The Digital Health in the Circular Economy, or DiCE, project, funded through the EU’s Horizon Europe programme and coordinated with the involvement of the Brussels-based WEEE Forum, brought together twenty participating organisations from nine European countries. Its final report concludes that manufacturers, healthcare providers, policymakers, recyclers and patients all have essential roles to play in reducing healthcare electronic waste while maintaining the highest standards of patient safety. Pascal Leroy, Director General of the WEEE Forum, framed the stakes bluntly: digital health technologies are transforming medicine, with millions of devices helping patients live longer, healthier lives while making care more personalised and efficient, but the rapid growth of this market is creating a largely overlooked problem in the form of a fast-growing stream of electronic waste. The project, he said, has shown how to mitigate that problem and recover increasingly precious and strategically critical raw materials.

The scale of the challenge is difficult to pin down precisely, because no comprehensive global estimate of medical electronic waste yet exists. What evidence is available, however, points in one direction. Research indicates that some 83 million wearable medical devices were placed on the European market in 2020 alone, and that globally the figure could approach two billion devices annually by 2050 if current trends continue. That growth sits against a broader backdrop in which electronic waste of all kinds already exceeds 62 million tonnes worldwide every year, according to the United Nations, and is projected to reach 82 million tonnes by 2030. In Europe, only about 54 percent of electronic waste is properly collected, meaning a substantial share of embedded materials simply disappears into landfill or incineration streams.

At the heart of the DiCE report is a set of five priorities for redesigning the healthcare ecosystem. The project recommends that repairability, refurbishment and remanufacturing potential be considered when medical devices are first designed, so that service lives can be extended rather than cut short. It calls for digital product passports and detailed bills of materials to improve the recovery of valuable components and critical raw materials, for the expansion of convenient collection and return systems through pharmacies and other trusted locations, and for better alignment of medical device regulations with sustainable product design rules so that environmental goals complement rather than conflict with patient safety requirements. Finally, it urges the development of new circularity indicators that reward lifetime extension, reuse and repair rather than recycling alone. The report concludes that extending product lifetimes delivers substantially greater environmental benefits than concentrating on end-of-life recycling.

Everything, the researchers argue, starts with design. According to the European Commission, roughly 80 percent of a product’s environmental impact is determined at the design stage, and DiCE translated that insight into a five-step Circular Design Guide built on four design case studies developed with clinicians, engineers and users. The guide integrates circular thinking into existing digital health development processes rather than replacing them or asking teams to start from scratch. Across the case studies, cleanability, disassembly, component lifetimes, clinical workflows and traceability all proved essential considerations. Tamara Hoveling of TU Delft, the lead author of the guide, noted that the healthcare sector increasingly depends on digital technologies yet many devices are designed to be used and discarded, and that the central challenge was to preserve clinical performance and patient safety while extending product life, recovering valuable materials and reducing environmental impacts.

Some of the project’s most striking findings came from a series of detailed Life Cycle Assessments examining representative digital healthcare products. Researchers found that electronic components such as printed circuit boards, batteries and displays dominate the environmental footprint of individual devices. But the studies also revealed something unexpected: redesigning healthcare systems often produces greater environmental gains than redesigning the devices themselves. Reusable electrocardiogram lead sets reduced environmental impacts by 81 to 94 percent compared with disposable alternatives, although once reuse systems were introduced, cleaning and sterilisation became the primary environmental hotspot. Electronic pharmaceutical labels reduced climate impacts associated with drug manufacturing by approximately 27 percent, because medicines could remain usable when label information changed instead of entire batches being discarded. Powered electronic surgical staplers cut the overall climate impact of surgery by about 12 percent, as shorter procedures and hospital stays more than offset the additional electronics. Smart pillboxes, meanwhile, represented only a tiny fraction of the overall footprint of a patient’s treatment pathway, demonstrating that system design frequently matters far more than the device itself.

The project also moved beyond modelling into real-world testing. Consumer pilots involving 414 participants in Belgium, Spain and Slovenia found that more than 60 percent of participants were willing to return unwanted healthcare devices when convenient collection systems were available. DiCE deployed 25 easily accessible pilot collection machines in pharmacies, public buildings, supermarkets and care facilities across the three countries. The smart, secure system works by having users scan a QR code that unlocks a collection hatch; each returned device is captured by an interior camera, identified through an image recognition system and registered, creating a traceable record. The project also evaluated reverse logistics solutions including dedicated GRIN collection boxes, which are smart automated return-collection machines, alongside pharmacy-based and postal return systems, demonstrating that convenient collection infrastructure is essential for recovering valuable products and materials.

Industry voices within the consortium emphasised that the transformation is as much a business challenge as a technical one. Caroline Allard, Senior Sustainability Manager at Philips, observed that digital technologies are redefining healthcare through connected devices, artificial intelligence and data-driven care, yet this transformation also increases demand for materials, energy and resources. The challenge for manufacturers, she said, is to decouple better health outcomes from greater environmental impact by designing products, services and business models that keep materials in use for longer and minimise waste. The report’s technical analysis supports that ambition: redesigned powered surgical staplers achieved a potential material recovery rate of 90 percent, compared with 51 percent for devices on the market today, illustrating how much value current design practices leave on the table.

Perhaps the most striking message from the final report is one of optimism. Unlike many environmental problems, the researchers argue, this is one of the few for which the practical tools already exist: better design, repair, refurbishment, accessible collection systems, high-quality recycling and clearer regulatory alignment. Many patients want to dispose of devices responsibly but simply do not know where to return them or whether they can be reused, and better collection systems make doing the right thing far easier. The project has also produced a Circularity Dashboard, a policy-support tool available at circulardigitalhealth.eu that turns complex system data into accessible insight, allowing policymakers to compare circularity, cost and environmental performance across what-if scenarios, along with practical training materials to help manufacturers, healthcare providers and policymakers adopt circular approaches.

Launched in October 2022 and running until September 2026, DiCE set out to shift digital healthcare from a linear take-make-waste model to a circular one that maximises the recovery of products, components and valuable raw materials, deliberately basing its decisions and strategies on real-life pilots and community-engaged experiments in healthcare systems across Belgium, Slovenia and Spain. The project also employed motivational strategies drawn from behavioural science to encourage sustainable behaviour among patients and clinicians. Its final conclusion is that a more circular healthcare system is achievable if manufacturers, healthcare providers, governments and patients work together, and that future systems should be designed to keep products and materials in circulation for as long as possible through better design, repair, refurbishment, reuse and, ultimately, high-quality recycling. For a sector whose digital transformation is accelerating at nearly 20 percent annually, the blueprint arrives at a moment when the alternative, a rising tide of incinerated electronics carrying critical raw materials, is becoming impossible to ignore.

Subject of Research: Circular economy strategies for reducing electronic waste from digital healthcare devices

Article Title: Digital healthcare and electronic waste: There is a solution, EU experts say

Article References: Digital healthcare and electronic waste: There is a solution, EU experts say. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: electronic waste, digital health, circular economy, medical devices, recycling, Horizon Europe, life cycle assessment, eco-design, critical raw materials, WEEE Forum, patient safety, reuse

The research team, led by Chunyan Si and Petar Sabev Varbanov of the Pázmány Péter Catholic University network along with colleagues including Yee Van Fan and Lidija Čuček, focused on the European Union’s twenty-seven member states, where packaging accounts for 39 percent of all plastics conversion. Their model simulates the period from 2018 to 2030, beginning with the year the EU’s single-use plastics restrictions took effect and China’s import ban on plastic waste reshaped global recycling flows. Four materials compete within the simulation: conventional low-density polyethylene, polylactic acid bioplastic derived from corn, kraft paper, and natural cotton, each with distinct weights, lifespans and end-of-life pathways.

What distinguishes this framework from a conventional life cycle assessment is its treatment of time and feedback. The model is built from 144 interconnected system elements organised into five subsystems: demand, production, consumption, end-of-life management and environmental impact. Causal loop diagrams map the reinforcing and balancing feedbacks, such as how growing reuse inventories of durable bags suppress new production, which in turn lowers emissions until those bags wear out and demand surges again. Stock-flow equations then translate these relationships into quantitative projections, with 74 equations and 70 parameters drawn from official statistics, technical reports and published life cycle inventories.

The reuse assumptions are grounded in observed behaviour rather than idealised scenarios. Kraft paper bags, which last roughly a year and a half under favourable conditions, are assumed to survive between one and three uses before moisture and handling destroy them. Cotton bags, with an estimated three-year lifespan, are credited with 50 to 150 uses. Plastic and bioplastic bags remain strictly single-use, reflecting prevailing retail practice. Crucially, the functional unit is a single carrier bag of equivalent 15-litre capacity, so the model compares services rather than objects, and material-specific mass differences, from 18 grams for plastic to a hefty 456 grams for cotton, are explicitly accounted for in every calculation.

Validation against historical data from 2018 to 2021 lends the projections credibility. Mean error rates for population, bag demand, waste generation and landfill accumulation all fell within plus or minus 6 percent, and the model reproduced landfill trends with a coefficient of determination of 0.81. Weaker correlations for bag demand and waste generation reflect the limited year-to-year variation in the short historical record rather than structural flaws, the authors note. With the model thus anchored, the team ran single-material strategies, in which one bag type serves the entire market, and four mixed scenarios in which the plastic share declines in steps of 20 percent, culminating in a consumer-preference scenario with 50 percent cotton informed by European survey data.

The single-material results upend several popular assumptions. Polylactic acid bioplastic emerges as the clear environmental winner on the two metrics studied, cutting greenhouse gas emissions by 42.3 percent and energy consumption by 55.4 percent relative to conventional plastic by 2030, figures consistent with independent life cycle literature. Yet the authors caution that bioplastics accounted for only 0.5 percent of global plastic production in 2022, and a full substitution would raise global agricultural land use by an estimated 1.2 percent, competing with food production. Kraft paper, meanwhile, performs worse than plastic on emissions under every reuse level tested, remaining 2.4 to 20.1 percent higher by 2030, because paper manufacturing emits up to seven times more greenhouse gases per unit than plastic production, though its energy consumption is generally lower thanks to plastic’s fossil-intensive feedstocks.

Cotton tells the most dramatic story of all. Producing one cotton bag consumes roughly the energy of manufacturing 400 conventional plastic bags, so at low reuse rates of 50 uses the cotton pathway ends 2030 with emissions 49.7 percent above the plastic baseline. Push reuse to 150 uses, however, and the picture inverts: emissions fall 18.9 percent below baseline and energy consumption drops by 47.2 percent. The model also captures the characteristic oscillations of reusable systems, in which emissions and energy use rise as new bags are produced, fall once reuse inventories saturate demand, then climb again as bags reach the end of their lifespan and production must resume.

The mixed-material scenarios reveal that phasing out plastic alone is not enough. Under low reuse conditions, every substitution scenario produced higher emissions than the all-plastic baseline, with the cotton-heavy Scenario 4 reaching 37.7 percent above baseline. Under high reuse, the same scenarios delivered emissions reductions of 8.5 to 20.3 percent. Energy consumption, by contrast, fell in every scenario at every reuse level, ranging from 5.6 to 45.1 percent below baseline, because plastic’s petroleum-based raw materials are so energy-intensive. The lesson is stark: reducing plastic production and raising reuse intensity must proceed together, or well-intentioned substitution can backfire on the climate.

Sensitivity analysis sharpened the policy implications further. Shifting 5 percent of waste from landfill to recycling cut simulated emissions by 5.63 percent and energy use by 6.47 percent, whereas an equivalent shift to incineration changed outcomes by less than half a percent. The most aggressive waste-management improvement tested, a 10 percent recycling increase combined with a 15 percent landfill reduction, lowered emissions by 11.10 percent and energy consumption by 13.34 percent. Reuse frequency proved even more powerful: extending cotton bag reuse from 50 to 150 uses reduced emissions by 45.8 percent, dwarfing the effects of any macroeconomic parameter. Even accounting for degraded recycled material quality, which raised emissions by up to 12.97 percent at the lowest substitution factor tested, the relative ranking of scenarios held firm.

The authors acknowledge limitations, including the exclusion of retail distribution, secondary household uses of plastic bags, and impact categories beyond emissions and energy such as land use and water depletion. Still, the framework offers policymakers a transferable tool for testing packaging strategies before committing regulatory resources, and it delivers a clear message for consumers: the environmental value of a reusable bag is not fixed at the factory gate but earned, use by use, in the years that follow. A tote bag abandoned in a cupboard is, by this accounting, one of the most carbon-expensive objects a household can own.

Subject of Research: System dynamics simulation of greenhouse gas emissions and energy consumption across plastic, bioplastic, paper and cotton carrier bag life cycles in the EU-27

Article Title: System dynamics modeling for simulating greenhouse gas footprint and energy consumption of plastic packaging and its alternatives

Article References: Si, C., Fan, Y. V., Čuček, L., Teng, S. Y., Dokl, M., Lendvai, L., Kravanja, Z., & Varbanov, P. S. (2026). System dynamics modeling for simulating greenhouse gas footprint and energy consumption of plastic packaging and its alternatives. Cleaner Engineering and Technology, 34, Article 101305. https://doi.org/10.1016/j.clet.2026.101305

Image Credits: AI Generated

DOI: 10.1016/j.clet.2026.101305

Keywords: system dynamics, life cycle assessment, plastic packaging, carrier bags, bioplastics, reuse, greenhouse gas emissions, energy consumption, circular economy, EU policy, recycling, cotton tote bags