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. While there will be no difference in the look, feel and performance of our endoscopes, the handles will be composed of material with a lower carbon footprint.

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 ABS plastic used in the handles emits 70% less CO2 than handles made from purely fossil-based ABS plastic.* (Note that this reduction applies to the carbon footprint of the ABS plastic in the handle only, not the full lifecycle for the finished good.) 

In the future, we will build on this initiative by expanding the use of bioplastics in other parts of our endoscopes. We will also work towards introducing  bioplastic material with an even smaller carbon footprint.

 

*Based on cradle-to-gate LCAs on the raw material from the supplier. The LCAs compared ABS plastic made with 100% fossil-based feedstock with our new bioplastic ABS (which consists of 50% second-generation bio-based feedstock and 50% fossil-based feedstock).  

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

Download a copy of Ambu’s carbon reduction plan  

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 with single-use, you dispose of the endoscope itself after each use. But it is important to consider that, unlike reusable endoscopes, single-use endoscopes do not require reprocessing.

A multitude of single-use products are used for reprocessing

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

  • check Chemicals and water
  • check Brushes
  • check Sponges
  • check Cloths and personal protective equipment

While further research is needed to get a picture of the full life cycle in different clinical areas, one urology 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 litres of water1-3, and for reusable cystoscopes, 60 litres 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, the 100+ steps of reprocessing 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

The future of single-use endoscopes

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.

Our environmental initiatives

Ambu's primary goal is to deliver innovative devices that help healthcare professionals improve patient care and save lives.

At the same time, we are acutely aware of our obligation as the leading single-use endoscope company to act responsibly towards our colleagues and business partners and the planet on which we all live.

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

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

Learn more about single-use benefits

Discover how Ambu’s sterile single-use endoscopes provide consistently high quality and performance, improve patient safety, help streamline workflow and give you greater cost-transparency across multiple clinical areas.

SINGLE-USE BENEFITS

Learn about Ambu single-use endoscopes for clinical areas

Pulmonology
Explore

Ear, Nose & Throat
Explore

Gastroenterology
Explore

Urology
Explore

JOIN THE CIRCLE

Want to get involved?  

Our efforts to minimise our environmental impact are part of an ongoing journey we are taking together with our partners, customers and other stakeholders.

If you're interested in joining us on our path towards a more circular approach to endoscopy, sign up for our newsletter. You'll be the first to hear about environmental initiatives, and to discover opportunities to participate in pilot projects and partnerships.

SIGN UP NOW

 

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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