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Creating a circular healthcare economy: Sustainable strategies for a circular healthcare

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Bart van Straten, Delft University of Technology

Letizia Alvino, University of Twente

Tim Horeman, Delft University of Technology

Copyright Year: 2023

ISBN 13: 9789463667302

Publisher: TU Delft Open

Language: English

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Table of Contents

  • About the authors
  • Preface
  • Acknowledgements
  • Part I: Circular engineering principles
  • Part II: Using (medical) waste as source for raw material
  • Part III: A sustainable market
  • Authors' notes

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About the Book

Our world is the only planet, as far as we know, which harbors life. The number of humans on our planet has grown tremendously in recent centuries. In 1800 one billion humans occupied our earth; on 15 November 2022, this number reached 8 billion.

A result of this growth, the emissions of carbon dioxide (CO2), the primary greenhouse gas emitted by human activities, drastically increased. The increased concentrations of greenhouse gases in our atmosphere foster the long-term increase of our earth’s temperatures, also referred to as global warming.

While the earth’s population grew, so did our mass consumption society. After the Second World War humanity witnessed gigantic global economic development with great technological improvements. Computers, laptops, airplanes, tablets and Internet of Things connected humans all over the world. The hunger for plastics and steel grew as all products had to be manufactured in ever-increasing volumes. As the economy developed, our consumption grew apace.

The healthcare sector has seen the same increase of consumption. The number of patients grew, and so did the number of single-use medical products. As products become more complex and more different materials were combined., recycling became more difficult. Thus, hospitals transformed into waste factories with ever-growing waste streams. The consumption of (disposable) medical devices takes up scarce raw materials and contributes to the growing CO2 emissions.

In this book, Van Straten, Alvino and Horeman present their findings on how to create a sustainable healthcare economy by introducing different circular strategies. In 9 chapters, they present a wide variation of studies as practical cases to show what strategies and actions can be taken in order to implement sustainable strategies for a circular healthcare.

This book was written in line with the courses the authors developed at TU Extension School, the open online education edX platform of Delft University of Technology/TU Delft, a leading university in science and technology, recognized for its world-class research. This book is a manual for everyone who follows the online course ‘Circular strategies for a sustainable healthcare’, but certainly also for everyone who wants to discover more about circular strategies and wants to understand the principles and practices of circular economy and urban mining. This book is suitable for students, researchers, policymakers and practitioners in the fields of healthcare sustainability, management, business and economics.

About the Contributors


Bart van Straten is an expert in the field of sustainability and the circular healthcare economy. He is affiliated with several institutions and companies including Van Straten Medical and GreenCycl as well as educational and government-related institutions. He co-founded GreenCycl, an organization with a mission to decrease the amount of medical waste. Bart holds a doctorate in BioMedical Engineering from Delft University of Technology/TU Delft with a specialization in the circular reuse of surgical devices and surgical waste materials. During his PhD research, Bart developed a Field Lab together with Tim Horeman for experimental research on reprocessing surgical waste into new raw materials and medical products. His research has won several awards, for example in the Utrecht Circular Innovation Top 20, as builder of the world’s first recycling process for hospital waste.

Bart joined the research group Sustainable Surgery & Translational Technology led by Tim Horeman at TU Delft, where he is a lecturer on medical device prototyping and teaches several related courses. Bart focuses on integrating sustainable engineering and circular design in education as a researcher and lecturer. He has published widely on using the operating room as gold mine for new raw materials. As chairman of the Royal Dutch Normalization Institute, NEN Platform Sustainability & Medical Devices, he was involved in writing the Dutch national NEN-3 guideline for reusing single-use medical deviceswhich was published by NEN on 1 June 2020.

Letizia is Assistant Professor of Marketing at the Faculty of Behavioural Management and Social Sciences (BMS) at the University of Twente. Her expertise is in neuromarketing. Letizia investigatesthe neuronal and cognitive mechanisms that identify and define decision-making processes and buying behaviorin marketing, both B2B and B2C. In particular, she analyses and studies the biological basis underlying the buying decision process in relation to different marketing operations (e.g., branding, pricing) and product characteristics (e.g., label).

Letizia has been a visiting scholar at various universities, research institutes and business associations including TU Delft, Private Label Manufacturers Association (The Netherlands), IULM University (Italy), SRK University Bhopal (India) and Global Alliance of Marketing & Management Association (Japan).

Tim Horeman is Associate Professor in Sustainable Surgery & Translational Technology and Academic Portfolio Director (APD)-Medical technology of TU Delft. Tim has ample experience in the objective assessment of surgical skills and surgical instrument functioning based on interaction force, instrument motion and other data sources. Currently, Tim is leading the development of a new generation of sustainable surgical instruments for advanced (robot) surgery, that should foster the introduction of more functional instruments in less wealthy parts of the world.
As it is essential to bring lifesaving surgical innovations in reach of surgeons and healthcare workers, Tim became a distinguished serial medtech entrepreneur with a strong focus on surgical devices and evidence-based implementation studies. He is PI and (co)founder of the international companies GreenCycl, MediShield & ForceSense, Surge-on Medical and SuperSeton, which have brought multiple innovations to the worldwide market of surgical equipment. Tim is (co)author of over 80 journal publications, inventor on 18 patent (families) and PI on multiple international research projects in the field of surgical instrument waste processing, SMART implants, global instruments and Minimally Invasive Surgery. In 2016, Tim was awarded the Dutch royal engineer of the year award for his contributions to the healthcare sector. In 2018 and 2022 Tim was elected Tech Committee member of the European Association of Endoscopic Surgery with a strong focus on sustainable surgical instruments and processes within his newly created definition of “Hospital mining”.

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