Washable vs SPU Slide Sheets: Which Is Better for the Environment?

In healthcare, sustainability is no longer a buzzword — it's a requirement. But when it comes to patient handling equipment like slide sheets, the question gets complicated: Are washable slide sheets actually better for the environment than single-patient-use (SPU) alternatives?

At first glance, reusable sheets look like the obvious eco-friendly option. But when you dig into the full chain of manufacture, use, and disposal, the story changes — and not always in the way you’d expect.

The Scenario: Real Numbers from a Typical UK Hospital

Imagine a hospital with 800 beds. Each year, it might either:

• Use 15,000 SPU slide sheets, each disposed of after one patient

• Or operate with 3,000 washable slide sheets, rotated so that one is in use, one is clean, and one is being laundered
  

In both models, we assume one patient = one sheet, and each washable is laundered once per patient.

The Result: Which Has the Bigger Carbon Footprint?

Virtually identical. The assumption that reusable equals greener doesn’t always hold up when you factor in the entire supply chain.

Slide Sheet Type	Total Annual CO₂ Emissions
SPU Slide Sheets	13,725 kg CO₂
Washable Slide Sheets	13,724.1 kg CO₂

Note on the Numbers: These figures are illustrative estimates, based on typical usage patterns and publicly available emissions data. Actual results will vary depending on your hospital’s infrastructure, laundering practices, and procurement sources. Our goal isn’t to declare a universal “winner,” but to highlight the key environmental factors so you can apply them to your own setting and make an informed, sustainable choice. Note on Scope: This comparison focuses on the in-use emissions (washing, drying, PPE, waste, and transport). Manufacturing emissions are not included, and are assumed to be broadly similar per sheet, regardless of type. This allows us to focus on how systems, not just products, drive environmental impact.

What’s Behind the Washable CO₂ Burden?

Washable slide sheets come with an entire ecosystem of products and processes. We accounted for every element involved in the real-world application of a washable system:

1. Electricity to Wash & Dry

Over 15,000 cycles per year adds up to over 3,495 kg CO₂.

2. Detergents & Plastic Bottles

Manufacture, shipping, and disposal of plastic containers add over 1,150 kg CO₂.

3. Single-Use PPE (Gloves & Aprons)

Rather than using one set of PPE per slide sheet, hospitals typically process large batches in one go. We've adjusted our model to reflect:

• 600 aprons per year

• 1,200 gloves per year (600 pairs)
  

This accounts for a single staff member using one apron and one pair of gloves per batch of 25 sheets, across 600 batches annually. These items are still:

• Manufactured from oil-based plastic

• Shipped (often from separate overseas sources)

• Disposed of as clinical waste (incinerated or landfilled)
  

Even with bulk use, this still contributes meaningfully to the footprint — but it’s far more accurate than assuming one glove and apron per sheet.

4. Wastewater Pollution

Even with modern wastewater treatment, detergent discharge affects water systems and marine life. We’ve modelled this at 0.5 kg CO₂ per wash, totalling 7,500 kg annually.

5. Multiple Import Chains

Unlike SPU sheets — which are typically shipped in bulk from a single manufacturer — washable systems require importing detergent, bottles, aprons, and gloves from separate sources. Each has its own manufacturing footprint, shipping route, and waste stream.

Cost Comparison: The Financial Reality

Slide Sheet Type	Approx. Unit Cost	Annual Volume	Annual Cost
SPU	£4.00	15,000	£60,000
Washable	£6.00	3,000	£18,000

Washables are far cheaper over time, even when accounting for 10% annual losses from damage, wear, and replacement.

Maintenance and Performance Over Time

Cost alone isn’t everything. Performance degradation is a key issue with washable sheets:

• After ~10 washes, the slip quality deteriorates

• As friction increases, so does the risk of injury to staff and discomfort to patients

• Without a well-managed exchange or quality-check system, older sheets may remain in use past their safe lifespan
  

By contrast, SPU sheets are always fresh — guaranteeing optimal glide and performance every time.

So while the initial financial cost of washables looks better, the hidden operational risk and performance deterioration could ultimately lead to:

• Increased injuries

• More time per transfer

• Higher long-term cost in insurance and staff absence

  
  

SPU Slide Sheets: Simpler, Predictable, Consistent

SPU sheets offer:

• Consistent quality

• No need for laundering

• No secondary products

• Lower injury risk from degraded performance

So Which Is Greener — or Better?

In our analysis:

• SPU and washable sheets produce almost the same CO₂ output annually in use

• SPU offers consistent performance with minimal infrastructure

• Washables are more cost-effective long-term — if managed properly

• The right choice depends entirely on your systems, resources, and behaviours

Disposal: Landfill vs Incineration

Disposal carries an environmental cost — and this varies depending on the system used.

SPU Slide Sheets: Incineration

SPU slide sheets are treated as clinical waste and typically incinerated after one use. Based on DEFRA estimates for lightweight polypropylene waste, this produces around 0.3125 kg CO₂ per sheet. For 15,000 SPU sheets, that equates to 4,687.5 kg CO₂ annually. While some incinerators recover energy, the majority still emit CO₂ and trace pollutants directly into the atmosphere.

Washable Slide Sheets: Landfill, Plastic, and Water Leaching

Even reusable systems have a disposal burden. Each year, 3,000 washable sheets are assumed to be retired and sent to landfill, generating around 0.8 kg CO₂ per sheet, or 2,400 kg CO₂ annually.

In addition, around 500 detergent bottles (non-recycled) go to landfill, contributing 300 kg CO₂.

And while we’ve already accounted for the energy emissions from wastewater treatment in the main model, it’s worth noting that detergent discharge also creates a separate environmental pressure — leaching into soil and water systems. Although not CO₂-heavy, this long-term ecological impact is more aligned with landfill pollution than process emissions, so we note it here for transparency — without re-counting CO₂ figures.

Total CO₂ emissions directly linked to landfill waste from the washable system: 2,700 kg CO₂ per year (excluding wastewater to avoid double-counting).

System	Disposal Method	Annual Emissions
SPU (15,000)	Incinerated	4,687.5 kg CO₂
Washable (3,000)	Landfill + Bottles	2,700 kg CO₂

This shows that while incineration has a higher carbon footprint, landfill has broader ecosystem risks. Neither option is “clean,” and both require careful handling — particularly when assumptions are made based on disposal method alone.

The Real Takeaway

This isn't a story of one being “better” than the other in isolation. It’s about how the product is used in the real world.

If you're selecting slide sheets, don’t just look at cost per unit. Consider the systems, behaviours, and infrastructure needed to make your choice safe, sustainable, and future-proof.

The answer isn’t “washable or SPU” The answer is: it depends on your infrastructure. A well-managed washable system may offer cost benefits and sustainability — but only if you have the right laundering setup, rotation checks, and waste streams in place. Without those, single-patient-use may offer a simpler, safer, and more predictable environmental impact.

References

• UK Government DEFRA Emission Factors 2023

• Our World in Data – Plastic & Freight CO₂

• NHS Sustainable Development Unit

• LCA studies on detergent & PPE impact (Ecoinvent, peer-reviewed sources)

• EPA estimates on landfill and wastewater pollution

• Usage estimates