A Life Cycle Assessment (LCA) is a systematic analysis of the environmental impacts associated with all the stages of a product’s life from cradle to grave. This starts with the extraction of raw materials, materials processing, manufacturing, distribution, use, repair and maintenance, and disposal or remanufacturing or recycling. LCAs provide a comprehensive view of the environmental impacts associated with all stages of a product’s life cycle. This can prevent a narrow outlook on environmental concerns and help to avoid shifting problems from one life stage to another.

History of the development of LCAs:
Late 1960s and early 1970s: Initial forms of LCA were used for energy analyses of systems, known as “net energy analysis.” The Coca Cola Company conducted one of the earliest LCAs in 1969 to understand the environmental impacts of its packaging options, comparing reusable versus disposable containers.
1970s and 1980s: The energy crisis of the 1970s led to an increased interest in energy efficiency and conservation, and this helped to stimulate the development of LCA. The concept of LCA began to gain wider acceptance and application in several industries.
Early 1990s: LCA methodologies started to become more formalized and standardized. The Society of Environmental Toxicology and Chemistry (SETAC) played a key role in this, establishing a working group in 1990 to develop a framework for LCA.
1997: The International Organization for Standardization (ISO) published the first international standards for LCA (ISO 14040), which provided principles and a framework for conducting and reporting LCA studies.
2006: The ISO updated its LCA standards (ISO 14044), including new requirements for conducting LCAs, such as a mandate for critical reviews for comparative assertions intended to be disclosed to the public.
2011: The United Nations Environment Programme (UNEP) and the Society of Environmental Toxicology and Chemistry launched the Life Cycle Initiative to enable users around the world to put life cycle thinking into effective practice.
2010s and beyond: LCA became widely used in both academia and industry and started to play an increasingly important role in policy-making. The use of LCAs expanded beyond products to include services, organizations, and even whole economies. LCAs began to extend to include social and economic impacts, in addition to environmental impacts, leading to the development of Life Cycle Sustainability Assessments.
2022: Researchers from Dalhousie University in Canada and Brighton and Sussex University in the UK release HealthcareLCA, an open-access database of LCAs of healthcare products.

The science behind LCAs is evolving and improving,  driven by advances in data collection and modelling, and by the urgency of addressing climate change.

In addition to taking a holistic view at environmental impacts, LCAs are crucial for environmental research for the following reasons:

Decision support: They provide valuable information to help decision-makers in industry, government or non-profit organizations to make more informed decisions.

Identifying improvements: By understanding the life cycle of products or processes, organizations can identify areas where improvements can be made to reduce environmental impacts.

Benchmarking: They provide a basis for comparing products or services, and can help identify which products are more environmentally friendly.

Communication: They help in communicating information about the environmental performance of products or services to stakeholders, including consumers and regulators.

Policy and strategy formation: Policymakers can use LCAs to help develop regulations, guidelines, and policies that promote more sustainable practices.

Business competitiveness: In a world increasingly concerned with sustainability, companies can leverage

LCA to demonstrate their commitment to environmental stewardship, providing a competitive edge in the marketplace.

Below is a summary of LCAs comparing reprocessed single-use devices (R-SUDs) with their virgin alternative.  In every case, reprocessed devices are found to reduce greenhouse gas emissions compared to using an original device for each patient procedure.

Anna Schulte, Daniel Maga, Nils Thonemann. Combining Life Cycle Assessment and Circularity Assessment to Analyze Environmental Impacts of the Medical Remanufacturing of Electrophysiology Catheters. Sustainability, January 17, 2021

This LCA compares the environmental impacts of using remanufactured versus newly manufactured electrophysiology catheters. The results show environmental superiority of reprocessing in 13 of 16 categories, including global warming impact reductions of more than 50%.

Julia A. Meister, Jack Sharp, Yan Wang, Khuong An Nguyen. Assessing Long-Term Medical Remanufacturing Emissions with Life Cycle Analysis. Processes, December 24, 2022.

This LCA sensitivity analysis takes a closer look at the Schulte-authored Fraunhofer study (below).  It compares the carbon emissions of virgin and remanufactured electrophysiology catheters. The study finds that remanufacturing can achieve up to 60% emission reductions per use and remanufacturing cycle and 57% over the total lifespan of the device compared to virgin manufacturing. An “extensive sensitivity analysis and industry-informed buy-back scheme simulation” reveals long-term emission reductions of up to 48% per remanufactured catheter life.

Amanda Andersen, Siri Fritze Sørensen. A Case Study of the Environmental and Economic Sustainability of Using Remanufactured Ultrasound Catheters. Aalborg University, June 2022

This master’s thesis investigates the environmental and economic benefits of deploying remanufacturing as a strategy for circular economy in the healthcare sector in Denmark. The case study of remanufacturing single-use ultrasound catheters at Aarhus University Hospital shows that remanufacturing reduces climate change impact by 36%, with an overall, approximate 40% reduction in all environmental categories. The results indicate that remanufacturing single-use medical devices is a viable solution to reduce environmental impact and costs, and legalizing remanufacturing could pave the way for a sustainable transition in the healthcare sector in Denmark.

Chantelle Rizan, Tom Brophy, Robert Lillywhite, Malcom Reed, Mahmood F. Bhutta. Life Cycle Assessment and Life Cycle Cost of Repairing Surgical Scissors. The International Journal of Life Cycle Assessment, June 2, 2022

Evaluates the environmental impact and financial cost of repairing reusable surgical scissors as an alternative to replacement in healthcare settings. The study concludes that repairing surgical scissors at the end of their functional life can significantly reduce life cycle costs and environmental impact (average 19% reductions in carbon emissions and 30% reduction in 18 midpoint indicators) compared to purchasing new ones. The findings support the potential of regional or national repair centers as a sustainable strategy for the healthcare sector and emphasize the importance of optimizing the decontamination process to further enhance environmental benefits.

Chantelle Rizan, Mahmood F. Bhutta. Environmental Impact and Life Cycle Financial Cost of Hybrid (Reusable/Single-Use) Instruments Versus Single-Use Equivalents in Laparoscopic Cholecystectomy. Surgical Endoscopy, September 24, 2021
This study evaluates the environmental and financial impact of hybrid surgical instruments (combining single-use and reusable components) for laparoscopic cholecystectomy. Results show that using hybrid instruments significantly reduced environmental impact (average 60% reduction in 17 midpoint indicators) and carbon footprint compared to single-use equivalents, while also providing substantial cost savings. The authors conclude that “adoption of hybrid instruments could contribute to carbon reduction targets and cost-effective healthcare practices.”

Bart van Straten, Sharina Ligtelijn, Liecke Droog, Esther Putman, Jenny Dankelman, Nicolaas H. Sperna Weiland, Tim Horeman. A Life Cycle Assessment of Reprocessing Face Masks During the Covid-19 Pandemic. National Library of Medicine, September 3, 2021

This study compares the climate change impact and cost-effectiveness of reprocessed face masks compared to new disposable face masks in the context of the Covid-19 pandemic. Through LCA and cost analysis, it was found that reprocessed face masks had a 58% lower carbon footprint when reused five times compared to new masks used only once. The study highlights the potential benefits of circular economy strategies in reducing the environmental impact of medical products and advocates for the consideration of circular design engineering principles to create more sustainable and cost-efficient medical devices.