In May 2022, Cook Medical, a medical device manufacturing company, received the Chelsea Santucci Greenovation Award from Kimberly-Clark Professional. Cook Medical won this award for its industry-leading efforts in recycling nitrile gloves. Erin Kunkel, Corporate Social Responsibility Manager at Cook Medical, shared her insights on how this recycling goal changed Cook, what kinds of industry barriers medical device companies face when recycling materials, and what the future of recycling could hold for health companies.

How did Cook Medical get involved in this nitrile glove recycling project?

An innovative Environmental Health and Safety specialist Karl Schiefer noticed the amount of nitrile glove waste being produced in our manufacturing areas. He connected with a member of our procurement team (Kevin Briles), who reached out to the manufacturer and found out about the RightCycle Program by Kimberly Clark. The RightCycle program is an innovative program led by Kimberly-Clark Professional to recycle single-use cleanroom and laboratory gloves and garments. The main goal of the program is to provide better waste management resources that coincide with the industry’s Corporate Social Responsibility and sustainability efforts. Karl then worked with housekeeping to develop a process for collecting and sending the gloves back through RightCycle, and the housekeeping team took on the associated daily tasks to make this into a successful and sustainable program.

What does Corporate Social Responsibility mean to Cook Medical?

Corporate Social Responsibility at Cook Medical means that we are doing business differently than conventional medical device manufacturing. We are looking through the lenses of
ethical governance, environmental sustainability, and working together to remove barriers inhibiting our communities. We are working to become a more equitable and sustainable organization that solves problems for our communities while serving patients.

Why is recycling important to Cook Medical?

Recycling is important to us for many reasons. First, we believe in understanding and addressing the health of patients holistically, which includes the positive and negative impacts associated with a person’s environment. Studies have proven that air quality impacts lung and heart health, access to natural spaces impacts mental health outcomes, and so on. As a medical device manufacturer, we see it as our responsibility to understand our impacts on the environment and improve them for the long-term health of people and the planet.

We also recognize that the materials we use to produce medical devices are finite—we cannot take for granted that the plastic tubing (derived from petroleum), metals wires, and many other
components that go into a single device will be available to us indefinitely. There is a lot of value in our materials because we have regulatory and quality obligations to work with virgin materials (those without recycled content). For this reason, we are increasingly interested in scrap rates, overproduction/expiration, and the amount of materials that go to waste during the manufacturing process. Thinking in a more circular manner enables us to look at the byproducts of our processes as opportunities rather than wastes.

A Kimberly-Clark Professionalrepresentative presents the Chelsea Santucci Greenovation Award to Cook Medical team members.Photo courtesy of Cook Medical.

What are barriers that medical and health companies face when it comes to recycling?

It can be challenging to parse through the complex processes and varied materials that go into manufacturing medical devices and identify actionable opportunities to improve. Every adjustment to the process can have down-the-line impacts. We must be very mindful that this is a heavily regulated and quality-controlled space and everything we do can have an impact on patient outcomes and our ability to deliver a product to a patient in need. Therefore, it is critical to empower the people who know our processes best to recognize inefficiency or waste in their daily work and give them the tools to work together and continuously seek improvement.

Connecting with recycling vendors and brokers who can guarantee your recyclables will not end up in a landfill has been an increasing challenge over the last few years. The commodity value for certain plastics is much higher than others, and as we transition to a more circular economy, we should see values increase across the board. For now, the value of recycling plastic and the availability of a local vendor to take your recyclables vary regionally. For this reason, it is important to develop transparent relationships with your regional vendors and think innovatively where you lack options. In central Indiana, we have partnered with nonprofit RecycleForce to broker our recyclables and waste streams while providing employment and wrap-around services for those who were formerly incarcerated. RecycleForce is a social enterprise focused on the re-entry of returning citizens from incarceration. The nonprofit is located in Bloomington, IN and has recycled more than 65 million pounds of electronic waste since starting in 2006. Their mission is to reduce crime through employment and job training while improving the environment by recycling electronic waste. We have also formed connections with companies who turn mixed plastics into biofuel or waste-to-energy in regions where this is the only primary alternative to avoid sending those plastics to the landfill.

It is also a challenge to recycle a completed medical device, as it is composed of various plastics and metals adhered together. The finished good is often considered bioburden due to the nature of use within the human body and must be incinerated to follow hospital protocol. These are all barriers to the recycling of finished medical devices.

How did Cook Medical overcome those barriers, and what recommendations would you have for other companies? 

Cook Medical received the Chelsea Santucci Greenovation Award for the last two years for the volume of gloves being recycled by our headquarters site. This is the direct result of employees who were empowered to recognize an inefficiency and work together to resolve it, continuously seeking improvement as they did so. These are some of our core Cook values and Karl, Kevin, and others readily demonstrated them by identifying the issue of nitrile glove waste and coming up with a sustainable solution together. It is also key to mention that Kimberly Clark saw the value of the used nitrile and created the takeback program to give consumers a more sustainable option. Checking into your vendors’ existing takeback or recycling-facilitation programs can be a great option, prior to searching for regional recycling or waste-to-energy solutions. I would also recommend looking into social enterprise solutions in your area that might create jobs for marginalized populations or otherwise solve myriad societal issues while facilitating recycling. We have found this type of partnership to be very rewarding and to go beyond a typical vendor/customer transaction.

What do you think is the future of recycling in the medical device industry?

Recycling and circular economics thinking will need to become the standard in the medical device industry over the coming years. We are already seeing suppliers throughout the supply chain increasingly being held accountable for the recyclability of their goods and the packaging in which they deliver them. From nitrile gloves supplied to a device manufacturer to a medical device sold to a hospital system, today’s waste to landfill rates are not sustainable. Emerging recycling and waste-to-energy technologies and social enterprise business models will continue to disrupt business-as-usual and will hopefully provide industry-scalable solutions. Current regulatory requirements to use virgin materials restrict us from considering recycled content materials in product development. The regulatory landscape and long timeline for the submission of products prohibits the switch from carbon intensive polymer-based plastics to new, less carbon-intensive bio-based materials. Knowing that patient safety needs to remain our primary consideration, we need to begin to think more critically as an industry about the origins of our requirements, the intended and unintended consequences they are having, and how we could be more open to emerging technologies like biomaterials in the future.

For more information, contact Erin Kunkel at e[email protected] or Marsha Lovejoy at [email protected].