Ambu’s circular approach

Single-use endoscopes and the environment

Leading by example 

We aim to create solutions that not only improve healthcare for professionals and their patients, but also have the lowest environmental footprint possible via:

  • An integrated circular approach from product design to manufacturing and disposal of our devices 
  • Research to find renewable materials that reduce the impact of the plastic in our products and material used for our packaging 
  • Solutions for take-back and recycling processes that keep our products from ending up in landfills and transform waste into energy 
  • Immediate actions that offset the environmental impact of our products while we simultaneously work towards long-term solutions 

Ambu’s ongoing collaborations with customers, partners and suppliers help to drive a circular approach, which every participant adds to and benefits from. Join the Circle.  

 JOIN THE CIRCLE

Get an overview of our efforts to drive circular thinking in the healthcare industry.

Introducing bioplastics in our endoscopes

The world’s first endoscopes with bioplastic material

One tangible example of how we are paving the way in sustainability for single-use endoscopy is by introducing the use of bioplastics in our endoscope handles. This will start with Ambu® aScopeTM Gastro Large, and by 2025, we aim to  use bioplastics in every endoscope handle we produce.

A more sustainable source of material

Bioplastics are made from second-generation bio-based feedstock mixed with fossil-based raw materials. Second-generation bio-based feedstock:

  • check Is made from by-products and waste, such as used cooking oil
  • check Doesn’t compete with food and agriculture production
  • check Opens the possibility to recycle the organic waste into valuable resources

Reduces our carbon footprint

The use of bioplastic material in our endoscope handles will reduce the carbon footprint of the ABS plastics we use by 70%. In the future, we will build on this initiative by expanding the use of bioplastics in other parts of our endoscopes.

For more information on our bioplastics initiative, read the FAQ.

Learn more about single-use endoscopes and the environment

Scroll down to learn how single-use endoscopy solutions compare with reusable ones in the area of sustainability and how we envision the future for the recycling of single-use endoscopes.

Have you considered the hidden waste associated with reprocessing?

It's true that single-use endoscopes are disposed of after each use. But it is important to consider that single-use endoscopes do not require reprocessing.

A multitude of single-use products are used for reprocessing

Single-use eliminates the energy consumed for reprocessing as well as the disposal of cleaning materials such as:

Chemicals and water

Brushes

Sponges

Cloths and personal protective equipment

While further research is needed to get a picture of the full life cycle, one study showed that the solid waste from one reprocessing cycle was four times heavier than the waste of one single-use cystoscope.1

The image shows the solid waste generated by one reprocessing cycle of reusable endoscopes. Single-use eliminates reprocessing and all the associated waste.

One reprocessing cycle
uses more water than a typical shower

Studies show that the amount of water used for one reprocessing cycle of a reusable bronchoscope uses 64 liters of water1-3, and for reusable cystoscopes, 60 liters of water are used.

The amount of water used for reprocessing a reusable bronchoscope and cystoscope, respectively, is more than the amount used in an average shower.1-3

The reprocessing of reusable endoscopes
involves hazardous gases

In addition to the impact on water quality, reprocessing's 100+ steps can involve gases and liquid chemical by-products of high-level disinfectants (such as o-Phthalaldehyde and glutaraldehyde) that can be hazardous and, in some cases, illegal when disposed of in sewers.4-6

 

Chemicals that are harmful to your staff and the environment

Chemicals used for reprocessing not only have a negative environmental impact, they can also cause asthma, dermatitis,
mucous membrane damage, and eye and skin damage for healthcare professionals.7

What do comparative studies say?

Single-use impact equal to or less than reusable in some cases

Three studies suggest that when everything is considered, the environmental impact of single-use ureteroscopes, bronchoscopes and cystoscopes is in fact equal to or less than that of their reusable counterparts. Further research is needed to determine the full life cycle impact.

Ureteroscopes
A peer-reviewed study showed the environmental impact of a reusable flexible ureteroscope and a single-use flexible ureteroscope are comparable.8
Learn more

Bronchoscopes
A peer-reviewed study concluded that the energy consumption and CO2 emissions of single-use bronchoscopes were equivalent to or less than what resulted from reprocessing reusable bronchoscopes.2
Learn more

Cystoscopes
A peer-reviewed life cycle study found that the environmental footprint of a flexible cystoscopy procedure can be reduced by using a single-use cystoscope instead of a reusable one.9
Learn more

Research shows great promise for the recycling of single-use endoscopes

A recyclability analysis of aScope 4 Broncho showed that, theoretically, this endoscope can be safely collected and disassembled and more than 85% of its weight can be recycled10

While current regulations make the recycling of single-use endoscopes unfeasible due to medical risks, our long-term goal is recycling at scale in all focus markets by 2025.

Currently, we have a take-back and energy recovery partnership with Sharps in the U.S. and a take-back and recycling pilot project in Germany.

While we explore future possibilities for safe single-use endoscope processing and recycling, we're launching other initiatives. For example, we've partnered with Plastic Bank® to support the collection of ocean-bound plastic waste to offset the effect of our aScope endoscopes in EMEA and Latin America.

Learn about Ambu's environmental commitments, actions and partnerships.

Learn about Ambu single-use endoscopes for clinical areas

Pulmonology
Explore

Ear, Nose & Throat
Explore

Gastroenterology
Explore

Urology
Explore

References

1. Tiphaine Boucheron, Eric Lechevallier, Bastien Gondran-Tellier, Floriane Michel, Cyrille Bastide, Nathalie Martin, and Michael Baboudjian.Cost and Environmental Impact of Disposable Flexible Cystoscopes Compared to Reusable Devices. Journal of Endourology. Oct 2022.1317-1321. https://doi.org/10.1016/j.purol.2021.08.067.

2. Birgitte Lilholt Sørensen, Henrik Grüttner. (2018) Comparative Study on Environmental Impacts of Reusable and Single-Use Bronchoscopes

3. Australia: https://www.mdba.gov.au/sites/default/files/water-volumes-teacher-notes.pdf (55L per shower)
EU: European Environment Agency https://www.oieau.org/eaudoc/system/files/documents/41/209216/209216_doc.pdf
US: Alliance for Water Efficiency: https://home-water-works.org/indoor-use/showers

4. https://www.civco.com/blog/how-to-dispose-of-high-level-disinfectants-safely

5. https://www.oshasolutions.com/blog/why-neutralize-high-level-disinfectants/#:~:text=Is it Illegal?,(POTW) without first neutralizing.&text=That the sole active chemical of the neutralizing solution is glycine.

6. Program-wide Scope Reprocessing Competency Package, Kaiser Permanente, p. 41, https://studylib.net/doc/7338200/rinse%09flush

7. Walters 2019, SGNA 2013

8. Davis NF, et al. J Endourol. 2018 Mar;32(3):214-217. Carbon footprint in flexible ureteroscopy: a comparative study on the environmental impact of reusable and single-use ureteroscopes (Carbon Footprint in Flexible Ureteroscopy: A Comparative Study on the Environmental Impact of Reusable and Single-Use Ureteroscopes (s-icd.ca))

9. Baboudjian, et al., Life Cycle Assessment of Reusable and Disposable Cystoscopes: A Path to Greener Urological Procedures, Euro Uro Focus, 2022 Dec, Epub ahead of print

10. Recycling pilot project – data available upon request

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