Study: OR waste training boosts recycling, but impact fades with time

Editor's Note

A single training session on waste segregation significantly increased recycling rates among OR staff, but gains began to erode within two months, according to a study published May 26 in Nature: Scientific Reports. Conducted at Ankara University Cebeci Hospital, the quasi-experimental study assessed the impact of a single-session, face-to-face waste segregation training on OR staff behavior over a four-month period.

Researchers enrolled 53 perioperative professionals—including doctors, nurses, anesthesia technicians, and cleaning staff—and collected data across three time points: baseline (pre-training), immediately post-training, and two months later. Staff received a 40-minute in-person session with both theoretical and practical instruction on the environmental impact of OR waste, proper bin usage, and the broader climate implications of healthcare-related emissions. Staff awareness also shifted. Before training, 40% of doctors lacked adequate knowledge of proper segregation practices. Interestingly, those most supportive of the training were often the least informed (p=0.02), highlighting significant education gaps. After training, 90.6% of participants expressed satisfaction, and 98.1% affirmed the importance of waste management.

Despite the initial success, the rebound in medical waste and dip in recycling at follow-up suggest that a one-time session is insufficient for lasting change. The study recommends profession-specific, recurring training to reinforce sustainable behaviors and prevent backsliding. It also identifies time pressure and individual resistance as leading barriers to consistent waste segregation in high-acuity OR environments.

While this single-center study did not measure cost savings, the observed 30% increase in recycling and 17% decrease in medical waste align with prior findings linking better segregation practices to reduced environmental impact and operational expenses. The results underscore the critical role of continuous, targeted training in embedding sustainable practices into perioperative workflows.

Key findings include:

• Recyclable (blue bag) waste per surgery increased significantly from 1.30 kg to 1.80 kg (p=0.01) immediately after training.
• Medical (red bag) waste per surgery decreased from 4.92 kg to 4.14 kg, though the reduction was not statistically significant (p=0.09).
• Total recyclable waste rose from 18.90 kg to 25.81 kg (p=0.001).
• Total medical waste dropped from 71.10 kg to 59.35 kg (p=0.01).
• Two months later, the changes began to regress, with recyclable waste at 1.79 kg per surgery and medical waste climbing back to 5.07 kg per surgery.

Staff awareness also shifted. Before training, 40% of doctors lacked adequate knowledge of proper segregation practices. Interestingly, those most supportive of the training were often the least informed (p=0.02), highlighting significant education gaps. After training, 90.6% of participants expressed satisfaction, and 98.1% affirmed the importance of waste management.

Despite the initial success, the rebound in medical waste and dip in recycling at follow-up suggest that a one-time session is insufficient for lasting change, researchers write. They point to time pressure and individual resistance as leading barriers to consistent waste segregation in high-acuity ORs. They also note that although cost savings were not measured, results align with prior findings, underscoring the critical role of continuous, targeted training improving OR sustainability.