In Pursuit of Greener O&P Production
July 2021 Issue
Kyle Trivisonno, CTP, knew he had found his calling as soon as he started his first job as a prosthetic technician.
Trivisonno, founder of Human Plant Solutions, headquartered in Newton, Kansas, had dyslexia and had struggled through school. A technician's job was a perfect fit because he could learn hands-on and help people.
"I fell in love with what I was doing," he says.
"I was connecting and helping someone and also doing critical problem-solving."
Still, it wasn't perfect. At the end of the workday, he'd come home covered in fine dust from grinding carbon and fiberglass. He worked in a lab with dust collection, and he wore personal protective equipment, but he still found himself itchy from the particles floating in the air.
"You realize that this is probably not healthy, but since I loved what I was doing, I did it anyways," he says. "I didn't want to put myself at risk. That set me on the path to investigation."
Soon enough he had the idea to make a socket from hemp fabric, a sustainable material that is less corrosive than fiberglass or carbon and, when laminated properly, can be stronger than carbon, he says. His coworker Marc Dunshee, who has a transtibial amputation, was willing to try Trivisonno's prototype.
Dunshee took the prototype socket and ran with it. A lot. He's completed marathons and even an Ironman triathlon.
"There's no failure of the socket, no fatigue at all," Trivisonno says. "He's able to run a marathon and have no swelling, no blisters."
With that initial success, Trivisonno became convinced of the value that hemp fiber could bring to O&P. Not only is it durable, lightweight, and eco-friendly, it's also available around the world and thus accessible to those who might not have access to other materials.
"If you look at the raw numbers, there are 40 million amputees globally that do not have care," Trivisonno says. "I think we have to look at the problem from the ground up and find a locally sourced solution." He points out that some hemp varieties even grow in Siberia with snow on the ground.
Human Plant Solutions is a fabrication partner with Synergy Prosthetics, San Diego, California. One of Synergy Prosthetics' practitioners has a transtibial amputation and has used a hemp device for over a year to surf and rock climb.
Human Plant Solutions is just one O&P company working to make the industry more environmentally friendly. Manufacturers, distributors, and clinics have found several sustainable solutions that include using eco-friendly materials, ramping-up recycling efforts, reducing waste, and utilizing alternative energy.
While this focus on sustainability hasn't always been a part of O&P's past, Trivisonno says it should be a part of the industry's future.
"Historically, I'd say that being environmentally friendly has not been a main focus of the industry," Trivisonno says. "At the end of the day it's a tough job; you are limited on time and resources, and you do what you can and use what's available. But becoming sustainable isn't as hard as you might think. It's important to me, and it's important to a lot of people."
A Focus on Sustainability
An emphasis on sustainability has long been a priority at Össur, Reykjavik, Iceland. The company has worked to certify its largest manufacturing and distribution facilities to meet international environmental standards.
"We take our responsibility to be environmental stewards very seriously and have been steadily working on extending the scope of our monitoring to clearly understand our global carbon footprint and how to improve upon it," says Jon Sigurdsson, president and CEO.
Recently, the company decided that it would commit to becoming carbon neutral for energy and fuel consumption, waste generation, business travel, transportation of goods, and electric consumption of finished goods suppliers. It's perfect timing for the company's 50th year in business.
"We thought it would be a great way to mark the anniversary milestone, to make it happen this year," Sigurdsson says.
This accomplishment is part of a years-long effort. To get to this point, Sigurdsson says the company had to first understand its carbon footprint before it could set achievable goals based on it.
"The first step to any comprehensive environmental sustainability program is to set achievable goals and implement a plan based on a thorough overview of the operating situation," Sigurdsson says. "Over the past few years, Össur has made great progress in mapping our carbon footprint and chose specific initiatives within our operations that we believe would have the greatest impact."
Össur chose to focus on reducing emissions from its operations and is working toward getting 100 percent of its electricity from renewable energy sources. Some of the environmentally friendly steps the company has taken include:
1 Össur's headquarters and main prosthetic manufacturing site in Iceland run on 100 percent renewable energy, which is backed up by a Guarantee of Origin certificate.
2 At the main office and large-scale distribution office in the Netherlands, the company utilizes solar panels on the roof that provide almost half of that operation's annual electricity consumption.
3 To reduce emissions by freight, the company chooses ground and ocean freight when possible.
"We also have a clear strategy for further reducing waste and improving efficiency in all of our processes, which we believe will thereby minimize pollution from waste," Sigurdsson says.
He says the company is proud of how far it has come but recognizes that there is still work to be done.
"We see this as a marathon, not a sprint," he says. "We are certainly proud of how far we have come but also realistic that the journey is just beginning. While we expect there will most certainly be challenges on the way, the positive reaction we have received from all of our stakeholders and the enthusiasm within our organization makes me think anything is possible."
Better Quality Plastic and Less Waste
Leaders at Curbell Plastics, Orchard Park, New York, say they want to be a part of the solution when it comes to reducing the amount of plastic in landfills.
This seems challenging considering that they are, in fact, making their livelihood by selling plastic.
"Curbell is a distributor of performance plastics, which are very different from single-use plastics, the primary focus of plastics pollution. The performance plastics we provide have a long, useful life, especially in the O&P industry," says Mark Shriver, director of safety and environmental affairs. "That gives us an edge not only over traditional materials and our competition, but also in the fact that it fits who we are. We truly care about the environment."
Their strategy, he says, is to reduce the amount of single-use plastic the company uses, recycle as much as they can, encourage their customers to also recycle, and to reduce and ensure that the plastic Curbell does distribute is high quality and thus will last a long time.
He points out the difference in single-use plastics, like those in disposable water bottles, and the performance plastics they provide.
"Performance plastics are part of the materials that make up modern-day society," Shriver says. "Without them you wouldn't have many of the things we enjoy today like a cell phone or planes that fly across the country without refueling."
He says performance plastics are ideal materials for O&P products because they are lightweight and durable.
Unfortunately, not all plastic used in O&P devices is recyclable. Often, the plastic is contaminated during fabrication when adhesives, transfer papers, and foam are added, eliminating its ability to be recycled.
"So many O&P labs want to do good for the environment," says Jeff Wilson, Curbell senior business development manager for orthotics, prosthetics, and podiatry. "It's hard to tell them why it doesn't always work well within an O&P lab."
What they can do is help their customers reduce their waste output overall, says Wilson. He says he works with customers to help them order materials to size, thus reducing waste and cutting their costs.
Also, Curbell recently developed a release spray to help when fabricating with foam molds. Wilson says he was asked by technicians using a sacrificial plastic sheet over their molds as part of their process to develop something to eliminate this step.
"We worked to develop the release spray, so they won't have to use that sacrificial piece of plastic," Wilson says. The initial version of the spray was a Teflon aerosol spray that worked but wasn't good for the environment, he says. They kept working until they came up with a water-based, environmentally friendly version.
The company also tries to eliminate waste by donating excess materials to high school shop classes.
"We always try to divert all our materials from landfills in one way or another," Shriver says. "It's not perfect but neither is the world we live in."
Making O&P more sustainable and environmentally friendly will require work from everyone, the experts say. Historically, it has not been a focus of the industry.
"We took what we learned from aerospace and other industries and applied what we knew because they were the best materials we had at the time," Trivisonno says. "That's not the case anymore."
He says to get to where it needs to be, the industry may have to experiment with new processes or products built with sustainable materials that don't sacrifice quality.
"There are a lot of opportunities to improve and make better prosthetics and be better for humanity," he says.
At Össur, working to be sustainable meant that company had to look at all of its operations and figure out how to make changes.
"Sustainability is an ongoing process and the ultimate goal is to demonstrate our commitment to this responsibility by incorporating sustainability into all of our business operations," says Sigurdsson. The good news is that what is better for the environment can also be what is better for the company.
"We always apply frugal thinking, whether that means minimizing all kinds of waste, or more efficiently using raw materials, resources, or time," Sigurdsson says. "We have discovered that implementing our sustainability was a ‘win-win' case, both in terms of cost savings and reducing pollution."
While the industry still has work to do, it's important to start trying, Trivisonno says.
"Resources are limited," he says. "Fossil fuels will eventually run out. It's really our job to try. It doesn't mean we'll be perfect. It's doesn't mean we'll do everything right now. But we've got to keep learning and try our best."
Maria St. Louis-Sanchez can be contacted at firstname.lastname@example.org.