visors. For respiratory protection, the FP2SLw and FFP2 respirators have the same filtration capacity. However, the FFP2 respirator, manufactured in Ireland, is lighter and has a lower environmental impact, making it the preferred option. When high filtration performance is not required, the surgical mask is the most environmentally sustainable choice among respiratory PPE.