Sir, in response to Ifrah Khan's Being mindful of the environment: Why does it matter to dental students?,1 we agree that the dental profession is a significant contributor to plastic usage and would also like to note the alarming increase of this during the COVID-19 pandemic. While single-use PPE protects dental professionals against the virus as they continue to provide essential service to the public, the long-term impact of the disposal of these materials remains a concern for the environment.
To enhance their fluid and pathogen filtration properties, some enhanced PPE donned during Aerosol Generating Procedures (AGPs) (e.g. respirators) are made of materials consisting of higher numbers of plastic polymeric layers compared to basic PPE (e.g. surgical face masks).2 As more AGPs will likely need to be conducted with the gradual return of elective dental procedures, the use of enhanced PPE is expected to increase as well. The concern in this situation is whether waste services will be able to manage the disposal of these materials safely.
“The long-term impact of the disposal of these materials remains a concern for the environment”
The persistence and durability of plastic polymers make it challenging to break them down into components that can be safely released into the environment. The combustion of plastic polymers not only produces air pollutants, but leaves micro-plastic residues as well.3 If not managed appropriately, the release of these substances into the environment can damage the delicate balance of ecosystems and bring about catastrophic effects. While there are legislations and government directives in place to prevent this from happening,4 the threat of another wave of the pandemic and the precarious state of the current economy can pose significant strain to waste services and make it challenging for them to safely manage clinical plastic waste.
The WHO has warned that COVID-19 may become endemic within the population.5 Thus, the public and healthcare sector's demand for PPE will likely remain high for the foreseeable future. It is crucial that we explore alternatives to ensure that our use and disposal of PPE is sustainable so that we can minimise the damage to the environment.
PR Chua, and JQ Teh, Glasgow
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Brenza A. COVID-19 'May Never Go Away,' Warns the World Health Organisation [Internet]. Health.com. 2020 [cited 8 November 2020]. Available from: https://www.health.com/condition/infectious-diseases/coronavirus/what-is-an-endemic-virus (Accessed April 2021).
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Chua, P., Teh, J. COVID-19 and plastic use in dentistry. BDJ Student 28, 6 (2021). https://doi.org/10.1038/s41406-021-0218-2