Opportunities for the ‘biobased hospital’

Wageningen UR research paving the way to Bioeconomy for Dutch hospitals

Partly due to a feasibility study by Wageningen UR, the Rijnstate hospital in Arnhem has drawn up a long list of hospital items that can be made from fermentable biobased materials in the future. The waste can be directly shredded in the wards, after which it is deposited in a fermentation tank via the sewers. The innovation generates energy, reduces waste production and improves hygiene and logistics.

The bedpan is probably one of the most well-known hospital items. Nursing staff bring the shiny steel bedpans to a washing machine to be cleaned, which requires lots of work, energy, water and cleaning products. If it were up to Marc Koster of the Real Estate department of Rijnstate, things will be very different as of 2017: “We believe that by installing 51 shredders at various locations in the hospital we can shred disposable items and ferment them into biogas at a central location.”

Koster says that in addition to benefitting the environment, there is a good business case for this solution: “We would earn on the investment and see a positive net cash value from day one and have recovered the entire investment within 11 years.” The inspiration for the fermentation process comes from the Reinier de Graaf hospital in Delft, which embraced the concept of the Pharmafilter company in 2012. In Delft, the shredder has for several years been handling ward waste such as meal leftovers, bedpans, blood bags and eating utensils.

Fermenting utensils, bed linens and surgical gowns

The Pharmafilter shredder is called ‘Tonto’, which is Spanish for ‘the fool’. The shredded products are moved to a central unit where solid matter and water are separated. The organic components then go to the fermenter, while indigestible components and conventional plastic end up in a sludge fraction. The watery fraction is purified in a membrane bioreactor, before active carbon and ozone break down any medication residue.

Rijnstate wants to take it one step further. “Using Wageningen UR’s list of biobased materials we want to try and ferment a much larger part of our hospital waste,” says Koster. The list not only includes familiar disposable items such as coffee cups but also a wide range of sputum pots, syringes, linens, caps, shoe covers and surgical gowns.

The consideration of using fermentation and achieving a transformation towards biobased goes hand in hand with an expansion of the hospital capacity and strategic plan. The Rijnstate hospital aims to combine its building plans with an ambitious reduction of the ecological footprint, by reducing 600,000 kilograms of waste a year, achieving CO2 reductions and minimising water consumption.

160,000 kilos of fermentable material

At Wageningen UR Food & Biobased Research, scientist Martien van den Oever indicates that not just the bioplastic PHA is eligible for fermentation. “Pads, textile and the mountains of tissues used in hospitals can also probably be fermented in the future,” says Van den Oever. He calculates that 160,000 kilograms of material used at Rijnstate is at least partly fermentable or could be made from a fermentable equivalent. “This would result in biogas that is equivalent to 70,000 litres of diesel or 2.6 terajoules, which is over 700,000 kWh of energy.”

The expansion of the current PHA biobased range with other fermentable materials does, however, require tests to show whether the biobased material is fermentable. “The break-down of PLA, for instance, does not necessarily use the same micro-organisms as those active in the current Pharmafilter process,” Van den Oever explains. Wageningen UR hopes to perform further tests in partnership with Pharmafilter.

Plenty of easy pickings

Van den Oever makes a clear distinction between four categories. The Wageningen UR research shows that nearly half of the products used are probably already largely fermentable, such as tissues and toilet paper. Additionally, a little under ten per cent – mostly plates, soup bowls and cutlery – is already available in a biobased version but is not being purchased as such. Approximately fifteen per cent, including sheets, bowls, trays and jars currently made from polypropylene, can be made from fermentable materials with minor technical effort should there be sufficient demand. For around 2.5 per cent of the hospital items in Rijnstate, including Velcro, band-aids and suction jars, a biobased version would be a fairly significant challenge, according to the study. The remaining 25 per cent is paper, which is already recyclable.

“This means there are plenty of easy pickings,” says Van den Oever based on the feasibility study. But there are uncertainties as well. “PVC tubes, latex gloves and metal instruments such as scissors, blades and tweezers must be looked at from a new perspective.”

Stimulating the market

In the coming months, Rijnstate will determine which products can be replaced by fermentable versions and what the financial consequences will be. The follow-up project to the study will look at the possibilities of cooperating with other hospitals to increase the volume and stimulate the market. Koster hopes that decisions will be made in the short term, and that construction will start in late 2016 or early 2017. There are six other hospitals also looking to make the transition towards biobased with biobased materials and the Pharmafilter fermenter. In addition to the hospitals in Delft and Arnhem, these include the Erasmus MC in Rotterdam and the hospital in Terneuzen.


Contact the expert

ir. MJA (Martien) van den Oever
DLO Onderzoeker

ir. CH (Christiaan) Bolck
Programme manager biobased materials


Wageningen UR, press release, 2015-05-11.


Erasmus MC
Pharmafilter (NL)
Reinier de Graaf hospital (NL)
Rijnstate hospital
Wageningen University
ZorgSaam Ziekenhuis Terneuzen


Renewable Carbon News – Daily Newsletter

Subscribe to our daily email newsletter – the world's leading newsletter on renewable materials and chemicals