Life cycle assessment of stainless-steel reusable speculums versus disposable acrylic speculums in a university clinic setting: a case study

The reusable versus disposable debate is frequently discussed with regards to health care sustainability. Vaginal speculums used in pelvic exams are available in both disposable and reusable material designs. A comparative cradle to grave life cycle assessment (LCA) was conducted to determine and analyze the environmental impacts of using disposable acrylic speculums versus using reusable stainless-steel speculums in a women's university health clinic where around 5,000 pelvic exams are conducted on a yearly basis. Environmental impacts for the Tool for the Reduction and Assessment of Chemical and other environmental Impacts (TRACI) 2.1 categories were determined using process based LCA. The scope considered for the analysis includes the stages of raw materials, manufacturing, use, and end of life. The functional unit for all analyses is selected as 5,000 pelvic exams, which is equivalent to one year of clinic operation. The reusable stainless steel speculum system outperformed the acrylic speculum system in five impact categories: global warming, acidification, respiratory effects, smog, and fossil fuel depletion. There is one category, ozone depletion, where the acrylic speculum system performs better. When accounting for uncertainty, in the carcinogenics, non-carcinogenics, ecotoxicity, and eutrophication impact categories, there is no speculum system that outperforms the other. Overall, there is no speculum system that outperforms the other consistently across all TRACI impact categories, however, depending on the overall environmental objectives one may be preferable to the other.