Small steps toward a healthier environment will pay cumulative benefits that will far outlast and outlive us. We are all encouraged to reuse, recycle, conserve energy, go green, reduce our carbon footprint. It might seem downright trendy now to adopt green manufacturing technologies and explore ways to reduce waste in your business, but for O&P, the benefits may not always outweigh the costs.
The barriers to effective recycling efforts in the O&P industry are multifactorial. Smaller facilities may not have the manpower or the will to institute a recycling/reuse program. They have enough to do with patient care, burdensome paperwork and reimbursement issues, and staff and facility concerns; adding one more responsibility may be a back breaker. A smaller central fabrication facility simply may not have the volume of leftover or unused material to warrant the costs involved with reclamation of those materials, and a larger facility will have large cost outlays. And often, the price paid by material reclamation companies is abysmal.
“Our impact is negatable,” Scott Wimberley, RTPO, operations and technical director at Fabtech Systems, said. “With some of the materials we use, there is no reclamation method for them. It is such a niche industry.”
O&P business owners are consumers as well, and as such, can reduce, reuse, recycle and conserve much like they might at home, by using recycled paper products, LED or CFL light bulbs and coffee mugs. Small steps result in small savings. But big ticket savings can come from making an investment in green technology, installing solar panels and cost-efficient heating, and going paperless with EHRs. In the end, virtually every O&P business and central fabrication facility can do something to contribute toward a greener environment. The trick may be in thinking outside the box about recycling and conservation.
Facility and process savings
For some central fabrication companies, the issue may not be that they are creating too much waste, but their fabrication facility and processes are wasteful in terms of other energy consumption.
Wimberley stressed the importance of process planning and organization in minimizing waste in terms of time, energy and product.
“We can limit what we do, plan some sort of protocol for the amount of expenditure that you make into things and how schedule that,” Wimberley told O&P Business News. “So, for big heavy pieces of equipment that take a lot of energy to run, the jobs are staged so you’re able to do that in one shot vs. leaving it running.
“The things we do will have waste attributed to them, and that process involves safety regulations and other issues that make more waste than need be, but we’re still making less product than bigger industries. When you consider that, our impact is pretty small.”
Electricity, heating and cooling make up a huge chunk of a facility’s costs, but are important targets of waste and cost reduction.
“If you can flip the main breaker off to all unnecessary services at the end of the night…you’ll see that in your paycheck,” Wimberley said. Minimizing phantom loads—unused but plugged in electrical appliances and equipment, or energy “vampires”—can result in significant cost savings.
Mattear said a lower ceiling height affects both heating and cooling; good insulation will keep in the heat, while industrial fans effectively cool without the need for constant air conditioning.
Wimberley suggested choosing a heating source to best match a facility’s needs. He said many O&P facilities use convection heat, creating hot air that gets sucked out of the building by ventilation fans, which are required for safety purposes. Consequently, the furnace in the building has to run 24/7.
A radiant heat source is more efficient than convective heaters, he said. Radiant heat uses light waves to heat the environment, rather than heating up the air like a blower furnace. Air can circulate and eventually exit the building via ventilation fans, but the heat will remain.
“Recyclable materials in O&P has always been a conundrum,” Brad Mattear, CPA, CFo, Central US and National Strategic Account Manager, Cascade Orthopedic Supply, told O&P Business News. “People want to recycle until they find out there is a cost to recycle. And then you look at the cost benefit to recycling…you have to be pretty crafty to maximize the benefit.”
Mattear previously worked as general manager for a large central fabrication facility. “It irked me to death that we had all this leftover plastic and it made me angry that all of that plastic was going into a landfill. So I made it a point to find a place to get this recycled.”
He found a plastics recycler, which can be found in most cities, he said. “They’ll put a gaylord or a skid box in an area, and you fill it up with your scrap, and they’ll band it and take it. And they’ll fill up containers for container ships. They ship them to either Asia Pacific Rim or South America. There, the pickers open up the gaylords and separate the plastic into whatever their system is. For example, my plastic was getting shipped to Japan. The pickers were taking the plastic and recycling them so they can be manufactured into fast food toys for children meals.”
The problem with this is the extra employee effort to ensure the right type of plastic — colored, clear, copolyester, polypropylene, or a hybrid — is going into the right gaylord, because they shouldn’t be combined.
Denise Yonney, sales manager with Airlite Plastics Co. in Nazareth, Pa., said plastics contamination, either via comingling or contamination with other facility materials, such as plaster, is a problem to recyclers.
“With orthotics it is harder. A lot of orthotic shops are smaller, so either they don’t generate enough or they don’t have enough people on staff to keep it clean,” she told O&P Business News.
The large plastics extruder has three manufacturing lines that accommodate different sizes and textures of plastic. Yonney said they focus heavily on the O&P industry and mostly sell virgin plastic, but they have found a way to recycle some of their own scrap plastic from the customers they sold it to.
“We don’t buy any outside scrap, except from a few orthotic companies that we work with. They specifically have us buy their scrap back in the process, so it’s our material. We know it’s our material because it’s a specific color; we have been doing it a long time with this customer, and we’ve developed this recycling program with them. We would only use that in that customer’s orders. That customer worked with us to set a regrind level … and we work with them on the price, so they save a little money there too. All that material is blended in when we run the product; it is only used for a particular product. One particular customer uses it to make a walking boot. So it’s not touching plaster, and there’s really no contamination on the product.”
Yonney said they also sell their scrap plastic, particularly contaminated scrap, to an asphalt company, who uses it to fashion playground surfaces.
“This might be a good avenue for orthotic scrap,” Yonney said. But she acknowledged it may not be worth the trouble for a smaller shop.
“You are not going to get a lot of money, and you have to see how much freight it will take and how much of a headache it will be to gather that, how much do you really generate and how much would you get back,” she said.
The best way to limit your leftover plastic is to cut raw materials as close to their intended size as possible to begin with, Wimberley said.
“Does that mean you are going to get to a point where you throw nothing out? No. But out of a big sheet of plastic, you throw away 30% or more,” Wimberley said. “Some of that is process-dependent. You might need that percentage to form the piece and close the piece. But when you start buying your materials, if they are cut closer to sizing, you’re not dealing with secondary processing, which consumes energy.”
He thinks the recycling landscape could change if the price is right.
“The minute scrap plastic is $5 a pound, I’ll have to put a lock on the dumpster. Until then, the best reclamation source [a Chinese manufacturing company] would pay me $40 a ton. If that bag were worth $500, we’d be recycling like madmen.”
Foreign and recycled plastic
Mattear said manufacturing materials and plastics being developed overseas sometimes cannot be used in the United States because of the chemicals remaining in the product. A hybrid material for orthotic and prosthetic fabrication looks promising for use next year, he said, but because it contains formaldehyde, its use here, currently, has very strict government regulation and thus not cost effective for the field.
“They are trying to substitute an agent within the substrate so when they bring it to the US, it is able to be utilized,” he said.
Although using recycled plastic sounds like a good idea in theory, fabricators tend to shy away from using it, Wimberley said. It is not worth the savings per sheet or size.
“It’s not politically correct…everybody has to claim that everything is the highest standard because of reimbursement,” Wimberley said. Although this is not spelled out in reimbursement guidelines, there is a stigma attached to using reground or reclaimed plastic, aside from its potential to be less durable.
“Most practitioners and technicians want a virgin plastic; in our field, a lot of the orthoses we fabricate is with virgin plastic,” Mattear said. “Others don’t mind a regrind. But with regrind or recycled thermoplastic, when it is extruded again, it loses some of its structural integrity when compared to virgin plastic, thus the possibility for weakness.”
Foam and plaster recycling
For most O&P fabricators, once a plaster mold is used, it is tossed in the trash. Plaster is difficult to recycle back into plaster but it can be done, albeit at a significant cost and with decreased bonding power, Mattear said. However, he learned of a program in the Midwest in which farmers will pay for used plaster.
The gypsum in plaster acts as a fertilizer and soil conditioner, reduces runoff and counteracts soil acidity, among other benefits. “They will pulverize the plaster and use it in their fields. It loosens soil while providing much needed calcium and sulfate. It won’t adversely affect the pH balance in the soil,” Mattear said.
Residual polyfoam is often left over after model carving for cranial helmets, lumbar orthoses and the like. Again, although it may be easier to throw it out, there may be a reuse for it. Mattear suggested using the larger cuts of leftover foam for larger molds, such as for hip disarticulation, to lighten up the mold.
“When you wrap your large molds you fill them with those referenced or used cuts, and you pour your plaster into it. So now instead of having a 100% filled plaster mold, you have a space saver…but it is exponentially lighter than the weight of the plaster. This is important, because if somebody lifts up a mold and hurts their back, now you’re talking about workman’s comp.”
The decision to commit to a greener facility often starts at the top.
“When you talk about responsibility to recycle/reuse in material management, and you’re working with training and education to eliminate waste further… that is a huge consideration,” Wimberley said. “If you’re not continually educating what you know, to everyone who walks in the door, the company will never go in that direction. If you are not continually reviewing what you’re doing and why you do it, what the goal is, you will never practice it.”
Educating staff and employees in waste reduction or management may be as simple as watching a YouTube video on the subject, or bringing in a representative from a reclamation facility to explain the procedures they use to recycle. Not only does this make the process of recycling more interesting, when the benefit is clearly explained, it may be more effective in establishing the will to make the effort. Employees want to know that their bosses are also invested in the effort.
“One of my company’s major focuses is being green,” Mattear said. “We just installed solar panels [in the Chico facility]. We try to maximize the ability for customers to receive things electronically: paper statements, communications, etc. We push the electronic pathway as much as possible. All the distribution centers are electronic-based, with very few paper trails being produced right now.”
Importantly, “the owner traded in his SUV for a plug-in hybrid,” Mattear said. That kind of top-down commitment is often the best staff motivator.
Mattear suggested a partnership between a plastics extruder and a distributor to develop a program for recycling would help O&P manufacturers get on board with active recycling.
“For example, we buy plastic directly from the source, the extruder. It is in the extruder’s best interest to get these recyclable materials back, because they regrind then extrude into a sellable material. If a regional extruder could work with a national distributor to set up a recycling program, [companies] would jump on board,” Mattear said.
“In other words, the program has to be completely thought out by an outside source. They put a gaylord in your back room. You throw everything in there, and you may get a rebate or points toward your future purchases.”
Wimberley expects the O&P industry to move to using advanced thermoplastics. “The resins that we’re currently using are going to come to us already processed. It will already be an inert, solid piece that we heat up, change, cool and shape to the form we want.” He cited the Beth Project, and the materials they use that can be reshaped over and over, resulting in fewer refits.
The primary motivator for recycling is for financial reasons, either by creating a profit motive, or methods for cost savings.
“Helping is nice, but at the end of the day if we can do something for 40% less, that’s where the market drives itself,” Wimberley said.
“The reduction of waste within your program is going to give you the yield and the benefits right now. Even 3-D manufacturing is going to have side effects; there will be leftover materials from that. But if we look at what we are doing now and scale back and are smart about what we are doing, realizing there was 20% waste in this process and you got it down to 10% to 15%…you can make a difference, one you can feel ethically and financially.” — by Carey Cowles
This article represents only a small sample of recycling and other waste reduction and energy conservation initiatives employed by individual companies, and is not intended to be all-inclusive.
Disclosure: Mattear, Nightingale, Wimberley and Yonney have no relevant financial disclosures.