An Analysis of the Electronic Waste Produced by Dermatological Clinics Free

The impact of medical waste on the environment and its impact on climate change are well documented and are a concern for dermatologists generating this medical waste [1]. However, the amount of electronic waste (e-waste) due to the finite lifespan of dermatological medical devices and dermatology office equipment is often overlooked in terms of its impact on the environment and potential health effects. For example, LCD screens have been documented to have high levels of arsenic, an element that is linked to cutaneous squamous cell carcinomas [2]. In this article, we discuss some of the sources of medical waste in dermatology, and solutions for recycling this waste to minimize harm to human health and the environment.

E-waste has become a growing concern across many healthcare sectors, and dermatology is a large contributor [3]. In 2019, Health Care Without Harm (HCWH) published a report on the healthcare sector’s impact on the global climate crisis, revealing that if the healthcare sector were an independent country, it would rank as the fifth-largest emitter worldwide [4]. Their global analysis estimated the healthcare sector’s carbon footprint to be 2.0 gigatons of CO₂ in 2014, accounting for 4.4% of net global emissions [4]. While a comprehensive global statistical analysis reporting the carbon emissions from dermatology clinics has yet to be reported, multiple studies note that the specialty is particularly waste-intensive given the procedural and pathology-intensive nature of the specialty. For example, one report identified dermatology as the second-highest contributor to plug-and-process load electrical waste [5], likely due to the frequent use of tools such as hyfrecators, electrocautery, medical lasers, and other energy devices used in dermatological treatment procedures.

Due to the fast pace of outpatient dermatology and frequent procedures, many instruments and materials are consumed daily. While the lifecycle of these devices varies, rapid technological advancements push clinics to upgrade regularly, leading to the disposal of functional, but outdated, equipment. The most prominent sources of e-waste in dermatology clinics include microscopes, pathology staining devices, computers, printers, fax machines, and dermatoscopes. Many skin diseases are difficult to diagnose visually; therefore, diagnostic tools like Wood’s lamps, microscopes, pathology staining devices, and dermatoscopes are frequently used to ensure fast and accurate diagnoses [6]. In addition to these diagnostic tools, dermatologists rely on computers, printers, and fax machines for patient records, imaging, and research [7].

As of 2024, there are around 13,000 dermatology clinics in the USA, based on aggregated data from healthcare industry reports and national directories, such as the American Academy of Dermatology [8]. Based on these data, Table 1 estimates the volume of e-waste generated by dermatology practices, as well as their collective clinical footprint, which continues to represent a growing concern as modern reliance on electronic and digital infrastructure is increasing [9, 10].

E-waste disposal streams in the USA consist mainly of incineration, landfilling, and recycling [11]. Despite advanced filtration and scrubbing systems engineered to curtail heavy metal emissions from incineration, improper processing has been implicated in soil, sediment, and water contamination [12]. Likewise, landfills equipped with leachate containment systems have been prone to heavy metal migration into both ground and surface water reservoirs [12, 13]. Beyond the more imminent threats to environmental sustainability, the downstream consequences of lead, mercury, cadmium, and arsenic infiltration, in addition to chronic organic pollutant exposure, have been associated with adverse health sequelae, including kidney damage, neurological effects, and developmental deficits [14‒16].

In contrast to the challenges arising from divestment, recycling programs aimed at minimizing e-waste present an opportunity for prevention. The multistep process involves: (a) sorting: electrical components, light sources, chemicals, and plastics segregation; (b) pre-processing: hazardous materials’ removal (i.e., batteries, mercury); (c) dismantling: manual unit disassembly for materials recollection or disposal; (d) processing: materials’ recovery (i.e., precious metals), neutralization, hazardous agent disposal; (e) recycling: refurbishment and repurposing elements and devices with preserved utility; (f) disposal: dispatching unsalvageable or hazardous articles for destruction or discardment [17, 18].

E-waste recycling can take multiple paths, from mechanical recycling, pyrolysis, bio-metallurgical, and hydro-metallurgical to extract raw materials for reuse from e-waste [18]. Mechanical recycling (a process involving sorting [e.g., with magnets], cleaning, shredding, and processing) can be used to recover photovoltaic (e.g., solar cells in calculators, etc.) to recover tin, aluminum, iron, lead, zinc, and silver [18] Pyrolysis consists of multiple processes involving heating components at high temperatures in the absence of oxygen and can be used to recycle components of lithium-ion batteries (to reclaim cobalt and lithium) [18]. Bio-metallurgical recycling of e-waste utilizes microorganisms (e.g., Pseudomonas aeruginosa) that are able to process and refine electronic waste through bioleaching that can be used to recover copper, gold, zinc, and silver from printed circuit boards [18]. Hydro-metallurgical recycling can also be applied to recover materials from e-waste (e.g., printed circuit boards) through the use of solvents to leach and purify metallic products from shredded and preprocessed e-waste [18].

While best practices leverage technological innovation to streamline these operations, e-waste recycling has nonetheless been associated with increased costs, occupational health risks, and data security concerns [19]. Considering these caveats, its cost savings, energy efficiencies, resource conservation, and environmental burden reduction cannot be understated [20]. In dermatology, particularly, e-waste recycling confers additional benefits due to the complexity of devices used in practice. Generally, more complex devices have greater longevity, which reduces turnover and enhances both economic and environmental advantages [21].

Any discussion of clinical e-waste management would be remiss without addressing the ethical issue of accountability. A shared stakeholder model underscores the need for a coordinated effort among manufacturers, healthcare facilities, consumers, waste management professionals, and regulatory agencies. As emphasis evolves toward eco-friendly product design in dermatology [21], immediate action is required to establish health-conscious industry standards and incentivize clinic-level waste reduction policies. Collaboration between industry and policymakers is necessary to bridge environmental stewardship with equitable access to dermatologic care [22]. Office managers and dermatologists can minimize e-waste environmental burden by prolonging the time between replacing equipment to maximize useful life through repairing as opposed to replacing equipment, diverting equipment that is no longer usable or repairable to recycling programs, and using proper disposal techniques (e.g., bringing waste to proper hazardous waste centers) for equipment that cannot be adequately recycled.