Facts and fiction about PVC in healthcare

Misinformation about PVC or vinyl in healthcare and elsewhere is unfortunately prevalent. While NGOs are in the leading role, other voices also bring forth fiction about PVC. On this page you can find facts about PVC, based on the latest available evidence.

Fiction

"PVC use in medical devices is known to carry health risks, and some alternatives have been designed, including PVC-free blood bags."

Health Care Without Harm (2022): Plastics and health - An urgent environmental, climate and health issue. https://noharm-global.org/plastics_and_health. P. 7

Facts

PVC has been used for over 70 years in medical devices with no adverse effects observed.

PVC remains the only material that can meet the strict requirements for blood bags. These requirements ensure that the red blood cells can be stored for up to 49 days, which is crucial for patient safety – in particular for patients with rare blood types.

References

Commission Directive 2004/33/EC, Annex IV, L 91/35, https://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2004:091:0025:0039:EN:PDF

Stanworth, S. J., New, H. V., Apelseth, T. O., Brunskill, S., Cardigan, R., Doree, C., Germain, M., Goldman, M., Massey, E., Prati, D., Shehata, N., So-Osman, C., & Thachil, J. (2020). Effects of the COVID-19 pandemic on supply and use of blood for transfusion. The Lancet Haematology, 7(10), e756-e764. https://doi.org/10.1016/S2352-3026(20)30186-1

Fiction

"PVC's versatility ... is only due to the many, various additives used. Often toxic and used in high concentrations, these additives provide the desired characteristics for the products’ application e.g. rigidity/flexibility or opaque/transparent. Achieving the desired functionality of PVC products is therefore associated with serious chemical risk."

Health Care Without Harm Europe (2021): The polyvinyl chloride debate: Why PVC remains a problematic material. https://noharm-europe.org/sites/default/files/documents-files/6807/2021-06-23-PVC-briefing-FINAL.pdf. P. 6.

Facts

Through VinylPlus, the European PVC industry has made a targeted effort to substitute unwanted additives in the last two decades. As a result, replacement of lead-based stabilisers was completed in 2015, and low molecular weight phthalates have been substituted to nearly 100% by safe alternatives.

Furthermore, the Additive Sustainability Footprint® (ASF) methodology has been developed to proactively assess and promote the sustainable production and use of PVC additives throughout entire product lifecycles, including the roles of additives in the performance of PVC products. ASF is a science-based methodology that has been peer-reviewed by LCA experts and validated.

References

VinylPlus (2021): Progress Report 2021, https://vinylplus.eu/wp-content/uploads/2021/06/VinylPlus-Progress-Report-2021_WEB_sp-1.pdf, p. 12

VinylPlus: Additive Sustainability Footprint, https://www.vinylplus.eu/sustainability/our-contribution-to-sustainability/additive-sustainability-footprint

Everard, M., & Blume, R. (2019). Additive Sustainability Footprint: Rationale and pilot evaluation of a tool for assessing the sustainable use of PVC additives. Journal of Vinyl and Additive Technology, 26(2), 196–208. https://doi.org/10.1002/vnl.21733

Fiction

"PVC is the least recyclable of all plastics ... When the [PVC] plastic is recycled more than two or three times, its quality becomes so poor that it is no longer usable."

Health Care Without Harm Europe (2021). The polyvinyl chloride debate: Why PVC remains a problematic material. https://noharm-europe.org/sites/default/files/documents-files/6807/2021-06-23-PVC-briefing-FINAL.pdf. P. 21 & 29

Facts

PVC can be recycled 8 to 10 times depending on the application without losing its technical properties. This is possible because the recycling process does not measurably decrease the chain length of PVC molecules.

Since 2000, more than 7.3 million tonnes of PVC have been recycled in Europe through VinylPlus. Since 2022, this also includes PVC medical devices, which are collected and recycled through VinylPlus® Med. 10 hospitals are currently part of the scheme, with more than 30 on the waiting list. All recycling figures are validated by a third party.

References

Frank, Andreas & Messiha, Mario et al. (2021). Slow Crack Growth Resistance of reprocessed PVC. Plastic Pipes Conference PPXX, Amsterdam. https://www.researchgate.net/publication/354921933_Slow_Crack_Growth_Resistance_of_reprocessed_PVC

Yarahmadi, Nazdaneh & Jakubowicz, Ignacy & Gevert, Thomas. (2001). Effects of repeated extrusion on the properties and durability of rigid PVC scrap. Polymer Degradation and Stability. 73. 93-99. 10.1016/S0141-3910(01)00073-8

VinylPlus (2022). Progress Report 2022. https://www.vinylplus.eu/our-achievements/progress-report-2022

VinylPlus (2022). VinylPlus® Med Accelerates Sustainability in Healthcare. http://vinylplusmed.eu

Fiction

"Safer alternatives are already available for virtually all uses of PVC."

Health Care Without Harm Europe (2021). The polyvinyl chloride debate: Why PVC remains a problematic material. https://noharm-europe.org/sites/default/files/documents-files/6807/2021-06-23-PVC-briefing-FINAL.pdf. P. 2

Facts

In several critical healthcare applications, PVC is the only material that meet the strict performance and safety requirements. An example is blood bags, where only PVC allows for storage of red blood cells for up to 49 days. The long storage time is essential for the blood supply, particularly for patients with rare blood types.

In addition, alternative materials are often much more expensive than PVC. According to the European Commission, a price increase for medical devices of up to 30% can be expected if PVC is replaced by alternatives. Such as steep price increase would make access to quality healthcare less inclusive and have negative consequences for Europe's patient safety. 

A shift to other materials may most likely result in regretful substitution. Medical equipment is the result of very sophisticated engineering, where many materials are tried and tested before the final product can be introduced on the market. If medical device designers choose PVC for a specific application, it is because only this plastic meets the functional requirements. Without PVC, manufacturers would thus not be able to deliver a wide range of medical devices that save lives everyday.

References

European Commission, Directorate-General for Environment, (2022). The use of PVC (poly vinyl chloride) in the context of a non-toxic environment: final report, Publications Office of the European Union. https://data.europa.eu/doi/10.2779/375357. P. 296

Fiction

"For successful recycling, PVC products need to be 'super-separated' by product type to keep them from going to an incinerator or landfill."

Health Care Without Harm Europe (2021). The polyvinyl chloride debate: Why PVC remains a problematic material. https://noharm-europe.org/sites/default/files/documents-files/6807/2021-06-23-PVC-briefing-FINAL.pdf. P. 20

Fact

Successful mechanical recycling of all plastics depend on correct sorting at polymer level.

The PVC industry is leading the way: with the successful VinylPlus programme, the PVC industry has already recycled 7.3 million tonnes of PVC since 2000. Moreover, the VinylPlus 2030 commitment is to achieve at least 900,000 tonnes and 1 million tonnes per year of recycled PVC used in new products by 2025 and 2030, respectively.

References

VinylPlus (2022). Progress Report 2022. https://www.vinylplus.eu/our-achievements/progress-report-2022

Fiction

"In most of the world, the PVC production process combines ethylene – obtained from cracking naphtha or natural gas – and chlorine to produce ethylene dichloride (EDC). This is then converted to vinyl chloride monomer (VCM), and highly toxic waste is produced in the process: for every tonne of EDC an approximate four kilograms of by-products are produced, which contain persistent toxic chemicals. This includes several organochlorine chemicals that are recognised as persistent organic pollutants (POPs): dioxins, furans, polychlorinated biphenyls (PCBs), hexachlorobenzene (HCB). Finally, vinyl chloride (which is highly toxic, flammable, and carcinogenic) monomer, is polymerised into PVC."

Health Care Without Harm Europe (2021). The polyvinyl chloride debate: Why PVC remains a problematic material. https://noharm-europe.org/sites/default/files/documents-files/6807/2021-06-23-PVC-briefing-FINAL.pdf. P. 9

Facts

It is true that PVC production involves potentially toxic chemical substances like VCM.

However, these substances are intermediates and are handled appropriately in a closed system. All residual quantities of VCM in waste streams from the production process are recovered and recycled back into the process. Studies conducted during the 1970s on workers in PVC polymerisation plants revealed that VCM is a carcinogen, and that significant exposure over a prolonged period can cause cancer. Yet this serious work environment issue was solved almost half a century ago. No workers are in contact with the substance, which is handled in totally closed systems.

As early as 1995, the European Council of Vinyl Manufacturers’ members signed voluntary charters to ensure environmental releases of VOCs, EDC, VCM, dioxins and hydrochloric acid during handling and production requirements of VCM and PVC. The charters have been regularly updated so as to maintain requirements exceeding those described in the EU BAT reference documents.

References

Best Available Techniques (BAT) Reference Document (BREF) for the Production of Chlor-alkali published in December 2014 by the European Commission, pursuant Article 13(6) of the Directive 2010/75/EU on Industrial Emissions (IED). https://eippcb.jrc.ec.europa.eu/reference

The European Council of Vinyl Manufacturers (2019). ECVM Industry Charter for the Production of Vinyl Chloride Monomer and PVC. https://pvc.org/wp-content/uploads/2019/12/ECVM_Charter_v4.pdf

Fiction

"The EU’s zero-pollution and non-toxic ambitions cannot be met with PVC."

Health Care Without Harm Europe (2022). LinkedIn

Fact

PVC is an inert, non-toxic material, recognised as a Polymer of Low Concern by the OECD.

Reference

OECD (2009): ENV/JM/MONO(2009)1. Data Analysis of the Identification Of Correlations Between Polymer
Characteristics and Potential for Health or Ecotoxicological Concern.  https://www.oecd.org/env/ehs/risk-assessment/42081261.pdf. P. 11

Fiction

"The ‘dirty quartet’, formed by the polluting PVC, PC, PS and PUR, should be gradually phased out, considering their impractical polymer behaviour and need for compatibilisers, multiple treatment steps to actually be recycled, lack of separate collection infrastructure, high potential for leaching chemicals throughout their lifecycle, and more."

ECOS (2022): Falling into place: what future for plastic recycling in a circular and toxic-free economy? https://ecostandard.org/wp-content/uploads/2022/03/ECOS-RPa-PAPER-PLASTIC-RECYCLING.pdf. P. 7

Fact

PVC is an inert, non-toxic material, recognised as a Polymer of Low Concern by the OECD.

Through VinylPlus, the European PVC industry has made a targeted effort to substitute unwanted additives in the last two decades. As a result, replacement of lead-based stabilisers was completed in 2015, and low molecular weight phthalates have been substituted to nearly 100% by safe alternatives.

Further, the Additive Sustainability Footprint® (ASF) methodology has been developed to proactively assess and promote the sustainable production and use of PVC additives throughout entire product lifecycles, including the roles of additives in the performance of PVC products. ASF is a science-based methodology that has been peer-reviewed by LCA experts and validated.

PVC can be recycled 8 to 10 times depending on the application without losing its technical properties. This is possible because the recycling process does not measurably decrease the chain length of PVC molecules.

Since 2000, more than 7.3 million tonnes of PVC have been recycled in Europe through VinylPlus. Since 2022, this also includes PVC medical devices, which are collected and recycled through VinylPlus® Med. All recycling figures are validated by third party.

References

OECD (2009): ENV/JM/MONO(2009)1. Data Analysis of the Identification Of Correlations Between Polymer
Characteristics and Potential for Health or Ecotoxicological Concern.  https://www.oecd.org/env/ehs/risk-assessment/42081261.pdf. P. 11

VinylPlus (2021): Progress Report 2021, https://vinylplus.eu/wp-content/uploads/2021/06/VinylPlus-Progress-Report-2021_WEB_sp-1.pdf, p. 12

VinylPlus: Additive Sustainability Footprint, https://www.vinylplus.eu/sustainability/our-contribution-to-sustainability/additive-sustainability-footprint

Everard, M., & Blume, R. (2019). Additive Sustainability Footprint: Rationale and pilot evaluation of a tool for assessing the sustainable use of PVC additives. Journal of Vinyl and Additive Technology26(2), 196–208. https://doi.org/10.1002/vnl.21733

rank, Andreas & Messiha, Mario et al. (2021). Slow Crack Growth Resistance of reprocessed PVC. Plastic Pipes Conference PPXX, Amsterdam. https://www.researchgate.net/publication/354921933_Slow_Crack_Growth_Resistance_of_reprocessed_PVC

Yarahmadi, Nazdaneh & Jakubowicz, Ignacy & Gevert, Thomas. (2001). Effects of repeated extrusion on the properties and durability of rigid PVC scrap. Polymer Degradation and Stability. 73. 93-99. https://doi.org/10.1016/S0141-3910(01)00073-8

VinylPlus (2022). Progress Report 2022. https://www.vinylplus.eu/our-achievements/progress-report-2022

VinylPlus (2022). VinylPlus® Med Accelerates Sustainability in Healthcare. http://vinylplusmed.eu

Fiction

"Four types of plastics are particularly hazardous for health: polyurethane (PUR), polyvinyl chloride (PVC), polycarbonate (PC) and polystyrene (PS)."

ECOS (2021): Too good to be true? A study of green claims on plastic products. https://ecostandard.org/wp-content/uploads/2021/07/ECOS-RPa-REPORT-Too-Good-To-Be-True.pdf. P. 22

Fact

PVC is an inert, non-toxic material, recognised as a Polymer of Low Concern by the OECD.

Reference

OECD (2009): ENV/JM/MONO(2009)1. Data Analysis of the Identification Of Correlations Between Polymer
Characteristics and Potential for Health or Ecotoxicological Concern.  https://www.oecd.org/env/ehs/risk-assessment/42081261.pdf. P. 11

Fiction

"When recycling PVC, the toxic chemicals will remain in the new products."

Health Care Without Harm Europe (2022): Training on Circular Economy in Healthcare, Bristol, 9-10 November 2022

Facts

Legacy additives is an issue for many materials, not only PVC. However, the PVC industry has taken a proactive approach in the recycling of medical devices. Through partnerships with start-ups, a Near Infrared (NIR) scanner has been developed, which is used to sort out the DEHP-containing waste. This ensures that only REACH-compliant PVC is recycled. The scanner can be used on many other waste fractions.

References

VinylPlus (2022). VinylPlus® Med Accelerates Sustainability in Healthcare. http://vinylplusmed.eu

Fiction

"Some materials, such as polyvinyl chloride (PVC), are not considered as eco-friendly as it is made by a chemical reaction, between chlorine, carbon, and ethylene, and causes the release of harmful chemicals, which harms the environment."

Olivia Friett (2022): Editor's Comment: Green and Bear It. Medical Plastics News International - Europe edition - Oct/Nov/Dec 2022. https://www.medicalplasticsnews.com/medical-plastics-resources/medical-plastics-news-europe/medical-plastics-news-international-europe-edition-octnov-de. P. 7

Fact

PVC is made from 57% chlorine and 43% ethylene. PVC thus uses much less fossil-based feedstock – oil or gas – than other materials. Bio-attributed and bio-circular PVC, where the ethylene is derived from fossil-free feedstock, as well as non fossil-based PVC additives and compounds are also available on the market thanks to innovation by the industry.

PVC production plants in Europe have continuously improved their performance over the last 30 years, and their environmental impact has been steadily reduced. A voluntary Industry Charter for the Production of VCM and PVC has been in place since the mid-1990s to ensure that release of any unwanted substance is avoided. The Charters are being regularly updated so as to maintain requirements exceeding those described in the EU BAT reference documents.

References

Best Available Techniques (BAT) Reference Document (BREF) for the Production of Chlor-alkali published in December 2014 by the European Commission, pursuant Article 13(6) of the Directive 2010/75/EU on Industrial Emissions (IED). https://eippcb.jrc.ec.europa.eu/reference

The European Council of Vinyl Manufacturers (2019). ECVM Industry Charter for the Production of Vinyl Chloride Monomer and PVC. https://pvc.org/wp-content/uploads/2019/12/ECVM_Charter_v4.pdf