Environmental impact of personal protective equipment distributed for use by health and social care services in England in the first six months of the COVID-19 pandemic

J R Soc Med. 2021 May;114(5):250-263. doi: 10.1177/01410768211001583. Epub 2021 Mar 16.


Objective: To quantify the environmental impact of personal protective equipment (PPE) distributed for use by the health and social care system to control the spread of SARS-CoV-2 in England, and model strategies for mitigating the environmental impact.

Design: Life cycle assessment was used to determine environmental impacts of PPE distributed to health and social care in England during the first six months of the COVID-19 pandemic. The base scenario assumed all products were single-use and disposed of via clinical waste. Scenario modelling was used to determine the effect of environmental mitigation strategies: (1) eliminating international travel during supply; (2) eliminating glove use; (3) reusing gowns and face shields; and (4) maximal recycling.

Setting: Royal Sussex County Hospital, Brighton, UK.

Main outcome measures: The carbon footprint of PPE distributed during the study period totalled 106,478 tonnes CO2e, with greatest contributions from gloves, aprons, face shields and Type IIR surgical masks. The estimated damage to human health was 239 DALYs (disability-adjusted life years), impact on ecosystems was 0.47 species.year (loss of local species per year), and impact on resource depletion was costed at US $12.7m (GBP £9.3m). Scenario modelling indicated UK manufacture would have reduced the carbon footprint by 12%, eliminating gloves by 45%, reusing gowns and gloves by 10% and maximal recycling by 35%.

Results: A combination of strategies may have reduced the carbon footprint by 75% compared with the base scenario, and saved an estimated 183 DALYS, 0.34 species.year and US $7.4m (GBP £5.4m) due to resource depletion.

Conclusion: The environmental impact of PPE is large and could be reduced through domestic manufacture, rationalising glove use, using reusables where possible and optimising waste management.

Keywords: Environmental issues; health policy; public health.

MeSH terms

  • COVID-19 / epidemiology
  • COVID-19 / prevention & control*
  • England / epidemiology
  • Environment*
  • Health Personnel / statistics & numerical data*
  • Humans
  • Medical Waste Disposal / statistics & numerical data
  • Personal Protective Equipment / statistics & numerical data*
  • Social Support*


  • Medical Waste Disposal