Center for Earth Systems Engineering and Management

Healthcare infection control has led to increased utilization of disposable medical devices, which has subsequently led to increased adverse environmental effects attributed to healthcare and its supply chain. In dental practice, the dental bur is a commonly used instrument that can either be reused or used once and then disposed. To evaluate the disparities in environmental impacts of disposable and reusable dental burs, a comparative life cycle assessment (LCA) was performed. The comparative LCA evaluated a reusable dental bur (specifically, a 2.00mm Internal Irrigation Pilot Drill) reused 30 instances versus 30 identical burs used as disposables.

The LCA methodology was performed using framework described by the International Organization for Standardization (ISO) 14040 series. Sensitivity analyses were performed with respect to ultrasonic and autoclave loading. Findings from this research showed that when the ultrasonic and autoclave are loaded optimally, reusable burs had 40% less of an environmental impact than burs used on a disposable basis. When the ultrasonic and autoclave were loaded to 66% capacity, there was an environmental breakeven point between disposable and reusable burs. Eutrophication, carcinogenic impacts, non-carcinogenic impacts, and acidification were limited when cleaning equipment (i.e., ultrasonic and autoclave) were optimally loaded. Additionally, the bur’s packaging materials contributed more negative environmental impacts than the production and use of the bur itself. Therefore, less materially-intensive packaging should be used. Specifically, the glass fiber reinforced plastic casing should be substituted for a material with a reduced environmental footprint.

This paper’s intent is to explore the environmental gap analysis tool, Life Cycle Assessment (LCA), as it pertains to the decision-making process.

As LCA is more frequently utilized as a measurement of environmental impact, it is prudent
to understand the historical and potential impact that LCA has had or can have on its inclusion in public policy domain - specifically as it intersects the anticipatory governance framework and the supporting decision-making precautionary principle framework. For that purpose, LCA will be examined in partnership with the Precautionary Principle in order to establish practical
application.

LCA and Precautionary Principle have been used together in multiple functions. In two
case studies, the California Green Chemistry Initiative and in Nanotechnology uncertainty, there is a notion that these practices can create value for one another when addressing complex issues.

The recommendations presented in this paper are ones that recognize the current
dynamics of the LCA field along with the different sectors of decision makers. For effective
catalytic initiatives, adoptions of these recommendations are best initially leveraged by
government entities to lead by example. The proposed recommendations are summarized into
the following categories and explored in further detail later in the paper:
       1. Improvement in data sharing capabilities for LCA purposes.
       2. Common consensus on standards and technical aspects of LCA structure.
       3. Increased investment of resource allocation for LCA use and development.