THE CIRCULAR ECONOMY –WHAT IT IS AND HOW IT LINKS

TO HEALTH

Prof Jon Fairburn@profjonfairburn

Jon.fairburn@staffs.ac.uk

ABOUT ME

• Began co-operating with the World Health Organization (WHO) in 2009

• Main area is Environmental Inequalities and Environmental Justice

• Have chaired many meetings for the WHO• Chaired the stakeholder meeting for the

draft report – Circular Economy and Health from the WHO

WHY IS THIS IMPORTANT?

• The EU and many individual countries have developed Circular Economy Plans

• It is thought that a Circular Economy would lead to major benefits for society.

• However as of yet relatively little consideration of health impacts of a Circular Economy

DEFINITIONS

Focused on resources, closed loops and material flowse.g. WRAP (UK govt waste organisation) “we keep resources in use for as long as possible, extract the maximum value from them whilst in use, then recover and regenerate products and materials at the end of each service life.”

DEFINITIONS

“where the value of products, materials and resources is maintained in the economy for as long as possible, and the generation of waste minimised” (EC, 2015b).

OTHER RELATED IMPORTANT CONCEPTS

• Emboddied /Embedded energy

• Carbon footprints

• Life cycle analysis

All of which also need to define the system and scale they are working with

JEVONS PARADOX

• Technological progress and/or increased efficiency leads to an increase in demand and so also consumption.

ACTIVITY

EXAMPLES OF CARBON FOOTPRINTS

• World Wildlife Fund https://footprint.wwf.org.uk

• Detailed calculator with multiple languages and some country specific data inc Belgium

https://www.carbonfootprint.com/calculator.aspx

Flemish calculator http://voetafdruktest.wnf.nl/ or

https://carbonaltdelete.eu/nl/compenseer-emissies/

CIRCULAR ECONOMY AND WASTE: NEGATIVE IMPACTS

HEALTH ISSUES - NEGATIVE

1. Recycling and reuse of products –Chemicals of concern – bisphenol A and brominated flames retardants – both into new products but also into composting of waste.2. Presence of chemicals in goods imported to EU that are banned in manufacturing but then get recycled3. Long lasting products that have chemicals that have been banned

• Circular economy likely to increase the need for recycling/waste sites –

– How to chose those sites? Grandfathering approach common

– Mental as well as physical concerns with such sites

– Exporting of waste for ‘recycling’ to developing countries

HEALTH ISSUES - NEGATIVE

HEALTH ISSUES - NEGATIVE

Exporting of E-waste to developing countries to unregulated or informal dumping sites

• Open pit burning to remove electrical components and metals – releases of polycyclic aromatic hydrocarbons

• Creation of dioxins with poor incineration• Open acid bath procedures – dumping of

acids and heavy metals into soil• Bangladesh study Soil samples contained

compounds such as “lead, mercury, cadmium, arsenic, antimony trioxide, polybrominated flame retardants, selenium, chromium, and cobalt”

HEALTH ISSUES - NEGATIVE

CHINA AND THE CIRCULAR ECONOMY – (GLOBAL)

• China is one of the leading countries interested in Circular Economy

• Massive environmental problems

• For many years world largest importer of waste from all over the world

• Goods delivered on ships and then waste returned?

2018 – China which had been the biggest importer of waste in the world banned 24 types of material

Has caused chaos in the West especially – now a massive backlog and build up of waste

DISTRIBUTIONAL ASPECTS OF WASTE

• Environmental health risks in Europe and globally disproportionately affect vulnerable groups

• See Pasetto et al (2019) for a recent review

SOUTH YORKSHIRE (FAIRBURN ET AL 2009)

SOUTH YORKSHIRE (FAIRBURN ET AL 2009)

• Higher air pollution is more associated with lower socio-economic positions

• Residential location is strongly associated with exposure to environmental risks

EXAMPLES OF POLICY

RECYCLING RATES

HEALTH ISSUES - POSITIVE

• Reduction of waste• Better design urban areas to promote

active transport – reduction of greenhouse gases and air pollution

• Re-use of water system• More efficient use of energy

OTHER TOPICS TO CONSIDER

Food safety and healthy foodsWaste water re-useBuilt environmentAmbient air qualityClimate changeSee Chapter 7 of the main report - however best developed area by far concerns waste!

THE HEALTH SYSTEM

The size, resources used and resource impact of the health services in most European countries is considerable.

In the UK approx. 1.5 million employed by NHS.

Expenditure is approx. £125 billion per year

HEALTH SYSTEMS

• In Germany 7.3 million employed in healthcare spend 374 billion euros

• In Belgium 10.5% of GDP

• In most countries in Europe health spending is between 6 and 11% of GDP and in general they are increasing with an aging society

ACTIVITY – HEALTH SYSTEMS AND THE CIRCULAR ECONOMY – IDEAS ?

PADLET – IDEAS FOR HOSPITALS OR HEALTH SYSTEMS

• https://en-gb.padlet.com/jon_fairburn

• https://padlet.com/jon_fairburn/nto1elz50erb

OPTIONS – PERFORMANCE MODELS (THEORY)

Pays for the use of the product rather than the product itself (e.g. leasing)

Minimize total costs, risks (repair and obsolescence and disposal costs).

Incentivizes manufacturer/supplier to design products easier to maintain and to repair or refurbish.

PILOT STUDY –MUSCULOSKELETAL DISORDERS

• REBUS project – leasing arrangement for equipment to assist rehabilitation – lead to a 10 fold reduction in the volume of material that was manufactured

FLOOW2 HEALTHCARE

• Platform model – allows sharing of goods and equipment, facilities

• Issues – many hospitals purchase expensive equipment but it is not always being used

• Business to Business Platform• Place for requests as well as availability

Locations already using FLOOW2 for health sharing

ISSUES

• Concern about public reaction initially• Ability to set closed platform within an

organisation to test and grow• Review system• Safe online payment• Safety checks

BUSINESS TO BUSINESS PLATFORM

• Heeren Loo (disability care) sharing across 100 sites in the Netherlands

• https://www.floow2healthcare.com/healthcare-en.html

RESULTS IN 2018

• No of users 17,320• Estimated that the average value for an

active user was 3052 euros. • Still early adopter phase

• In Belgium (not healthcare) but sharing platform https://www.werflink.com/ for building industry

PROBLEMS WITH SHARING PLATFORMS

• Many are monopolies• Pay very little if any taxes• Tendency to become very powerful • Domination by large corporations can

exacerbate inequalities• Rights for workers can diminish e.g. UBER• Can create problems e.g. Air bnb and over

tourism

OTHER EXAMPLES OF INITIATIVES FOR HEALTH SECTOR

NORDIC CENTER FOR SUSTAINABLE HEALTHCARE

• NCSH is an independent platform that organizes all stakeholders in the cross sectorial discipline of Sustainable Healthcare. The network is open for all organisations located in, or with activities in the Nordic countries and Northern Europe.

• https://nordicshc.org/natverk-partners.html/

THE GLOBAL GREEN AND HEALTHY HOSPITALS

https://www.greenhospitals.net/

Plenty of case studies on what hospitals can do from around the world https://www.greenhospitals.net/case-studies/

DEMATERLISATION

• The replacement of physical goods by online services or the use of technology

Music, films, books, records

• In health – a vast backlog of paper records in many countries – many not digitised yet – any other possibilities (e.g. scans, xrays…..)

CRITIQUES OF CIRCULAR ECONOMY

Korhonen et al (2018) –• circular economy dominated by

practitioners and businesses little input currently by scientific community

• Concept is superficial and lacks critical analysis

• Identifies 6 key limits that need developing as a research agenda

CONCLUSIONS

• Waste dominates the circular economy at the moment in terms of health

• Other areas need much more development and research – big knowledge gaps

• Beware Techno-utopianism – TED talks are not going to save the world.

• Societal action and individual action needed

USEFUL RESOURCES

Circular economy and health: opportunities and risks (2018)http://www.euro.who.int/en/publications/abstracts/circular-economy-and-health-opportunities-and-risks-2018

Case study exampleLeslie H A, Leonards P E G, Brandsma S H, de Boer J and Jonkers N (2016) ‘Propelling plastics into the circular economy – weeding out the toxics first’ in Environmental International Vol 94 pp230-234

EU Circular Economy Packagehttps://ec.europa.eu/commission/publications/documents-strategy-plastics-circular-economy_en

Chem Trusthttps://chemtrust.org/

Health care without harm - https://noharm-europe.org/

A useful discussion here on healthcare and the circular economyhttps://www.theguardian.com/sustainable-business/2016/jan/27/circular-economy-healthcare-sector-business-waste-management-live-chat#comments

USEFUL RESOURCES

Ellen MacArthur Foundation https://www.ellenmacarthurfoundation.org/

Korhonen et al 2018 Circular Economy: The Concept and its Limitations https://doi.org/10.1016/j.ecolecon.2017.06.041

Pasetto et al 2019 Environmental Justice in Industrially Contaminated Sites. A Review of Scientific Evidence in the WHO European Regionhttps://www.mdpi.com/1660-4601/16/6/998

A Review of Frameworks for Developing Environmental Health Indicators for Climate Change and Health DOI: 10.3390/ijerph8072854 includes DPSEE model

Links to my papers and research can be found herehttp://eprints.staffs.ac.uk/view/creators/FAIRBURN=3AJonathan=3A=3A.html

SOCIAL MEDIA AND CAREER ADVICE

• @circulareconomy Ellen MacArthur Fdn.

• Sustainability careers and how to get one -NEW

https://www.sustainabilityexchange.ac.uk/careers1

includes guides and also webinars

Also https://www.earthworks-jobs.com/

CONTACT INFO

Linked in https://www.linkedin.com/in/jonfairburn/

Google Scholar https://scholar.google.co.uk/citations?user=PuwDEnYAAAAJ&hl=en

Twitter @profjonfairburn

Email jon.fairburn@staffs.ac.uk