Hostname: page-component-6898cfcb55-zsp5v Total loading time: 0 Render date: 2026-11-11T22:34:09.794Z Has data issue: false hasContentIssue false
  • English
  • Français

Popular infection prevention myths related to single-use plastics

Published online by Cambridge University Press:  24 July 2026

Pamela S. LeeOpen the ORCID record for Pamela S. Lee[Opens in a new window],
Shira AbelesOpen the ORCID record for Shira Abeles[Opens in a new window],
Preeti Mehrotra,
Trini Mathew,
Preeti Jaggi,
Shreya Doshi,
Vincent HsuOpen the ORCID record for Vincent Hsu[Opens in a new window] and
Hardeep SinghOpen the ORCID record for Hardeep Singh[Opens in a new window]
Pamela S. Lee*
Affiliation:
Division of Infectious Diseases, Harbor-UCLA Medical Center and the Lundquist Institute at Harbor-UCLA, Torrance, CA, USADepartment of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
Shira Abeles
Affiliation:
Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA
Preeti Mehrotra
Affiliation:
Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
Trini Mathew
Affiliation:
HealthTAMCycle3 PLLC, Troy, MI, USA
Preeti Jaggi
Affiliation:
Department of Pediatrics, Division of Infectious Diseases and Children’s Healthcare of Atlanta, Emory University, Atlanta, GA, USA
Shreya Doshi
Affiliation:
Division of Infectious Diseases, Children’s National Hospital, Washington, DC, USADepartment of Pediatrics, George Washington University, Washington, DC, USA
Vincent Hsu
Affiliation:
AdventHealth, Altamonte Springs, FL, USA
Hardeep Singh
Affiliation:
Loma Linda University School of Medicine, Loma Linda, CA, USASafety, Quality & Well-Being Institute at Houston Methodist, Houston, TX, USA
*
Corresponding author: Pamela S. Lee; Email: plee5@dhs.lacounty.gov

Abstract

An abstract is not available for this content. As you have access to this content, full HTML content is provided on this page. A PDF of this content is also available in through the ‘Save PDF’ action button.

Information

Type
Research Brief
Information
Antimicrobial Stewardship & Healthcare Epidemiology , Volume 6 , Issue 1 , 2026, e227
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Introduction

Health impacts from plastic chemicals are estimated to result in hundreds of billions of dollars in healthcare costs annually. Reference Trasande, Krithivasan, Park, Obsekov and Belliveau1 Emerging data also suggest adverse health impacts of microplastics and nanoplastics on human tissues. Reference Marfella, Prattichizzo and Sardu2 Plastic production, use, and disposal lead to significant greenhouse gas emissions, and are projected to account for 4.5% of all global greenhouse gas emissions by 2,060. Reference Landrigan, Raps and Symeonides3 Despite these human and planetary health impacts, the production and use of single-use plastics continue to grow exponentially globally. Reference Landrigan, Raps and Symeonides3

U.S. hospitals produce over 5.9 million tons of waste each year, including 1.7 million tons of plastic waste. Reference Kenny and Priyadarshini4 Large-scale information on healthcare waste composition is limited. However, healthcare waste audits show that single-use disposable items used for infection prevention and control (IPC) contribute significantly to plastic waste. Reference Mewaldt, Armand, Slutzman and Eisen5 IPC practices can create significant healthcare waste as a byproduct in the quest to ensure patient safety and achieve zero-harm. Reference Ong, Thiel and Singh6 Moreover, following ambiguous or non-evidence-based practices could lead to unwarranted, excessive use of single-use plastics and unintentionally perpetuate their use. Reference Greene, Merritt and Paina7 Many such practices are misconceived and persist as “myths,” ie, beliefs held to be true despite substantial evidence to the contrary. Reference Viehbeck, Petticrew and Cummins8 In an effort to bust myths related to IPC and single-use plastics, we assembled a group of IPC and patient safety experts to develop a list of common myths and examined them in relation to current evidence. We subsequently surveyed health professionals with expertise in infectious diseases/IPC regarding their perceptions of common practices that may be considered myths regarding the use of single-use plastics in IPC.

Methods

Using an informal network of expert presenters at national sustainability conferences, we convened a group of 8 experts across several disciplines: infectious disease, infection prevention, epidemiology, health care quality, patient safety, and healthcare sustainability. The group iteratively identified a list of 8 myths based on the current literature, their observations of healthcare practices across various clinical settings, and their experience in multiple healthcare settings (acute care hospitals, rehabilitation hospitals, skilled nursing facilities, clinics) and hospital types (academic, community, safety-net). We then developed a brief, one-question survey that asked healthcare professionals to select from a predefined list of common myths related to single-use plastics in IPC. We asked respondents to select up to 5 practices from the predetermined list of 8 myths based on how common and impactful they perceived that myth to be based on their own experience. We included an “other” category to allow respondents to enter their own myth if desired. Respondents were not asked to rank the myths. We distributed the survey via several listservs that included health professionals from across the US, mostly consisting of physicians and nurses with an interest in infectious diseases, IPC, and sustainability. Proposed myths included the use of: 1) disposable vs reusable isolation gowns, 2) disposable vs reusable stethoscopes for contact isolation rooms, 3) gloves vs hand hygiene for universal precautions, 4) double vs single peel pouches for sterile equipment, 5) plastic draping for clean equipment, 6) single use vs reusable non-critical devices, 7) plastic vs alternatives for providing beverages and dispensing medications, and lastly 8) whether patients had preferences for single-use disposable plastics vs reusables.

Results

The survey was distributed to a convenience sample of 317 health care professionals, of which 51 responded (response rate 16%). All respondents selected 5 myths in their response—ie, no respondent chose less than 5 answers in their response. Among the 8 myths (Figure 1), the most frequently selected myth was “Single-use gowns are preferable to reusable gowns for isolation precautions”—selected by 47/51 respondents (92%). The next most frequent myth was “Use of gloves is required to examine patients who need only universal precautions, rather than use of hand hygiene alone” (38/51; 75%). The least frequently selected myth was “Use of double peel pouches is preferred over single peel pouches when reprocessing certain sterile equipment (forceps, tongs) (10/51; 11%).

Figure 1.

Results for our survey titled “Identifying Popular Myths in Infection Prevention and Single-Use Plastics”. Actual text included in the survey with relevant abbreviation in brackets: Use of double peel pouches is preferred over single peel pouches when reprocessing certain sterile equipment (forceps and tongs) [double peel pouches]; clean equipment (wheelchairs, IV poles) must be draped in plastic to indicate that it is clean. [Equipment plastic draping]; patients prefer single-use disposable plastic items to reusable alternatives. [Patient plastic preferences]; disposable plastic cups are required for patient beverages and medication dispensing, rather than cups made of paper or reusable materials. [Disposable plastic cups]; single-use disposable stethoscopes must be used for patients in contact isolation rather than reusable stethoscopes that are cleaned with room turnover and left in the room. [Single-use stethoscopes]; non-critical devices (BP cuffs, pulse oximeters) are safer when they are single use compared to FDA-approved reprocessed items obtained via 3rd party reprocessors. [Single-use non-critical devices]; use of gloves is required to examine patients who need only universal precautions, rather than use of hand hygiene alone. [Gloves over hand hygiene]; single-use gowns are preferable to reusable gowns for isolation precautions. [Single-use gowns].

A bar graph showing the relative frequency of various myths related to infection prevention and single-use plastics.

New myths suggested by respondents related to topics, such as contact precautions for COVID, need for single-use laryngoscope handles and blades, and single-use anesthesia machine circuits; use of plastic resealable bags to maintain sterility. Each of these was suggested by a single person and discussed by the team, after which they were excluded from consideration for the top 5.

Discussion

Despite increasing evidence of environmental and health risks associated with single-use plastics, their use remains prevalent in healthcare. Practices favoring single-use plastics may arise from healthcare myths—ie, beliefs perpetuated despite lack of evidence or contrary evidence. We surveyed healthcare professionals with expertise in infectious diseases/IPC about which single-use plastic myths are most common in healthcare. The most common identified myths involved the use of single-use disposable gowns and gloves.

The myths identified in our study could be responsible for a significant excess in GHG emissions and solid waste. While our sample size was limited, and we did not assess the various practices and policies from which our respondents derived their experiences, these data provide a foundation for additional work to evaluate and mitigate the plastic waste potentially associated with these myths in healthcare. As a next step, policymakers and accrediting organizations could use this information to produce “myth-busting” guidance for hospitals, while keeping in mind facility-specific factors that may impact implementation of this guidance. Based on our results, such guidance could initially focus on appropriate glove use and IPC considerations associated with reusable isolation gowns. The findings also identify the need for professional societies to develop and implement clearer IPC guidelines to reduce pollution from single-use plastics in healthcare. Reference Smith, Singh and Sherman9

Acknowledgments

None.

Author contribution

PSL contributed to conceptualization, curation/analysis/validation of data, methodology, supervision, manuscript preparation, and manuscript review and editing.

SA contributed to conceptualization, methodology, manuscript preparation, and manuscript review and editing.

PM contributed to conceptualization, methodology, curation/analysis/validation of data, and manuscript review and editing.

TM contributed to conceptualization, methodology, and manuscript review and editing.

PJ contributed to conceptualization, methodology, and manuscript review and editing.

SD contributed to conceptualization, methodology, and manuscript review and editing.

VH contributed to conceptualization, methodology, and manuscript review and editing.

HS contributed to conceptualization, curation/analysis/validation of data, methodology, supervision, manuscript preparation, and manuscript review and editing.

Financial support

None reported.

Competing interests

None reported.

References

Trasande, L, Krithivasan, R, Park, K, Obsekov, V, Belliveau, M. Chemicals used in plastic materials: an estimate of the attributable disease burden and costs in the United States. J Endocr Soc 2024;8:bvad163. doi:10.1210/jendso/bvad163.CrossRefGoogle ScholarPubMed
Marfella, R, Prattichizzo, F, Sardu, C, et al. Microplastics and nanoplastics in Atheromas and cardiovascular events. N Engl J Med 2024;390:900–910. doi:10.1056/NEJMoa2309822.CrossRefGoogle ScholarPubMed
Landrigan, PJ, Raps, H, Symeonides, C, et al. Announcing the Minderoo – Monaco commission on plastics and human health. Ann Glob Health 2022;88:73. doi:10.5334/aogh.3916.CrossRefGoogle ScholarPubMed
Kenny, C, Priyadarshini, A. Review of current healthcare waste management methods and their effect on global health. Healthcare 2021;9:284. doi:10.3390/healthcare9030284.CrossRefGoogle ScholarPubMed
Mewaldt, C, Armand, W, Slutzman, J, Eisen, J. The plastic pandemic: quantification of waste on an inpatient medicine unit. J Clim Change Health 2023;11:100230. doi:10.1016/j.joclim.2023.100230.CrossRefGoogle Scholar
Ong, H, Thiel, CL, Singh, H. Health care actions for reducing plastic use and pollution. JAMA 2024;332:1783. doi:10.1001/jama.2024.17961.CrossRefGoogle ScholarPubMed
Greene, JA, Merritt, MW, Paina, L, et al. A pragmatic approach to streamlining single-use plastics in health care. Ann Intern Med 2025;178:1192–1194. doi: 10.7326/ANNALS-25-01264.CrossRefGoogle ScholarPubMed
Viehbeck, SM, Petticrew, M, Cummins, S. New myths: challenging myths in public health. Am J Public Health 2015;105:665–669. doi:10.2105/AJPH.2014.302433.CrossRefGoogle ScholarPubMed
Smith, M, Singh, H, Sherman, JD. Infection prevention, planetary health, and single-use plastics. JAMA 2023;330:1947. doi: 10.1001/jama.2023.20550.CrossRefGoogle ScholarPubMed
Figure 0

Figure 1.Results for our survey titled “Identifying Popular Myths in Infection Prevention and Single-Use Plastics”. Actual text included in the survey with relevant abbreviation in brackets: Use of double peel pouches is preferred over single peel pouches when reprocessing certain sterile equipment (forceps and tongs) [double peel pouches]; clean equipment (wheelchairs, IV poles) must be draped in plastic to indicate that it is clean. [Equipment plastic draping]; patients prefer single-use disposable plastic items to reusable alternatives. [Patient plastic preferences]; disposable plastic cups are required for patient beverages and medication dispensing, rather than cups made of paper or reusable materials. [Disposable plastic cups]; single-use disposable stethoscopes must be used for patients in contact isolation rather than reusable stethoscopes that are cleaned with room turnover and left in the room. [Single-use stethoscopes]; non-critical devices (BP cuffs, pulse oximeters) are safer when they are single use compared to FDA-approved reprocessed items obtained via 3rd party reprocessors. [Single-use non-critical devices]; use of gloves is required to examine patients who need only universal precautions, rather than use of hand hygiene alone. [Gloves over hand hygiene]; single-use gowns are preferable to reusable gowns for isolation precautions. [Single-use gowns].