Tag: plastics

Knowledge gaps for perishable liquid food packs threaten Green Deal

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Professor Fredrik Nilsson, Packaging Logistics, Faculty of Engineering, Lund University

Policymakers are currently deliberating on packaging reuse targets in the proposed EU Packaging and Packaging Waste Regulation (PPWR). But do they have the necessary evidence to make those decisions for all packaged products? A systematic review of 159 relevant scientific studies on packaging alternatives for perishable liquid foods[1] — milk, juices, nectars and plant-based drinks — suggests there is a clear gap in holistic impact assessment knowledge.

Packaging of perishable liquid foods exists in various forms such as aseptic paper-based beverage cartons or non-aseptic solutions such as plastic or glass bottles. Each packaging solution has an impact on the quality, safety and shelf life of the food it contains. In assessing packaging solutions, efforts should be made to understand the wider context of reuse targets for perishable liquid foods, with consideration for packaging types, food security, food safety, food waste and environmental impacts.

In both research and policy contexts, packaging is still often considered separately from its contents in impact assessments.

However, in both research and policy contexts, packaging is still often considered separately from its contents in impact assessments, despite an existing body of knowledge and evidence showing that food and its packaging should be treated as an integrated unit.

Consequently, policymakers served only with evidence of packaging impacts could be misled and make inaccurate decisions when discussing the measures included in the proposed EU Packaging and Packaging Waste Regulation (PPWR). This risks undermining the EU’s Green Deal ambitions.

The importance of the analysis

One of the primary objectives of the proposed PPWR is to ensure that “all packaging in the EU is reusable or recyclable in an economically viable way by 2030”, in line with the EU Green Deal and the EU Circular Economy Action Plan. Setting reusable packaging targets was always likely to spark a robust debate with the food industry. The European food system uses a large amount of packaging and the use of single-use packaging in particular has grown significantly in the past decades. For perishable liquid foods, producers today prefer recyclable single-use packaging — such as aseptic beverage cartons — for the sale of 75 percent of milk, 59 percent of juices and a major share of plant-based drinks in the EU[2].

We undertook a comprehensive and systematic analysis of all identifiable studies on single-use versus reusable packaging for perishable liquid foods.

With a specific focus on the 154 billion liters of perishable liquid foods produced in the EU each year[3], a more fundamental question occurred to the Packaging Logistics division in the Faculty of Engineering at Lund University. We wondered if a sufficient body of evidence existed to help policymakers make packaging reuse decisions, so we undertook a comprehensive and systematic analysis of all identifiable studies on single-use versus reusable packaging for perishable liquid foods.

The scale of the knowledge gap that we uncovered was eye-opening.

Findings from the study

Based on an analysis of 159 identified scientific papers, we came to three main conclusions.

First, the research and knowledge of food waste for single-use packaging compared to reusable packaging alternatives for perishable liquid foods was clearly insufficient. No studies were found that evaluated reusable packaging for such foods in relation to food waste, consequently no studies were found comparing single-use packaging with reusable packaging in this regard. A few studies were found that evaluated different single-use packaging alternatives in terms of the packaging and the liquid food being contained, finding that multilayer carton packages had the lowest environmental impact. Most environmentally-focused studies on food packaging did not consider the food saved or wasted.

The research and knowledge of food waste for single-use packaging compared to reusable packaging alternatives for perishable liquid foods was clearly insufficient.

Second, there were few studies comparing reusable and single-use packaging for perishable liquid foods in terms of food safety and quality. Instead, the majority of sampled papers simply provided insights and evidence for critical factors to be considered in food production and supply chain handling to keep liquid foods safe and of sufficient quality. This analysis surfaced several challenges related to reusable packaging, some related to food safety and others to quality limitations. For example, some studies pointed out quality-related challenges from plastic refillable bottles, such as the absorption of chemicals from previous use.

Finally, while there were many papers addressing shelf life as a critical aspect for perishable liquid foods — and many that empirically provided evidence of lower food waste in retail and at the consumer stage when shelf life is prolonged — there were still sizable knowledge gaps. No studies were found that compared the shelf life of single-use versus reusable packaging for perishable liquid foods. None were found that evaluated the shelf life of reusable packaging for such foods in relation to food waste, and none were found that clarified what optimal shelf life is for different products.

In our view, the key knowledge gaps at this time are: evidence of food waste impacts for reusable alternatives, so that a comparison with recyclable single-use packaging is possible; comparative studies on food safety and quality impacts through using single-use and reusable alternatives; shelf life comparisons; impact assessments that also take into account climate and land-use impacts; and, most importantly, food packaging studies that take into account the product that the packaging contains and protects. 

Key knowledge gaps need to be addressed

Policymakers should be insisting on accessing a more holistic knowledge base built on assessment of impact, before they finalize reusable packaging targets in the PPWR. 

The evidence we have today suggests that greater food safety, food security and food quality could be achieved by increasing the use of recyclable single-use packaging.

A more holistic perspective is crucial to help policymakers avoid measures that might miss higher environmental gains, compromise consumers’ health and wellbeing, and reconfigure the packaging industry. Further knowledge might indicate that reusable packaging for perishable liquid foods is feasible under specific circumstances. However, the evidence we have today suggests that greater food safety, food security and food quality could be achieved by increasing the use of recyclable single-use packaging. Support for that choice is already demonstrated today through the packaging chosen by the majority of European milk, juice and plant-based drink producers.

[1] Perishable foods are defined in EU legislation under Regulation (EU) No 1169/2011 as foods which, from a microbiological point of view, are highly perishable and are therefore likely after a short period to constitute an immediate danger to human health.

[2] AIJN, Liquid Fruit Market Report, 2018, p.7 https://aijn.eu/files/attachments/.598/2018_Liquid_Fruit_Market_Report.pdf

[3] Key figures on the European food chain, Eurostat, 2021



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High-quality recycling loops are best for circular economy

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On Europe’s journey to a circular economy, high quality recycling is essential. In fact, the recycling of fibre-based packaging constitutes one of the best examples. If you put your used paper products in the right recycling bin, you can count on them making their way to a facility that will recycle those materials so they can be used again many times to make packaging for breakfast cereal, boxes to carry your online deliveries, newspapers, and a whole host of other useful products.

Currently, about 75 percent of the raw materials used for the fibres in our packaging come from recycling. The rest comes from sustainably-managed forests. Our packaging helps keep fossil fuels in the ground, playing its part in making our planet greener. This is why fibre-based materials are widely recognized as one of the most sustainable choices available for packaging.

This is why fibre-based materials are widely recognized as one of the most sustainable choices available for packaging.

The EU’s packaging waste regulation: a key chance to enhance recycling systems

At Fibre Packaging Europe we believe the upcoming Packaging and Packaging Waste Regulation (PPWR) has a key role in making recycling even better. We now have a chance to set an ambitious 90 percent separate collection target for all EU member countries.  Here separate collection means transferring materials from your paper and board bin to the recycling plant. There is no better way to ensure that our packaging reaches recyclers after it has been used, and it will further increase an already-remarkable 81.5 percent recycling rate (Eurostat, 2020), higher by volume than plastic, metal and glass combined.

Where we see a risk in the PPWR is if the regulation gets the definition of ‘high-quality’ recycling twisted by restricting it only to what it calls ‘closed loops’. A closed loop means a cereal box would need to be recycled into another cereal box. When fibres are allowed to be recycled universally into any paper and board application and product, it is effective, it is resource efficient, and it reduces CO2 emissions through avoided transportation (to that cereal box factory). Most importantly, it is a good and simple way to continue increasing recycling rates.


Brought to you by Fibre Packaging Europe

Don’t get the loop twisted: why material loops make most sense for paper

But don’t just take it from us. We spoke to seasoned professionals in the recycling business that Fibre Packaging Europe represents to hear first-hand their thoughts on closed loops, the real challenges recyclers face and what can be done to overcome them.

Does closed-loop recycling have a role to play for fibre-based packaging? John Melia, strategy development and innovation director at DS Smith’s Recycling Division, is very clear on this point. “Closed-loop recycling of paper packaging would make no sense in a mature, well-functioning recycling system built on a thriving market for secondary raw materials. It would bring disruption to the market, reduce the quality and lifespan of fibre, and increase the use of fossil fuels in the supply chain. This would be a significant step back from the high-performing recycling system we have today.” 

Recycling systems based on ‘material loops’, on the other hand, mean that the raw materials we get from recycling processes are used in way that is far more versatile. They can be used to make a wide range of sustainable products that we use every day. The system works, and there is already in Europe a unique, thriving market for secondary raw materials in the fibre-based industry. In 2020, 56 million tons of ‘Paper for Recycling’ collected were transformed into equally high-quality new paper and board products.

If fibres get to the right recyclers, they have the tools to do the job

So how to make a high-quality recycling system even better? It all starts with collection.

“All fibre-based packaging is recyclable if, through collection and sorting, the material is guided to the right type of recycling mill”, explains Michel Willems, European Business Coordinator at Smurfit Kappa Recycling. ‘Separate’ collection systems, ones where non-paper materials such as plastic, metal and glass are collected separately from used paper products, can make it much easier to sort and send the material to the right recycling facilities. When it comes to fibre-based packaging products that are discarded by households, there’s an opportunity to further increase recycling rates.

So how to make a high-quality recycling system even better? It all starts with collection.

“As a general principle, the more homogenous a fibre-based waste stream is, the easier it is to find the correct mill to do the recycling. Nonetheless, the great advantage of fibre packaging recycling is that a homogenous waste stream is not an absolute necessity for the majority of paper-based products. Most can easily be collected in the same bin, for example, at home. Such a stream, following standard quality checks, is ready for immediate recycling at many mills throughout Europe”, said Michel.

“Our business is built around reducing the environmental impact of packaging on the planet, improving supply chains for billions of people. We have an excellent, high-performance recycling system for cardboard with the highest recycling rate of any packaging material in Europe. Corrugated board packaging occupies a very special place because it has been the most recycled product forever. We recycle a box a minimum of 25 times in its life. At the end, it just returns to nature. Our environmentally friendly product is 100 percent renewable, recyclable and biodegradable”, added Michel.

For John Melia, this point is far more important to a successful circular economy than looking at changing recycling systems. “The EU should be focusing on what we know will bring rates of paper recycling even higher: better recycling infrastructure including increased segregation of recycling raw materials through separate collection of municipal waste,” he says. “We in the industry are doing our part, but achieving the full potential of the fibre recycling system will only be possible through government policies that focus on what we know will make a difference.”

So, when we look to complete the loop on the circular economy, let’s listen to the recyclers themselves. Let’s build on the high-quality recycling that already exists to build a greener Europe with the packaging products we know are sustainable.



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Let your pantry work for you with these easy kitchen organization tweaks | CNN

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Sign up for CNN’s Eat, But Better: Mediterranean Style. Our eight-part guide shows you a delicious expert-backed eating lifestyle that will boost your health for life.



CNN
 — 

Home organization shows can be simultaneously uplifting and deflating with rows of matching containers on every shelf of the pantry and cabinets. Typically they’re in a gleaming white kitchen, no less.

Let’s leave the aesthetics aside for a moment, because I will be honest and tell you that I do not own a gorgeous kitchen. It is downright ugly in many respects, but it is functional. And function is the reason I’m making the argument that you should store your pantry ingredients in containers.

Even if you’re not using matched sets of brand-new modular storage or bins (and I’m not suggesting that you do), decanting ingredients from their bags and other packaging into containers is a smart move. Here’s why I do it and why I believe everyone should start containing their ingredients.

There’s no one-size-fits-all solution for pantry storage because every kitchen layout has its own specific challenges. However, a general rule of thumb is that containers are simpler to store in cupboards and on shelves than bags.

Instead of piling bags and digging through the stack to find what you’re looking for, containers are stackable and easily movable. One wrong grab can send a cascade of snack bags or granola bars crashing to the floor, but containers keep food in check.

Both glass and plastic are durable, though families with kids frequently prefer plastic containers because of the weight and breakability factor. As for round versus square containers, “round ones don’t maximize the space in between” as effectively as square or rectangular containers do, said Shara Kay, a Los Angeles-based certified professional organizer and owner of SK Organizing.

My pantry storage situation includes a mix of airtight plastic rectangular containers, glass mason jars, larger restaurant-style food storage bins and repurposed containers — all from various brands in various sizes. Some are ingredient-specific, such as those for my brown sugar and granulated sugar, and others are generic containers.

For those with deep pantry shelves, a hybrid solution — aka “containers for your containers” — might be necessary. Open-top or open-front pantry storage bins can help group similar items together and allow you to pull out one large container rather than a lot of small jars or canisters. This works well for keeping ingredients such as baking soda, baking powder, vanilla extract and other baking-related items together.

If your shelves are less than 12 inches deep, according to Kay, you may not want to double up on bins. But if you have a deeper reach-in pantry, “you probably do, because things will get lost in the back.”

In my pantry, I have a mix of purchased bins and repurposed open box-style containers, including a few old letter trays from my office that hold small mason jars of my granola, dried fruit and other breakfast snacks.

Clear containers can help people visualize what they have immediately, Kay said, making it easy to see if there’s enough penne in the pantry for tonight’s dinner or if it’s time to restock the black bean stash. If you always end up buying an extra box of pasta because you can’t remember what you have on hand, containers may help with overbuying.

Airtight containers also keep snacks and other loose items from losing their crunch too quickly. “If you’re taking a long time to consume things and they’re going stale,” Kay said, “that’s a good instance to decant.” Bag clips can’t maintain an airtight seal, but if you store your half-open bags of Cheez-Its in a sealable container, you’re winning the war.

Clear containers can help people keep track visually of what ingredients they have on hand.

However, you’ll still need to do routine pantry maintenance to make sure you’re not leaving foods in bins for too long. It’s smart to use the first-in, first-out rule with your ingredients, whether they’re in the pantry, fridge or freezer.

I personally don’t buy so much food that I won’t use it before it goes stale or past its expiration date, but if that’s an issue in your house, keep track with writable stickers on your containers and bins. And if you have a few handfuls of ingredients left, Kay said, “when you’re decanting, use up the stuff at the bottom before adding to the top.”

No one wants to believe they could get pests in their pantry, but it’s better to think about this situation before it happens. And as someone who lives in a century-old home, I’m here to give you the news firsthand: The pests will take the smallest opportunity to invade every single time.

Whether plastic or glass, sealed containers are the best line of defense against rodents and insects. Kay’s rule is “the more airtight, the better,” but I’ll go one further. Containers beat bags every time because I have yet to meet a mouse, ant or moth that can penetrate a rigid container. And I unfortunately can’t say the same for store packaging — even sealed cardboard boxes.

As convincing as my argument for containers may be, it doesn’t mean you have to buy out your local home goods store immediately. Start with the containers you have on hand, such as mason jars or plastic bins. Or if you need to buy a set of containers, “start with five and see how it goes,” Kay said. “If it’s working for you, then acquire more.”

Brand-new containers aren't necessary. Start with what you have, such as mason jars or plastic bins.

Similarly, “don’t go decanting every single snack in your pantry on the first go-round,” Kay added. She recommends starting with baking staples such as flour and sugar as well as other items that are usually scooped and measured incrementally rather than all at once. Rice or grains and dried beans are ideal candidates, as are nuts and dried fruit.

For those who still want to keep ingredients in their bagged packaging, you have two options. One is to store your open bags of snacks in larger sealable containers, as mentioned earlier, and the second is to stack your bags in open-top bins.

“My family won’t eat some food if it’s not in the original packaging because they’re drawn to the original packaging,” Kay admitted. As you start transitioning to the container method of pantry storage, you’ll find the right balance for your family as well.

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No silver bullet: Ensuring the right packaging solutions for Europe

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When most people think of McDonald’s they likely think of quality food, good value and consistently reliable convenient service. But I hope they also think about our values.

At McDonald’s, we care deeply about our impact on the world. Our purpose is to feed and foster local communities. We are always striving to use our influence and scale to make a positive impact on the planet and in the communities we serve across Europe and globally. We are on a journey to help implement and accelerate solutions to keep waste out of nature and valuable materials in use.

Our purpose is to feed and foster local communities.

During my trip to Europe, I’ve seen some of these solutions in action. While in Brussels I had the opportunity to visit one of our restaurants at the forefront of advancing our circularity goals. McDonald’s is the first major partner of a pioneering initiative ‘The Cup Collective’. It is a great project by Stora Enso and Huhtamaki to collect cardboard beverage and ice cream cups in and around our restaurants and recycle them on an industrial scale into paper fiber. At our busy  restaurant in Brussels-North station, I saw the initiative firsthand. This is a fantastic example of several stakeholders working together to solve a problem through their expertise and innovation.

I know policymakers across the EU are trying to solve many of the greatest challenges we face today, including Europe’s growing packaging waste problem, and we at McDonald’s fully support this, as the example above demonstrates. The problem is, history itself is littered with examples of the unintended consequences of well-meaning policies and laws. I believe the current Packaging and Packaging Waste proposal by the EU is one such regulation. By focusing solely on reusable packaging, we at McDonald’s and many of our partners and competitors in the informal dining out sector believe that Packaging and Packaging Waste Regulation (PPWR) will actually be counterproductive to the overall goals of the Green Deal. And we support the goals of the Green Deal, which is why this concerns us.

The informal eating-out sector is particularly complex and is not well understood. We feel the impact study the EU commissioned ahead of the PPWR proposal did not necessarily reflect that as much as it could have. We want such important decisions to be based on science, facts, and evidence, which is why we commissioned a report with the global management consultancy Kearney to assess environmental, economic, hygiene and affordability impacts of various packaging solutions. As a result of this, we firmly believe the proposal will be damaging not only for the environment, but also for the economy, food safety and for consumers.

Of course, the idea of reusing something over and over again as opposed to only once seems like the obvious solution — but it’s more complicated than that. For reuse models to have a positive impact on the environment, consumers need to return the reusables. A reusable cup needs to be returned and reused 50 to 100 times — whether for takeaway or dine-in — to make it environmentally preferable to a single-use paper cup.

Reusables by their very nature also need to be washed every time they’re used. For an industry like ours, serving millions of customers every day, that requires significant energy and water. Europe’s water infrastructure is already under stress, and the Kearney study shows reusable packaging requirements for dine-in restaurants would increase water use — and could require up to 4 billion liters of additional water each year. Washing also requires more energy resulting in increased greenhouse emissions. The study shows that a shift to 100 percent reusable packaging by 2030 would increase greenhouse emissions by up to 50 percent for dine-in and up to 260 percent for takeaway. They also require specialist washing to ensure they meet hygiene standards.

The study shows that a shift to 100 percent reusable packaging by 2030 would increase greenhouse emissions.

When it comes to plastics we are particularly concerned. McDonald’s has made huge progress when it comes to reducing plastic in our supply chain and restaurants. In the European Union, more than 90 percent of our packaging is locally sourced, primarily from European paper packaging suppliers. We are shifting packaging materials to more sustainable alternatives to ensure easier recovery and recycling. 92.8 percent (by weight) of McDonald’s food packaging in Europe is wood fiber and 99.4 percent of that fiber packaging comes from recycled or certified sources.

Worryingly though, the study we commissioned says that reuse models will lead to a sharp increase in plastic materials in Europe.Reuse targets proposed in the PPWR will create four times the amount of plastic packaging waste for dine-in, and 16 times for takeaway. That’s a lot more plastic instead of recyclable paper and cardboard and is the opposite of what the EU wants to achieve.

So, what should be done? Given that Kearney’s data shows recyclable, fiber-based packaging has the greater potential to benefit the environment, economy, food safety and consumers, we believe the EU should pause and conduct a full impact study before moving ahead. The European Commission’s current impact assessment lacks depth and does not consider economic and food safety aspects. Member countries should not unilaterally introduce legislation before this has been assessed to avoid fragmentation of the single market.

We believe the EU should pause and conduct a full impact study before moving ahead.

In dine in and takeaway, we are looking for equivalence of treatment between recycled and recyclable (paper based) single use packaging and reusable tableware. Any legislation should take into account the specific needs of complex business sectors, and the right packaging solutions.

A rush to a solution for a complicated situation will only make the problem worse. I hope that the report McDonald’s commissioned and launched with Kearney will stimulate the policy debate about the mix of solutions needed. Europe has a proud history of collaboration and pragmatism when it comes to solving important problems and challenges, and I am confident we can draw on that when it comes to this particular issue — because there really is no silver bullet when it comes to solving Europe’s packaging problem.

www.nosilverbullet.eu



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High levels of chemicals could pose long-term risks at Ohio train derailment site, researchers say | CNN

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CNN
 — 

An analysis of data from the US Environmental Protection Agency’s measurements of pollutants released from the Norfolk Southern train derailment in East Palestine, Ohio, suggests that nine of the dozens of chemicals that the EPA has been monitoring are higher than would normally be found in the area, according to a group of scientists from Texas A&M and Carnegie Mellon University.

If the levels of some of these chemicals remain high, it could be a problem for residents’ health in the long term, the scientists say. Temperature changes or high winds might stir up the chemicals and release them into the atmosphere.

The highest levels found in East Palestine were of a chemical called acrolein, the analysis says.

Acrolein is used to control plants, algae, rodents and microorganisms. It is a clear liquid at room temperature, and it is toxic. It can cause inflammation and irritation of the skin, respiratory tract and mucous membranes, according to the US Centers for Disease Control and Prevention.

“It’s not elevated to the point where it’s necessarily like an immediate ‘evacuate the building’ health concern,” said Dr. Albert Presto, an associate research professor of mechanical engineering at Carnegie Mellon’s Wilton E. Scott Institute for Energy Innovation, who is working on the university’s chemical monitoring effort in East Palestine. “But, you know, we don’t know necessarily what the long-term risk is or how long that concentration that causes that risk will persist.”

Much of what scientists know about chemical exposure comes from people’s contact with chemicals at work, Preston said, which generally means exposure for about eight hours a day. People now living in East Palestine are in constant contact with the chemicals, he said, and the impact of that kind of exposure on the human body is not fully understood.

The EPA and local government officials have repeatedly said that their tests show the air quality in the area is safe and that the chemicals should dissipate. As of Sunday, officials have tested air in 578 homes, and they say chemical pollution levels have not exceeded residential air quality standards.

EPA’s air monitoring data shows that levels of monitored chemicals “are below levels of concern for adverse health impacts from short-term exposures,” an agency spokesperson told CNN on Monday. “The long-term risks referenced by this analysis assume a lifetime of exposure, which is constant exposure over approximately 70 years. EPA does not anticipate levels of these chemicals will stay high for anywhere near that. We are committed to staying in East Palestine and will continue to monitor the air inside and outside of homes to ensure that these levels remain safe over time.”

However, residents have reported rashes and trouble breathing, sometimes even in their own homes, Presto said.

“When someone says to them then, ‘everything is fine everywhere,’ if I were that person, I wouldn’t believe that statement,” he said.

So who’s right? The scientists say it’s not a black-and-white issue.

“I think it’s important for the public to understand that all sides are right. No one’s lying to them,” said Dr. Ivan Rusyn, director of the Texas A&M University Superfund Research Center and part of the team that did the analysis. “It’s just that every time you’re sharing information, whether it’s Administrator of EPA Michael Regan or Governor [Mike] DeWine or someone from Ohio EPA, when they say certain things are ‘safe,’ they really need to explain what they mean.”

Rusyn says the EPA and local officials need to do a better job of communicating with the public about the risk to residents when they are exposed to chemicals released in the crash.

Communication struggles have been a consistent pattern over the years and over numerous environmental disasters, he said. Officials will often do a good job of collecting and releasing data but then fail to give the proper context that the public will understand.

“That’s what I would like to encourage all parties to do rather than to point fingers,” Rusyn said. “The general public has to trust authorities. Cleanup is continuing. They are doing monitoring. We just need to do a better job communicating the results.”

Government communication about residents’ real level of risk has been a significant source of frustration in East Palestine, Presto said.

“People are furious. They feel like they’re getting this black-and-white answer – things are safe or not safe – when it’s not a black-and-white sort of situation,” Presto said.

The EPA says it will continue to monitor the air quality in the area and in residents’ homes. It is also setting up a community center so residents and business owners can ask questions about agency activity there.

The agency said it is collecting outdoor air samples for contaminants of concern, including vinyl chloride, a hard plastic resin used to make plastic products like pipes or packaging material that can be a cancer concern; n-butyl acrylate a clear liquid used to make resins and paint products that can cause eye, throat, nose and lung irritation or damage as well as a skin allergy; and ethylhexyl acrylate, another colorless liquid used to make paints, plastics and adhesives that can cause skin and eye irritation.

The EPA also collected field measurements for hydrogen sulfide, benzene, hydrogen cyanide, hydrogen chloride, phosgene and particulate matter.

Scientists from Texas A&M and Carnegie Mellon are monitoring the chemicals in the area using a mobile lab that they’ve used for the past decade to measure air pollution in real time in cities across the country. They expect to release data from their own tests in East Palestine on Tuesday.

The mobile lab has extremely sensitive equipment that can measure pollution in the parts per trillion. Scientists would then be able to plot them on a graph to show, in real time, where the concentrations of chemicals may be and at what level, Presto said.

Mobile lab workers will try to determine whether there are chemicals in the air that the EPA isn’t monitoring. They are also looking at pollution levels in places where the agency did not set up monitoring stations.

“The situation has to be monitored, and the EPA should continue measurements, and they should also communicate to the general public as to what they’re seeing and put this into context of risk, rather than use the numbers and expect people to figure it out for themselves,” Rusyn said.

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Beware the budget butt lift, regulators warn amid social media-inspired boom | CNN

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In hindsight, Nikki Ruston said, she should have recognized the red flags.

The office in Miami where she scheduled what’s known as a Brazilian butt lift had closed and transferred her records to a different facility, she said. The price she was quoted – and paid upfront – increased the day of the procedure, and she said she did not meet her surgeon until she was about to be placed under general anesthesia.

“I was ready to walk out,” said Ruston, 44, of Lake Alfred in Central Florida. “But I had paid everything.”

A few days after the July procedure, Ruston was hospitalized due to infection, blood loss, and nausea, her medical records show.

“I went cheap. That’s what I did,” Ruston recalled recently. “I looked for the lowest price, and I found him on Instagram.”

People like Ruston are commonly lured to office-based surgery centers in South Florida through social media marketing that makes Brazilian butt lifts and other cosmetic surgery look deceptively painless, safe, and affordable, say researchers, patient advocates, and surgeon groups.

Unlike ambulatory surgery centers and hospitals, where a patient might stay overnight for observation after treatment, office-based surgery centers offer procedures that don’t typically require an inpatient stay and are regulated as an extension of a doctor’s private practice.

But such surgical offices are often owned by corporations that can offer discount prices by contracting with surgeons who are incentivized to work on as many patients per day as possible, in as little time as possible, according to state regulators and physicians critical of the facilities.

Ruston said she now lives with constant pain, but for other patients a Brazilian butt lift cost them their lives. After a rash of deaths, and in the absence of national standards, Florida regulators were the first in the nation to enact rules in 2019 meant to make the procedures safer. More than three years later, data shows deaths still occur.

Patient advocates and some surgeons – including those who perform the procedure themselves – anticipate the problem will only get worse. Emergency restrictions imposed by the state’s medical board in June expired in September, and the corporate business model popularized in Miami is spreading to other cities.

“We’re seeing entities that have a strong footprint in low-cost, high-volume cosmetic surgery, based in South Florida, manifesting in other parts of the country,” said Dr. Bob Basu, a vice president of the American Society of Plastic Surgeons and a practicing physician in Houston.

During a Brazilian butt lift, fat is taken via liposuction from other areas of the body – such as the torso, back, or thighs – and injected into the buttocks. More than 61,000 buttock augmentation procedures, both butt lifts and implants, were performed nationwide in 2021, a 37% increase from the previous year, according to data from the Aesthetic Society, a trade group of plastic surgeons.

As with all surgery, complications can occur. Miami-Dade County’s medical examiner has documented nearly three dozen cosmetic surgery patient deaths since 2009, of which 26 resulted from a Brazilian butt lift. In each case, the person died from a pulmonary fat embolism, when fat entered the bloodstream through veins in the gluteal muscles and stopped blood from flowing to the lungs.

No national reporting system nor insurance code tracks outcomes and patient demographics for a Brazilian butt lift. About 3% of surgeons worldwide had a patient die as a result of the procedure, according to a 2017 report from an Aesthetic Surgery Education and Research Foundation task force.

Medical experts said the problem is driven, in part, by having medical professionals like physician assistants and nurse practitioners perform key parts of the butt lift instead of doctors. It’s also driven by a business model that is motivated by profit, not safety, and incentivizes surgeons to exceed the number of surgeries outlined in their contracts.

In May, after a fifth patient in as many months died of complications in Miami-Dade County, Dr. Kevin Cairns proposed the state’s emergency rule to limit the number of butt lifts a surgeon could perform each day.

“I was getting sick of reading about women dying and seeing cases come before the board,” said Cairns, a physician and former member of the Florida Board of Medicine.

Some doctors performed as many as seven, according to disciplinary cases against surgeons prosecuted by the Florida Department of Health. The emergency rule limited them to no more than three, and required the use of an ultrasound to help surgeons lower the risk of a pulmonary fat clot.

But a group of physicians who perform Brazilian butt lifts in South Florida clapped back and formed Surgeons for Safety. They argued the new requirements would make the situation worse. Qualified doctors would have to do fewer procedures, they said, thus driving patients to dangerous medical professionals who don’t follow rules.

The group has since donated more than $350,000 to the state’s Republican Party, Republican candidates, and Republican political action committees, according to campaign contribution data from the Florida Department of State.

Surgeons for Safety declined KHN’s repeated interview requests. Although the group’s president, Dr. Constantino Mendieta, wrote in an August editorial that he agreed not all surgeons have followed the standard of care, he called the limits put on surgeons “arbitrary.” The rule sets “a historic precedent of controlling surgeons,” he said during a meeting with Florida’s medical board.

In January, Florida state Sen. Ileana Garcia, a Republican, filed a draft bill with the state legislature that proposes no limit on the number of Brazilian butt lifts a surgeon can perform in a day. Instead, it requires office surgery centers where the procedures are performed to staff one physician per patient and prohibits surgeons from working on more than one person at a time.

The bill would also allow surgeons to delegate some parts of the procedure to other clinicians under their direct supervision, and the surgeon must use an ultrasound.

Florida’s legislature convenes on March 7.

Consumers considering cosmetic procedures are urged to be cautious. Like Ruston, many people base their expectations on before-and-after photos and marketing videos posted on social media platforms such as Facebook, Snapchat, and Instagram.

“That’s very dangerous,” said Basu, of the American Society of Plastic Surgeons. “They’re excited about a low price and they forget about doing their homework,” he said.

The average price of a buttocks augmentation in 2021 was $4,000, according to data from the Aesthetic Society. But that’s only for the physician’s fee and does not cover anesthesia, operating room fees, prescriptions, or other expenses. A “safe” Brazilian butt lift, performed in an accredited facility and with proper aftercare, costs between $12,000 and $18,000, according to a recent article on the American Society of Plastic Surgeons’ website.

Although Florida requires a physician’s license to perform liposuction on patients who are under general anesthesia, it’s common in the medical field for midlevel medical practitioners, such as physician assistants and nurse practitioners, to do the procedure in office settings, according to Dr. Mark Mofid, who co-authored the 2017 Aesthetic Surgery Education and Research Foundation task force study.

By relying on staffers who don’t have the same specialty training and get paid less, office-based surgeons can complete more butt lifts per day and charge a lower price.

“They’re doing all of them simultaneously in three or four different rooms, and it’s being staffed by one surgeon,” said Mofid, a plastic surgeon in San Diego, who added that he does not perform more than one Brazilian butt lift in a day. “The surgeon isn’t doing the actual case. It’s assistants.”

Basu said patients should ask whether their doctor holds privileges to perform the same procedure at a hospital or ambulatory surgery center, which have stricter rules than office surgery centers in terms of who can perform butt lifts and how they should be done.

People in search of bargains are reminded that cosmetic surgery can have other serious risks beyond the deadly fat clots, such as infection and organ puncture, plus problems with the kidneys, heart, and lungs.

Ruston’s surgery was performed by a board-certified plastic surgeon she said she found on Instagram. She was originally quoted $4,995, which she said she paid in full before surgery. But when she arrived in Miami, she said, the clinic tacked on fees for liposuction and for post-surgical garments and devices.

“I ended up having to pay, like, $8,000,” Ruston said. A few days after Ruston returned home to Lake Alfred, she said, she started to feel dizzy and weak and called 911.

Paramedics took her to an emergency room, where doctors diagnosed her with anemia due to blood loss, and blood and abdominal infections, her medical records show.

“If I could go back in time,” she said, “I wouldn’t have had it done.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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