Point-of-test (PoT) diagnostics offer numerous benefits, such as speed, convenience, and improved patient outcomes. This approach is transforming healthcare by enabling rapid, accurate decision-making while reducing the need for extensive laboratory infrastructure. However, as the demand for PoT diagnostics continues to rise, it is crucial to evaluate their environmental and economic sustainability.

The environmental impact of PoT diagnostics largely stems from the use of disposable components, most of them single-use plastics, that contribute to waste and increase the carbon footprint. Economically, PoT diagnostics can be cost-effective by reducing the need for centralized laboratory infrastructure and shortening hospital stays. However, the initial investment in developing sustainable materials and technologies can be high. Balancing these costs with the long-term benefits of reduced waste and improved healthcare efficiency is crucial for economic sustainability.

Materials, Manufacturing, and Management

Sustainability in healthcare aims to reduce environmental impact, conserving resources, and ensuring equitable access. In the context of diagnostics, the emphasis is on:

Many PoT diagnostic devices are single-use and rely on materials such as plastics and electronics, contributing to waste production and environmental issues. Sustainable alternatives include biodegradable, recycled and ethically sourced materials, along with eco-friendly manufacturing processes (1). Additionally, modular and reusable device designs can reduce waste generation (2).

PoT devices often rely on portable power sources like batteries, which have environmental and disposal challenges. Energy-efficient designs and renewable-powered devices can mitigate these impacts (3). Some diagnostic instruments are designed for reuse rather than disposal after a single use. This approach minimizes waste and promotes sustainability. Advances in AI, and the use of exisiting technologies (e.g., using a smartphone camera for quantifying lateral flow test results, such as used by SWIFTR) are optimizing analysis processes and reducing waste. These technologies enhance efficiency and minimize energy consumption.

PoT diagnostics generate biomedical and electronic waste. Ensuring proper disposal or recycling of these materials is critical for sustainability (2). Establishing take-back programs for expired or used diagnostic devices could reduce landfill contributions (4). Raman and Infrared spectroscopy are gaining traction due to their non-destructive nature and reusability. These techniques eliminate the need for single-use consumables, thus reducing waste.

The Need for Innovation in Sustainable PoT Diagnostics

Although these efforts are essential for creating a more sustainable future in healthcare diagnostics, there are advancements that are setting the stage for a more environmentally friendly future in diagnostics. Innovations in microfluidics, biosensors, and digital technologies are enhancing the efficiency and sustainability of PoT diagnostics.

Examples include:

• Paper-based diagnostics: These devices are inexpensive, lightweight, and biodegradable, making them valuable in resource-limited settings (5).
• Digital integration: Using smartphones and AI for data analysis reduces the need for additional hardware and enhances usability (6).
• Circular economy models: Designing devices for recyclability or reuse can minimize waste and resource depletion (7).

However, it is not only about reducing the direct environmental impact of PoT diagnostics. Sustainability also includes accessibility and affordability. PoT diagnostics can provide equitable healthcare access by reducing dependence on centralized facilities and enabling remote healthcare delivery. Looking at the bigger picture we need to take into consideration other indirect benefits such as, reducing (i) hospital visits and therefore carbon emissions from travelling to and from home, (ii) the risk of infections for the patient and others, and (iii) use of plastics and transport of test samples from hospitals to central analytical labs.

PoT have the potential to transform global healthcare, but the long-term success depends on aligning with sustainability principles. By adopting innovative materials, efficient designs, robust waste management systems and supply chains, PoT diagnostics can contribute to a healthier planet while improving healthcare outcomes.

References

1. https://doi.org/10.3390/jcs8090342
2. https://ondrugdelivery.com/sustainable-design-for-medical-devices/
3. https://doi.org/10.1556/204.2023.00013
4. https://doi.org/10.3390/ijerph192214820
5. https://doi.org/10.3390/bios14060300
6. https://topol.hee.nhs.uk/the-topol-review/
7. https://www.ellenmacarthurfoundation.org/circular-examples/pioneering-circularity-in-the-healthcare-industry-royal-philips