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Criteria for the selection and purchase of medical devices typically include safety for patients and staff, efficacy and ease of use, and purchase and handling prices. On the basis of such criteria, single-use disposable medical devices are increasingly supplanting reusable devices in the United States (US) and elsewhere.  Although purchase and maintenance costs for disposable devices are perceived to be less than for reusables, this fails to account for indirect costs within institutions as well as to society from the environmental impacts attributable to the entire life cycle impact of a device.  Such an analysis is commonly performed using life cycle assessment (LCA).  Growing awareness of the negative impacts from the practice of health care on the environment and public health calls for the routine inclusion of life cycle criteria into purchasing decision-making process. 

We will present our LCA results of reusable vs. disposable blood pressure cuffs at Yale-New Haven hospital, including environmental, human health, and economic dimensions.  This case study is easily used to generalize any scenario in which an institution is considering substitution of reusable with disposable devices. Importantly, we will discuss how LCA could be incorporated into routine purchasing practice guidelines.


  • Define Life Cycle Analysis (LCA)
  • List the factors that contribute to hospital acquired infections
  • Discuss the evidence for (and against) conversion from reusable to disposable blood pressure cuffs
  • Apply the concept of Life Cycle Analysis to institutional purchasing practice guidelines 


Jodi Sherman, Yale University, School of Medicine/Anesthesiology
Jodi Sherman is an Assistant Professor of Anesthesiology at Yale University, School of Medicine.  She is also the Environmental Compliance Officer of perioperative services at Yale-New Haven Hospital.  Dr. Sherman is an internationally recognized speaker and author in the emerging field of sustainability in anesthesia.  Her research interest is in life cycle assessment (LCA) of anesthetic practice, quantifying energy, greenhouse gas emissions, human health impacts, and economic densities of anesthetic drugs, OR devices, and perioperative behaviors to help guide clinical decision making toward more ecologically sustainable practices. Dr. Sherman collaborates with environmental engineers, epidemiologists and health economists towards this goal.

Cristina DeVito, MS, Yale-New Haven Hospital
Cristina DeVito, MS, serves as the Sustainability Coordinator for Yale-New Haven Hospital (YNHH) in New Haven, Connecticut. Under Cristina’s direction, YNHH is supported in the development of ongoing sustainability initiatives, assessment and data collection, goal setting and creating a culture of environmental excellence. Cristina’s expertise lies in the areas of implementing sustainable operations, overseeing the waste management program and ensuring regulatory readiness. Cristina is a member of the Environmental Advisory Group for VHA and recently earned her M.S. at Georgetown University.

Matthew Eckelman, PhD, Assistant Professor, Northeastern University
Matthew Eckelman is an Assistant Professor at Northeastern University in Civil and Environmental Engineering, with a secondary appointment in Chemical Engineering. His research covers life cycle assessment and systems modeling of the environmental impacts of chemicals and emerging materials. Specific areas of research include environmental implications of nanomaterials, both in terms of their production and environmental releases; assessment of biofuels and bio-based chemicals derived from various types of biomass; and energy and environmental costs and benefits of the production, use, and recovery of engineering metals.

Outside of Northeastern, Dr. Eckelman consults regularly on sustainability-related projects with a range of businesses (ranging from the Fortune 500 to start-ups), institutions, and government agencies, with a particular focus on industrial chemicals and formulated products. He also sits on the Advisory Board of the Resources Optimization Initiative in Bangalore, India. Dr. Eckelman previously worked in the Massachusetts State Executive Office of Environmental Affairs and Design that Matters, a non-profit product design company, and was a Peace Corps science instructor in southern Nepal for several years. He received a doctorate in Chemical and Environmental Engineering from Yale and did postdoctoral work there with the Center for Green Chemistry and Green Engineering.

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