Episode Transcript
[00:00:00]
Hello and welcome to this fourth series of GOSH Pods Goes Green. In this series, we will be exploring plastics in healthcare. I'm Nicola Wilson, the head of sustainable education at Great Ormond Street, and the project Lead for Born Green generation initiative at the hospital. Today I'm joined by, by Dr.
Elza Port from the UK Comfort Loop Project, and we'll be talking about the systems approach to sustainable products. Can you tell me a little bit about yourself and your role and your goals within it?
Thank you so much for having me on this podcast. So I'm, I'm Elza, I'm a researcher at the Plastic Waste Innovation Hub at University College London or UCL.
And I'm a mechanical engineer and in this project I work on the materials and design aspects of absorbent hygiene products.
Wow. I just love the fact that even though our fields are so far apart with me being a paediatric nurse, that actually [00:01:00] these things have such commonalities. Thank you so much.
One question that I'm asking everyone in this series, because I think it's really useful to understand where we come from, and it's kind of apart from the project. But I kind of wanna know what was your trigger point? What was the moment that you realised that we have this climate and health emergency and that you felt an urgency to act or to bring it into your professional world?
I find it quite difficult to point it down to single trigger point. I think for me it was a very gradual process where I maybe made first some small personal choices that I thought would be more sustainable. Thinking about the food we eat or the way we travel. Then this opportunity came along where with the, the project that I'm working on now where I can really work on those values around sustainability in a professional sense as well.[00:02:00]
So for me, it wasn't this aha moment where I thought, now we have a problem and I need to act on it. It's all these little steps towards it's all these little steps towards. Making decisions in my personal, but also now my professional life.
Yeah. Thank you. And can you tell us about the Comfort Loop Project and what products are you focusing on?
Comfort Loop is looking at sustainability options for absorbent hygiene products. And that covers many products, including nappies, adult incontinence, and period products. And these are largely disposable products, so we use them once and then we throw them away. And in the UK, 1 million incontinence products are used every year and also thrown away.
For nappies, this number is even bigger. 'cause globally 300,000 nappies are used and thrown away every minute. [00:03:00] So that's a huge, huge amount of waste. And in the UK and other European countries, that's, that amounts to about 8% of the, the black bin waste. So about 8% of general waste is this absorbent hygiene product waste, and there's almost no circularity.
So most of this will be incinerated or landfilled, or if there's no infrastructure in in countries, then it might end up in the environment. So in the Comfort Loop project, we look into how this can be more sustainable by looking at other options including reduce, reuse, recycling, composting options but also alternative new waste treatment methods.
Wow. It is really staggering when you say that statistic of how much is thrown away. I, I suppose it's staggering, but somehow not surprising. When and we don't need to [00:04:00] look far to see the problem about plastic waste around us. I think personally we would see it as even more of a stark problem If we weren't in the UK and didn't have that privilege, and maybe we were in a country where waste was often shipped to, and it landed on our shores, then maybe we would see that as, as a a larger problem.
But can you help us understand that global scale of plastic waste that's generated by hygiene products?
I think hygiene products are maybe a funny one 'cause it's not, you don't immediately think about plastics. But when we think especially about the nappies and the adult incontinence products, roughly 20 to 30% is traditional plastics like polyethylene, polypropylene.
And then another 15 to 40% is another polymer called a super absorbent polymer, which the name already ex describes it. It's responsible for the absorbing [00:05:00] function in the product. And the ratios are a little bit different if you're looking at children's products or adult products. But about, so about a third is traditional plastics, and then let's say another third is this, this super absorbent polymer.
Those de both degrade very, very slowly. So there are plastics in that sense. With daily use for infants, but also people with living with incontinence, that all adds up to millions of tonnes of plastic waste globally. And the United Nations has actually reported these absorbent hygiene products as one of the main contributors to plastic waste, but it's hidden because we don't think of nappies as a plastic product.
Yeah, I remember someone saying to me recently that if, if you take Henry VIII as an example, if he had used nappies as a child, as, you know, single use nappies as a child, that still exists today. And [00:06:00] that makes you,
you're absolutely right.
Wow. Gosh. You know, it's not just about how much we are producing every second, every minute now.
It's that longevity of the accumulation That's so staggering, isn't it?
It's absolutely staggering. It's hundreds of years they can exist.
Wow. And, but I feel that you guys give us hope, right? Because there, at least somebody out there is looking at this and looking at it, and you describe it as like a systems approach.
What does that really mean?
I am, first, I'm so glad that we're giving you hope. What we mean by a systems approach is that we don't only think about the product itself, but also about the people who use it or the people who care for someone who use it. All the other stakeholders in what we call the system.
So manufacturers, waste authorities policy makers. I'm probably forgetting many, many people here. But the, [00:07:00] the point is that we think about the product, having a whole lifecycle from raw materials to manufacturing, to use to disposal, and then incineration or landfill, and also recognising that there are so many aspects to this, and these are amazing products.
Let's not forget that they provide an essential function to many, many people in taking care of your children or maybe your parents. We have to acknowledge that, that this is a very complex problem and there may not be an easy solution, and it needs to include everyone who is included in this so-called system.
And that's why we take, say we take a systems approach because we don't look at one single aspect of the problem, but we try to look at as many as we can.
I get that not every plastic is a bad plastic. Right? Because there are sometimes that you just utterly need it. Yeah. I suppose in healthcare we [00:08:00] completely see that the, our volume of single use plastics is phenomenal.
But like you, with this project, you can't just wipe it out straight away. We have to think through the whole process.
Absolutely not. Yeah. Yeah.
Which is easier said than done, right?
Yes.
What I love about your project though, is that you all come from very different backgrounds. When I do a project, it's you pulling in procurement or nurses or risk or infection control or different health professionals, but you are really, truly made up of a wide variety of professions. Can you tell us a bit about who else is involved?
We have a very big range of disciplines in our team. We have a very big team. So we're supported by, by many professors and a policy expert, our research managers.
But the core team who's really working on this project on a day-to-day basis it's basically four of [00:09:00] us. So there's a behaviour psychologist, Ayşe. Now we have a lifecycle assessment expert, Gema, a biochemist, Luba, and then there's me as a mechanical engineer. And we all approach this from our different disciplines and we collaborate a lot to understand each other disciplines as well.
To really have the systems effort and to really learn from each other and learn about the different stakeholders and the different aspects of this product. Because as a mechanical engineer, I might get very excited about the materials and how amazing these materials are, and it's great to have than someone like Behaviour Psychologist to really think about the people.
That use this product and how they use the product. And I think that's the strength of our team, that we all come at it from a different perspective and remind each other of the importance of all these different disciplines and, and factors in the, in the project
[00:10:00] that you don't kind of, I suppose, get trapped down your own little rabbit hole that is too easy to fall down.
Right? Yeah.
It's very easy to be trapped in your own thinking and your own discipline, and it's great to have. Very many different, different opinions or views and expertise as well.
Yeah, definitely. That sounds like such a great team. I would love to have similar people around me through my projects.
And are there any materials or technologies you are particularly excited about that could replace those plastics in these products?
Hmm.
I think a technology that I'm quite excited about is not necessarily replacing the plastics in these products, but it's more around reusable products. So it's actually a different type of products. It's made from different materials, but it's reusable, it's [00:11:00] washable. And what amazes me about this is that the image we have in our minds of a reusable nappy is the Terry Nappy.
Like just a sheet that you wrap around your baby, and that's, that's a reusable nappy. But if you look at what is out there now, they look very cute, they have very fun patterns and they come, they've come a long way from the, the Terry Nappy. And I think that's an area where I'm quite excited about to see how that's gonna further develop.
I love that. I'm thinking about my son right now. I'm pretty certain that he's got little wee foxes on his nappy, which is just really cute. Yeah. Now I tend to find, and maybe this happens to you, maybe it doesn't, but when I talk to people and say I work in sustainability, almost the first thing that people say is, oh yes, we should recycle more, shouldn't we?
Or I've seen people put the wrong [00:12:00] things in the recycling and, I dunno, maybe it's that we're very British about recycling in a way that I didn't expect. And we are definitely gonna talk about waste in the last episode of this series. But when you talk particularly about absorbent products, what are the challenges around that kind of recycling aspect of them?
Recycling is a, as anything with absorbent hygiene products, quite a complex problem. As I said earlier, about 99% of all this waste goes to landfill or incineration. We only know of a handful of recycling facilities for absorbent hygiene products globally. So there's one in Wales and there's one in the Netherlands.
There's one in Japan. And we visited the one in the Netherlands, and it's complex to recycle because [00:13:00] absorbent hygiene products are complex products. They consist of different materials. So for easy recycling, ideally you would have a product that is just made of one material. Now, these absorbent hygiene products, they're plastics, they're absorbent polymers, they're glues, they're elastics.
So that makes it quite complex to recycle because you ideally want to separate out all these materials. So, what they do in the Netherlands is they heat it to a very high temperature and very high pressure, and that gives them. That allows them to separate the plastics from all the other materials. So they recycle the plastics, but they still have to incinerate all the other materials.
And we know that they're constantly working on this technology to make it better, to find ways to recycle also the super absorbent polymers, but it's all work in progress. So even though there's some technology out there [00:14:00] that can do it. We still have to look for, for better ways for recycling and that's where one of my colleagues, Luba is doing some work to see if enzymes can be used to break down the super absorbent polymers so they can recite, be recycled in that way.
And that would be a completely new technology. So it won't happen tomorrow, but we are also thinking about the future 10, 20 years ahead.
Wow. So in a way there's gonna be so many different solutions that you kind of come up with, and different avenues that you can take this down it that is a wide scale.
Absolutely. And recycling is only one of the things because in a traditional sort of. Way of looking at waste. You ideally want to reduce your waste, so not produce it at all. Then see if you can reuse something, and then only recycling. And I think that's also what we. Try to do in this project is look at all those [00:15:00] different options, because you're right, sustainability and recycling are very, very closely linked together.
Yeah. But it's not the only way and it's a very important way, don't,
yeah, no, it completely is. And it's no surprise that in the Netherlands they're doing that really well and brilliant to the Welsh. And so that's, it's really good to hear. I think we do as a society need to learn more about that waste hierarchy and where to start with the reduce than reuse.
I for one, you know, as a mum, wish I had been able to use the reusable nappies more. But there are like, just real challenges to it on there, there's just practicalities of every day, and in my experience, I don't feel like society is set up for us to cope with this as our norm anymore. I certainly know when I even kind of mentioned it to nursery for instance, that kind of like, oh, well it doesn't tend to work, and [00:16:00] we see more of this.
And the challenges that you have to overcome as one individual. But what kind of cultural or behavioural shifts do you think are really needed for us to make reusable products like this more mainstream? Especially for like busy families. Families just are busy, right? But also there's maybe with extra needs, medical needs on top of them.
I think there's not one single thing that needs to change. Unfortunately. I wish I was able to say, well, if we just change this one thing. We're, we're good. We can change the whole system. Unfortunately that's not how it works, so we don't have one single thing that needs to change or that we saw in our research.
What we did see is that what parents think might be helpful is more information or education training about these products. People may not even know that is an option [00:17:00] because they've. Just been seeing disposable nappies around them. That's what they see when they go to baby training or healthcare health visitors.
So it's also about being exposed to these sort of products. I'm very glad that you knew about these and even considered them. But it's also about time constraints for parents. And also there might be a cost element because you do have to invest in these upfront. On the long run, they might be cheaper, but there is this first additional cost that you have to go through.
So if you're not sure if this is for you, that can be quite daunting. So diaper libraries might help, or a couple of free products that parents can just use. And also I think it's important to mention that it [00:18:00] doesn't have to be one way or the other. So in our studies, we found that many parents who do use reusables, they don't exclusively use reusables.
So very often they might decide to go for a disposable product when it's convenient when they're out there about, maybe when the kids go to a nursery. Use the reusables when they feel comfortable doing that. And I think that's where we need to find as a society, also a balance between supporting parents to make sustainable choices but also recognising that it's not always the best choice for the parents at that particular moment.
To go for a reusable, maybe a hybrid option is just a better way to be sustainable. Not just environmentally sustainable, but be sustainable in the the practise that they can sustain.
I [00:19:00] was, I was really, really lucky when my little one was born that I lived in an area where our local council supported you to have a set number that you could just request and pick up from the local library.
And to have that opportunity to then just try them and figure out how do I adapt? Or use them within my space and my home. And what occasions is it possible and what other occasions actually would I be pulling my hair out? Yeah.
Yeah. And it can also be very helpful if you know someone who's been using them, who knows how to use them.
'cause you do have to approach it slightly differently. So if there's someone who can teach you a good way to use them, that works for them. All those little things help in, as you say, as a society, make these choices. And it's not a one thing we have to change or something that can happen overnight. And that's where the whole system, everyone, not [00:20:00] just the parents, but the health visitors and nurseries, maybe even support from your employer.
It all needs to come together. To move towards these different solutions.
Yeah, and you're completely right in saying that in the education bit. I was so fortunate that one of the ward managers that I had worked with for absolute years sent me this brilliant message as I went on maternity leave of.
This is the how to guide. And it was just what I needed. 'cause I could pick it up and put it down and just read what my brain could cope with. 'cause you're so tired what you are, you know, trying to digest and, and the practicalities. So to have that nudge and I would love to see us at Great Orrmond Street.
We might not be able to use them in the hospital right, because of all of the hygiene issues and, and things like that. But it would be nice if we could support parents as they're discharged on that education bit just for them to feel a bit more comfortable with it. That would be a lovely step for us to [00:21:00] take.
Yeah,
we would very much support that.
I'm, I'm taking my nudge here. Now. Normally I don't ever reflect so much on like my personal world when I'm like talking about podcasts or talking about my professional world of sustainability. But this happens to have caught me at this key junction in life. Clearly and my next utter challenge that I'm going into with my eyes wide open, but I think I still will underestimate how hard it's gonna be, is gonna be potty training.
And I absolutely know that I don't have added complications that a lot of our parents at Great Ormond Street will have because my little boy is thankfully very healthy right now. And I can't imagine how hard this would be to undertake if you had a child with a chronic health condition. But I am fortunate that at 18 months that he is now, he is able to [00:22:00] say you know, wee wee when he's got his nappy off.
And he's also able to tell me when he's having a poo. I mean, obviously as a parent you can see it written all over their face when this is happening. And then you kind of like almost try and hand them over to your partner at the same time. But that doesn't always work. Would I be mad in thinking now it's a good time to potty train him?
You know, I've introduced some of the books we are reading about them and that kind of thing. Is that mad what's going on across the nation when it comes to this?
You're absolutely not mad. Toilet training age has actually gone up quite a bit over the past decades. So on average, a, a child was trained around 27 months in the 1980s, that number went up to 36 months or later in the early 2000s. A recent school readiness report found that one in four children in the UK are not toilet trained when they start school. [00:23:00] So this increase in toilet training age is not only producing more nappies. Which is not good for the environment, but it's also not good for children developing going to school.
Health professionals also warn that it's more difficult to catch bladder and bowel problems early on, such as child childhood constipation. So that's also potentially affecting the health of the child. So it's quite important not just for the environment, but for many different aspects to toilet train at an appropriate young age.
So I would say early potty training is good and it's actually involving many skills, not just sitting on the potty and doing a wee or a poo. So to me it actually sounds like you have already started potty training by introducing the books, by picking up on the signals of when you need to poo or we, but it is [00:24:00] true that in our findings from a survey, 50% of parents don't really know when to start potty training. And of course, every child is different. It might be 18 months, it might be a little bit later, and there's no fixed timeframe. But most children, they are ready around 18 to maybe 30 months. And if you think that your child is ready now, earlier is usually better.
Yeah, I, you can just see that behavioural aspect that's starting to hit of lying the on the floor and stamping his feet and the, the no’s is starting to come in and I'm like, I would really like to get this in before the no’s become really outrageous.
I mean, I probably won't manage, but I'm gonna give it a shot. Right. It's worth a try. And it's so fascinating that you pick up on those health impacts. Certainly over the years, obviously, being a paediatric nurse, those conversations around [00:25:00] constipation. And normal routines and stuff. But these, this has significant impact on families. And on on kids and their sort of self-consciousness and the way that they socialise and stuff.
So yeah, I hadn't really kind of thought of it from that perspective. I had more also thought about the finance. It would be really nice not to have nappies on a weekly shop. Right. And to take that away sooner rather than later, especially right now. You can definitely save some money by. Potty training and not having to rely on the disposable nappies anymore.
Yeah, that would be nice. Well, wish me luck. I think I might need it.
I think you'll do. Brilliant.
We'll see. When it comes to period products, we've had this. Brilliant successful campaign here at Great Ormond Street led by an occupational therapist called Jacqueline Gordon. And she's managed to raise awareness of reusable products.
And what I hadn't realised that if you are going [00:26:00] in for a major operation, actually it is quite likely to bring on your first period earlier and things like that. So things I just hadn't necessarily considered and the impact that that has on children, I can't imagine. Starting my period in a hospital.
Wow. I mean, that is a whole next level to dealing with being a woman. But what Jacqueline's been able to do is make sure that if a patient needs a product on admission, then we can just ask the occupational therapist and they'll provide them with period pants. And I think that that's just, I'm really, I'm really proud.
I'm really thankful that she's done that because it introduces that reusable product right from the get go. Right. It doesn't introduce all the things that we were probably introduced with or certainly I was introduced to in the nineties. Are we starting to see a shift nationally towards reusable period products?
And based on your project, what changes would you like to see?
I don't have any numbers on this, but I think it's safe to [00:27:00] say that there is generally a move towards reusable period products. As you say, back in the nineties, maybe even two thousands, they weren't even on the shelves. Not that I'm aware of.
And now you walk into your local Pharmacy and you can just get, you could just buy them. It's very easy. So what we know in general from our project, and we're only starting to look into period products just now, so we don't have an awful lot of information yet, but gen reusable products generally have a environmental impact, so that's really great.
And we're still working on this to find out what are the barriers to using the products. Because we also know not everyone is using these, and maybe not, it's not suitable for everyone to use them. But if we look at what we found for the nappies, which is a very different product and a different group, so I don't want to generalise too [00:28:00] much but I think what you're doing at Great Ormond Street is a great example of education information.
Exposing people to these products might just be the first step. For long term use, and also the upfront costs are also similar to nappies. It is much cheaper to buy disposable products than to buy a reusable period product. But in the long run, if you are using that reusable product for years and years and years, it will be cheaper.
So it's about what can we do with the upfront costs to make this an accessible product. But like I said, it's very much work in progress still, but I think there's some parallels that we can draw from our previous work.
I can't wait to hear it unfold as you get deeper into this aspect of your project.
Like you say, I think you know the, in a way. [00:29:00] Certainly for nappies, you are nudged a little bit by what your family or your mum's done before. And it'd be interesting to see that sort of societal nudge and how that interplays with the period product aspect. I feel like that's a dot, dot, dot watch this space.
Yeah. I suppose, maybe this is a question that's too tricky to answer, but how do you ensure that sustainable options are accessible to all families, including those with financial or health related challenges? Because that's really my world, I suppose. How have you considered that within the project?
It is a very tricky question and we may not have specifically considered it in the project, but what we do try is to take an holistic approach where it's not just about what is the sustainable option. 'cause we don't think that exists. And it might look different for everyone, and it also needs to take into [00:30:00] account your personal circumstances.
But I think one of the things that could help. Is having this information and education about the products so everyone can make an informed decision about whether or not this is something that could be helpful to them making a sustainable choice if they want to. We do know that some councils offer vouchers or usable net piece although those are not always taken up.
On the other hand, we do know of one council in the Netherlands that ran a very small pilot scheme. So this is in no means, this is in no means a perfect example, but they gave parents the option to use reusable nappies and trained them to use them. And what they found is that most parents actually kept using [00:31:00] the nappies.
For some extent. So no one was just using reusable nappies, but a lot of parents use some sort of hybrid where they use reusables sometimes and maybe not other times. And I think there's definitely some potential there to really look into these options of providing parents with products, with education, and if that can help us move towards a more sustainable.
System.
It'd be great to crack into those prenatal classes, wouldn't it? That would be a real nudge to have it on that kind of curricular for those groups would be brilliant. Yeah. Okay. Let's see what we can influence that would be fab. And I, what I love about your approach is that. It seems like you're all very practical and pragmatic about it.
It's not like it's black and white. You must do this and thou must do this. And I, you know, you see that a lot with us talking about [00:32:00] sustainable diets and things like that. And it used to be that I would feel. Almost a pressure that I wasn't vegan, but actually now we hear people talking more about, well, maybe it's about adding in more vegetables to your diet, or add in some extra lentils, make that meal go a bit further.
So that overall you are eating less of that meat and I suppose what I love about that is it's single small steps that you can take. And yes, maybe one day you will be vegan, but actually let's make it manageable for a person. And that's what you are describing in, in the comfort loop is it's not always going to be your practical option.
It's not going to fit everybody's lives, but what are those single steps we can all take that will make a difference? I love that. That's really nice. My last question, 'cause I feel like I've grilled you. Are there any policy changes or like funding models that could help make reusable products [00:33:00] more widely available, particularly in healthcare settings?
Again, a very tricky question, which I wish, again, I had a black and white answer to where there's one single thing that could happen and magically things come together. So again, lots of things have to come together, especially in a healthcare setting where time burden on caregivers is really high. Also the infrastructure and the space have to work.
Where, where are your bins? Do they actually fit? Do you have space and infrastructure to do washing of reusable products? It also needs to be cost effective. We all know the NHS has limited funding. So I would almost think of the healthcare setting as in mini ecosystem. Again, a system where there's many different stakeholders, and if we look at wider society and what we know from that in using reusable [00:34:00] nappies, I think you might be able to draw some parallels there with being exposed to the products, the training and education, the laundry facilities, the investment, the long-term vision.
That needs to be in place because it may be cheaper now to have disposable products, but in the long run, reusables might be a more financially better option. And it's also being realistic about in which cases it may or may not be the best. It may not work for all wards or all patients, so maybe also considering.
Is there some hybrid model that can work for our healthcare setting? I think that's very important to consider and really look at specifics of the hospital or the care setting. And it's not about one size fits all. One [00:35:00] policy, one financial model that will work for everyone.
You are absolutely right there. There just never is one model is there. But thank you so much for sharing your project with us, and talking to us about that. I feel like you, every time I talk to you, you give me a nudge in the right direction. Make me think about the single steps I can make in my personal life, but also in my professional life and what I can do to maybe be a part of these nudges, to see if we can help with this.
So thank you very much for joining me today.
It's been my pleasure.
