Respiratory Solutions

Going Green

• By Dick Fields
• May 01, 2010

When something is described as “green” these days, it implies an effort to save our big blue marble. One cannot board a plane or sit in a restaurant without repeatedly being reminded to conserve and preserve in order to limit the impact on the Earth’s fragile and precious ecosystem.

A multitude of businesses have adopted a green culture, and many more are exploring this eco-friendly trend. If you were to have this conversation with the owners of these same businesses 10 or 15 years ago, you would have been labeled a “weirdo tree hugger” and politely excused. In today’s landscape of defining who we are and what we stand for, allegiance to the green movement is seen as progressive.

In that spirit, our home respiratory and sleep therapy community must become more engaged and participate in the green movement. There are numerous ways to reduce wasteful processes and add more to the bottom line. What a great concept! Below are three relatively simple examples that would have an immediate impact on establishing your business as a responsible contributor to the health of our planet.

Recycling PAP Masks

The majority of PAP interfaces are labeled “multiple patient usage,” which signals that we can reuse these products in a variety of situations. Recycled masks can be given to indigent patients, used as demo masks for patients who require more intervention toward compliance, employed at free sleep clinics or sold for cash to those patients who need another mask, but are not eligible through insurance for some reason, like the dog ate their mask. Pasteurization is one method to consider when adopting the practice of recycling PAP masks.

With very few exceptions, most masks will hold up to multiple cycling through the pasteurization process. Our business purchased a tabletop pasteurizer several years ago from Olympic Medical. The equipment cost about $5,000, and it required some minor installation for a water supply and filtration system. The pasteurization process has afforded our company enormous rewards and fl exibility. The payback was almost immediate, due to our large volume of new CPAP setups. Our company also pasteurizes about 150 to 200 masks weekly for use in our health system sleep labs.

Many small- to mid-size home medical equipment companies cannot justify the expense due to their volume and staffing limitations. But some may want to consider the opportunity for a small business here, similar to dry cleaning. This process will require an equipment dryer, such as a used 3M Mistogen, which is available online. Anyone reading this idea can start to do the math and immediately realize the potential. Add the pasteurization process to a good manufacturer mask-replacement program, and you actually have a separate revenue-generating stream. Better yet, you help the environment by reducing the waste of tossing returned masks in the trash.

Granted, receiving a pasteurized mask may not be for every patient and occasionally we hear complaints about the “yuck factor,” but those are usually from the folks you just can’t please anyway. Recycling PAP masks is a no-brainer. It will reduce your cost of goods, generate a revenue stream and save our planet.

Cleaning Used Equipment

Another green opportunity exists with the use of a small ozone generator that will “defunk” PAP equipment returned from a patient who has exposed it to cigarette smoke or other odors. Typically, when this equipment is brought back to the warehouse, it will collect dust for a while, get thrown away and ultimately be carted off to a landfill.

With ozone generators, you can change that process and give new life to smelly equipment. Our business has used ozone generators for years. The units can be purchased online and can cost less than $100. The useful life of an ozone unit is very good, considering the expense. The ozone is very powerful, removing a large majority of the residual odor on equipment forever. The trick is not to totally depend on the ozone alone since many situations require the use of a manually sprayed deodorizing agent to augment the ozone’s effectiveness. The PAP unit and the ozone generator need to run continuously for several days in a well-vented cardboard box measuring about 3 feet by 20 inches by 15 inches. In a box that size, it may even be possible to defunk two pieces of equipment at the same time.

Before starting the process, remove all the filters. Further, there are times when a nonwarranty device will need to be taken apart so that the soundproof padding can receive more direct attention. Use the deodorizing spray liberally, but do not apply it to the PCA board (power supply). We have not experienced any problems or concerns using the ozone process, which enables our business to return a viable device back to inventory to generate revenue again.

Cutting the Use of Distilled Water

When it comes to heated humidification, we can limit the use of distilled water in those environmentally unfriendly plastic gallon jugs. I have been a PAP device user for four years now, and I have never used a drop of distilled water in my heated humidifier. I clean it every week, and my unit looks new.

Remember basic RT 101. Heated humidifiers produce water vapor. The molecules of water vapor do not permit the transport of “critters” to the patient. So even if the tap water were infested with critters, the patient would not receive any bacteria.

The primary reason to use distilled water (that plastic gallon jug) is due to the wide variations in the mineral content of tap water. The minerals react with the aluminum used in most nonpermanent heated humidifier canisters, thus creating some pitting, which will eventually erode and leak water all over the antique Tiffany nightstand. Generally speaking, most permanent heated humidifiers use stainless steel. Therefore, they are not subject to the concern of minerals pitting the metal. In addition, some tap water is high in calcium and other minerals that will leave a residue and discolor the interior. Big deal. It may not look great, but it will not harm the user, due to the moisture being delivered to the patient in the form of water vapor, as explained above.

My point here is to help us feel better about not encouraging patients to purchase those big jugs of distilled water, but to instead advise them to use tap water when applicable. Or we could recommend they use a simple, inexpensive water filter system to produce their own mineral-free water. Remember, those big gallon jugs over the lifetime of the patient add up. Some may be recycled, but many more will end up in a landfill near you.

What you chose to do with these green suggestions is a matter of how you want your business to be perceived and to what degree you will consider moving outside the box to help the planet.

This article originally appeared in the Respiratory & Sleep Management May 2010 issue of HME Business.