HPRC Recycler Roundtable Event

1. Healthcare Plastics Recycling: Unlocking the Potential of an Untapped* Feed Stream October 11, 2017 | Paper & Plastics Recycling Conference | Chicago, IL

2. Event Agenda 2 1. Welcome and Intro to HPRC 2. Opportunity Overview 3. Panel Discussion – Rigid Healthcare Plastics Recycling 4. Panel Discussion – Sterilization Wrap: A Circular Solution 5. Presentation: PureCycle Technologies 6. Interactive Breakout Sessions 7. Wrap up and Adjourn

3. 3 What is HPRC? HPRC is a private, technical coalition of industry peers across healthcare, recycling and waste management industries seeking to improve recyclability of plastic products within healthcare. Vision All healthcare plastics are safely and effectively recycled and widely accepted as a valuable resource.

4. Currently Engaged StakeholdersMembers Healthcare Facility Advisory Board Who We Are… 4

5. Plastics Sourcing Product & Packaging Design Manufacturing Warehousing Distribution Purchasing & Receiving Product Use Waste Collection & Processing Collection Sorting Processing FEEDBACK LOOP A Value Chain Approach to Inspire and Enable Recycling of Healthcare Plastics 5

6. Work Product: Design Guidelines for Optimal Healthcare Plastics Recycling Looks at product and packaging design features that inhibit post-use recycling potential. Articulates desirable design practices and less desirable design practices. Avoid multiple material types used within one product Avoid paper tapes or labels attached directly to products Avoid metalized plastics and paper/film packaging combinations Allow for the identification and removal of product residue Minimize the use of pigments in products Desirable Design Practice Less Desirable Design Practice Flagship Project: Product Design Improving Recyclability and Market Value 6

7. Work Product: HospiCycle “How to” guide and collection of tools for establishing plastics recycling in patient care settings. Looks at economic, regulatory, resourcing and infrastructure considerations Materials accredited for healthcare continuing education credits. Experience the Interactive Prezi at: http://bit.ly/HospiCycle Flagship Project: Product Use A Helping Hand for Hospitals 7

8. Connects supply with demand - - creating opportunity for hospitals to reduce waste disposal cost and recyclers to access valuable feedstock. Flagship Project: Disposal & Recycling Chicago Project Supply, Meet Demand Project Partners 8

9. Event Agenda 9 1. Welcome and Intro to HPRC 2. Opportunity Overview 3. Panel Discussion - Rigid Healthcare Plastics Recycling 4. Panel Discussion - A Sterilization Wrap: A Circular Solution 5. Presentation: PureCycle Technologies 6. Interactive Breakout Sessions 7. Wrap up and Adjourn

10. “The development and introduction of new packaging materials and formats across global supply and distribution chains is happening far faster than and is largely disconnected from the development and deployment of corresponding after-use systems and infrastructure.”1 1The New Plastics Economy: Rethinking the Future of Plastics; Ellen MacArthur Foundation, 2016 10

11. • 14,000 tons per day waste1 • 20-25% plastics2 • 85% noninfectious3 The opportunity: 1,000,000 tons/year 1 Kaplan, Susan, Blair Sadler, Kevin Little, Calvin Franz, and Peter Orris. “Can Sustainable Hospitals Help Bend the Health Care Cost Curve?”, The Commonwealth Fund, Issue Brief, November 2012. 2 Lee, B., M. Ellenbecker, and R. Moure-Eraso. “Analyses of the Recycling Potential of Medical Plastic Wastes.” Waste Management (2002): 461-470 3 Grogan, Terry. “Solid Waste Reduction in US Hospitals.” Hospital Engineering & Facilities Management (2003): 88‐91. Healthcare Waste Situation

12. PP PP, HDPE, PET, PETG, PS Sterilization Wrap PP PP, HDPE, PET Tyvek® (HDPE) Film and Laminated Packaging PVC The Opportunity Healthcare Plastics 12

13. 37% 19% 15% 24% 6%Sterilization Wrap Paper Rigid Plastics Other Flexibles (Non-Woven and Film Plastics) Other Recyclables and Waste The Opportunity Healthcare Plastics 13

14. Recyclables • Paper • Containers • Organics Commodity Market Specialty Re-use Infectious/Hazardous Treatment Landfill 1. A variety of stakeholders with differing priorities! 2. Existing contractual arrangements that limit flexibility and nimbleness. 3. A dynamic plastics market. What Does the Landscape Look Like Today? 14

15. Thinking “Circular” in Terms of Healthcare Plastics 15

17. 17 Panel Members: Rigid Healthcare Plastic Recycling Glen Goodsell Mandie Latture Scott Boito Recycling Coordinator Senior Account Manager Product Stewardship Manager Moderator: Bob Render Commercial Manager Ravago Recycling Group

18. Mayo Clinic in Rochester, MN • 3 Campuses  Mayo Clinic (outpatient)  Mayo Clinic Hospital, Saint Marys  Mayo Clinic Hospital, Methodist • Integrated medical center providing comprehensive diagnosis & treatment in virtually every medical & surgical specialty • 36,000 + employees • 21 million square feet 19

19. Recycling Healthcare Plastics & More Mayo Clinic Rochester Recycling Center recycled 5,500 tons of material in 2016 20

20. • 50 dock stops per day • 2 full-time night drivers • 1 full-time day driver • Collection routes are for all recyclables Transport 21

21. Storage Healthcare plastics generated in 1 day 22

22. • PETE & HDPE • LDPE - rigid and film • PP - water bottles • PP - rigid • PP - oversized rigid • PP - blue wrap • PS - blue polystyrene • PS - white polystyrene • HIPS & other • EPS A Glimpse at What We Are Sorting Today’s 13 Plastic Categories 23

23. Rigid PP is ground Sorting LDPE, PP, PS & Other 24

24. Rigid PP Flakes 25

25. Sorting – EPS Expanded polystyrene (EPS) 26

26. Sorting – PP Blue wrap is collected and baled separately 27

27. Sorting – PS White and blue polystyrene (PS) are baled separately 28

28. Insulin Syringe Body Separation 29

29. ACI Background • Privately Held • Established 1986 • 115 employees • Accredited Quality: – ISO9001:2008 – AALA • 5 plants in the US – 400,000 sq. ft • Global Presence – USA: Michigan, South Carolina, Nebraska and Arizona.Europe: Germany, UK 30

30. Separation Technologies • Optical sorting • Electrostatic sorting • Density separation • Infrared separation • Air separation • Metal separation • Melt filtration • Mechanical separation 31

31. Whole Insulin Syringe 32

32. Make up of Syringe Body Insulin syringes are made up of the following materials: • PP (SG - .92) • PE (SG .95) • PC (SG 1.2) • HIPS (GS 1.04) • Rubber (SG 1.15) • Stainless steel (SG 7.9) 33

33. Processing Issues • Grinding process must liberate as much metal as possible • Encapsulated metal inside the PP tips can be screened out when pelletizing • PP purity after processing will be 99% • Slight PE contamination will be present in the PP grind 34

34. Separating PP • Grind whole syringes • Run material thru a magnet to recover stainless steel • Separate any packaging out thru aeration • Process grind thru density separation • PP and PE will float, all other materials sink • Alter salinity of water slightly to recover HIPS 35

35. Separated PP Grind 36

36. PP Data Sheet Property Test Method Units Conditions Results Tensile Strength @yield ASTM D638 PSI 2.0 in./min., 2 in. gauge length 4,209 Flexural Modulus ASTM D790 PSI 2 in. span, 0.05 in./min. 175,530 Izod Impact Strength ASTM D256 Ft-lb/in 2 lb. hammer, 23 C 0.7 (C) Melt Flow ASTM D1238 g/10 min 230 C/2.16Kg 26.2 Specific Gravity ASTM D792 n/a Water temp 23°C+/-2°C 0.92 Ash Content ASTM 5630(B) % n/a 0.09 37

37. HIPS After Separation 38

38. HIPS Data Sheet Property Test Method Units Conditions Results Tensile Strength ASTM D638 PSI 0.2 in./min., 2 in. gauge length 3,983 *Elongation @ Break % 41.6 Flexural Modulus ASTM D790 PSI 2 in. span, 0.05 in./min. 324,036 Izod Impact Strength ASTM D256 Ft-lb/in 2 lb. Hammer 1.5 (C) Melt Flow Rate ASTM D1238 (Method A) g/10 min. 230°C / 2.16kg 10.3 Specific Gravity ASTM D792 (Method A) Water temp 23°C+/-2°C 1.04 39

39. • Global headquarters in Kingsport, TN • Long history in PET • Innovations to create modified PETs to meet demands of various markets • Medical device and food-contact packaging markets adoption high and increasing 39

40. • The modifications in PETG make it a more valuable product, both initially and upon recovery • Increased adoption of PETG leading to increasing instances of recycling batch fouling (PETG is amorphous and melts much lower than PET) • Economies of scale building to justify creating a dedicated stream, but still limited relative to major plastics • Eastman is dedicated to Sustainability on a corporate scale, so solving this discrepancy is highly desirable • We have experience with helping to create the PET recycling stream, but decades ago 40 Eastman’s “Problem”

41. • PETG is used where PET does not or cannot work and also where the attributes of clarity and sterilizability are valued • Many medical devices use PETG in their packaging and are approved as part of the device • Eastman has technical resources available to help with identification and separation strategies • Eastman has ideas about potential end-market uses for recovered material (e.g. use in carpet for increased dye retention) • But we are looking for fresh eyes to identify recovery and reuse/recycle streams • Help Eastman toward our sustainability goals 41 Eastman Needs Your Help

42. 42 Product Examples

43. 43 Q & A Rigids Panel Session

45. 45 Sterilization Wrap – A Circular Solution Panel Members: Dan Constant Katie Wickman Garrett Anderson Mike Phillips President Sustainability Operations Manager COO Manager

46. 46 Sterilization Wrap: A Circular Solution

47.  Consultancy firm specializing in landfill diversion of health care related waste and product destruction.  Closed loop and Circular economy specialists.  Consultant and program trainer for Halyard Health’s Blue Renew program.  Manufacturer of BlueCON Resin products. 47 Daniel Constant President Daniel@constantlygreen.net www.constantlygreen.net

48. 48 After HALYARD* Wrap has completed its first purpose of keeping the contents of your wrapped packages sterile, it's ready to begin a second life with BlueCON Resin™ Products. Derived from Halyard's BLUE RENEW* Recycling Program, BlueCON Resin™ Products include distribution and product totes, garbage cans, bedpans and wash basins. Closing the Loop on Hospital Plastics

49.  Halyard Health’s (formally Kimberly-Clark) Blue Renew initiative is a program to assist hospitals with collection and recycling of clean operating room waste.  Program initiated in 2010 and to date has trained and assisted over 1000 hospitals with proper collection techniques and landfill diversion of their waste.  Landfill diversion of clean waste exceeds 5 million lbs. annually, with an overall program goal of 40 million annually.  In 2016, BlueCON ResinTM derived from Halyard’s Blue Renew program was introduced to health care compounders and molding companies  BlueCON ResinTM contains over 80% hospital waste.  Products made from BlueCON ResinTM are available to national hospitals to create a “Circular Economy.” 49 Halyard Blue Renew Program Summary

50. Next Opportunity? Halyard’s Blue Renew program is just the start on “Greening the OR” and recycling clean waste from hospitals. Blue wrap is only 5% of the overall clean waste produced by hospitals daily. Example of other clean materials: • Polypropylene Saline Bottles • Polypropylene rigid containers • LDPE plastic film • Cardboard • PET bottles • Polypropylene non-woven material 50

51. Importance of Proper Training? Training of hospitals on clean collection and transporting practices are vital to the longevity of any recycling program. Recycling in the OR is not a normal practice. A new discipline and overall culture change has to occur with the staff to be successful: • Extensive OR and EVS staff training on why they are collecting clean waste, where to collect and how to keep clean must take place. • Educate them on where the material is going after it leaves the hospital and the expectations of the recycler. • Reporting back of clean volume and contamination found by the recycler is vital to their long term success. 51

52. Keys to Ongoing Success? • Hospital strive everyday to be more sustainable and be part of recycling programs to help reach their environmental goals. • Partnerships around recycling are always well received and offer great opportunities for area recyclers. • It is important to recommend program that make sense for the fast paced life in the OR. • Hospitals need reporting information back in the way of volumes recycled, final destination of the their waste and real time communication on how the program is progressing in the eyes of the recycler. • A successful recycling program at your area hospital can be very rewarding. 52

53. 53 The Potential

54. 28 quart Recycling Bin 14 ½ D x 10 ½ W x 15 ½ H - 2 lbs. 32 gallon Garbage Can 22” Diameter x 28” H - 7 lbs. 15 gallon Distribution Tote - w/hinged lid 11D x 23 W x 15 H - 4.5 lbs. BlueCON Resin TM made from 80% OR recycled waste 45 gallon can w/wheels & Flip lid 25 ¼ L x 21 ¼ W X 31 ¼ H - 9.75 lbs. Pontoon Bed pan Fractured Bed pan Stackable Bed pan Wash Basin Products Made from Sterilization Wrap 54

55. • Faith-based health system in Illinois • 12 hospitals, 400 sites of care • Mission to serve the health needs of individuals, families, and communities • Commitment to environmental stewardship • Founding sponsor of the Healthier Hospitals Initiative 55

56. 56 Energy & Waste Reduction 2016

57. 57 Sterilization Wrap Collection

58. Citadel Information Management Westmont, IL Garrett Anderson Operations Manager Since 1985, Citadel has helped companies protect their confidential information and reduce risk. Services include document shredding, record storage, imaging, product destruction, and electronics recycling. Committed to helping our healthcare partners divert waste from landfills and improve sustainability efforts. 58 Introduction

59. • Bagged blue wrap is collected from hospitals and transported to Citadel for processing. • Material is sorted and baled together before being shipped to the end recycler. 59 Process Description

60. • Pickup logistics • Contamination • Storage space • Weight 60 Challenges

61. • Recycling company located in Hillsville, VA • Our primary business is to collect untraditional scrap plastics and find applications to make them usable • Our mission is to reduce landfill waste by sorting and separating usable plastics and making finished products from scrap • New River Polymers was established in 2008 as a sorting and separating facility • Largest obstacle are cross contaminated products that need to be separated. 61

62. 62 Waste is guillotined and baled for pelletization. Scrap product being baled before pelletization.

63. 63 Grinder used to make purge plastics small enough to pelletize Example of hard plastic and purge

64. *Registered Trademark or Trademark of Halyard Health, Inc. or its affiliates. ©2014 HYH. All rights reserved. Program In Motion 64 Pre-check for contaminates before collector picks-up material. Collector or hospital bales material. One way to recycle is to re-process wrap back into pellets for future use. Process Steps Sterilization Wrap Recycling

65. 65 Sterilization Wrap Panel Session Q & A

67. 67 Q & A PureCycle Technologies

69. Interactive Sessions 69 2 Logistics 3 Working with Hospitals Learn Share Lead 1 Materials

70. 1 Materials 70 Interactive Sessions Bob Render Millie Calistri-Yeh

71. 2 Logistics 71 Interactive Sessions Katie Wickman Susan Williams

72. 3 Working with Hospitals 72 Interactive Sessions Lois Sechrist Janet Howard

73. Interactive Sessions 73 2 Logistics 3 Working with Hospitals Learn Share Lead 1 Materials

74. 74 Any “aha!” moments? Interactive Sessions

75. 75 Wrap Up and Adjourn! For more information Visit www.hprc.org

76. 76 For more information Visit www.hprc.org

HPRC Recycler Roundtable Event

HPRC: Healthcare Plastics Recycling Council

HPRC Recycler Roundtable Event