Assessment of usage, reuse and disposal of thermoplastic masks among radiotherapy technologists in India: A nationwide perspective

•The study addresses a literature gap on the utilization, reuse and disposal of thermoplastic masks.•Thermoplastic masks are often reused in curative treatments, government-run and busy centres.•The preferred way of disposal of used thermoplastic masks is through biomedical waste management.•Radiotherapy technologists are conscious for environmental effects of thermoplastic mask disposal. Radiotherapy (RT) relies on devices like thermoplastic masks (TMs), that are made up of specialized thermoplastic polymers, and used as an immobilization tool. The study aims to assess the practice of usage and reuse of TMs among radiation therapy technologists (RTTs) in India and explore their awareness of environmental impact during disposal. A cross-sectional survey was conducted among RTTs working in different healthcare settings. A structured questionnaire designed by a team of RTTs and radiation oncologists was used to collect responses. Questionnaire encompassed data pertaining to demographics, existing patient load, daily utilisation and reuse practice of TMs, preferred method of disposal and awareness of RTTs regarding environmental consequences associated with TM disposal. A total of 430 RTTs participated in the study, with a median age of 31 years and a median professional experience of 8 years. Among the participants, 213 (49.6 %) reported daily TM utilization in more than 50 patients. TM reuse was reported by 350 (81.1 %) RTTs, with 257 (60 %) reusing TMs in both curative and palliative treatments. Reuse of TMs was observed more commonly in RTTs working in government facilities (81.2 %). Regarding disposal preferences, 381 (88.6%) participants preferred discarding used TMs in biomedical waste and 64.8% of these ultimately ended up as discarded scrap. Awareness regarding adverse environmental impact associated with TM disposal was reported by 320 (74.4%) participant RTTs. The study highlights the prevalent practice of reuse of TMs, especially in curative treatments, government-run facilities and busy treatment settings. Additionally, it emphasises the imperative for enhanced bio-medical waste management practices to facilitate more effective handling and disposal of used TMs.