Melting down hips and knees: The afterlife of implants

 
Surgical implants

As people live longer and medical technology improves, more and more of us will have a surgical implant before we die. We are also getting cremated in larger numbers - and so there is often some expensive metal left among the ashes. Where does it go?

"You tell people what you do, and they think... well, that's a bit strange," says Ruud Verberne above the din of giant sorting machines twirling and clanking.

Verberne is co-founder of OrthoMetals, which recycles metal implants from cremated human bodies. That's everything from steel pins to titanium hips and cobalt-chrome knees.

These are the knees that we have to recover," he says. "Some metals can be sorted by magnets. And the remaining have to be sorted by hand."

Strange it may be, and a bit macabre perhaps, but this kind of recycling is a growth industry.

"I know the existence of five or six competitors that we have, most of them in the United States," says Verberne, whose company is based in the Dutch city of Zwolle. "But we were first."

The rise of cremation

Country 1995 2010

Japan

98%

99%

UK

68%

73%

Australia

53%

69%

Canada

40%

58%

Netherlands

46%

57%

China

33%

49%

USA

21%

40%

France

11%

30%

Italy

2%

13%

Ireland

3%

11%

Ghana

1%

4%

Source: Pharos International, Cremation Society of Great Britain

Verberne had a long career in aluminium recycling. Then, in 1987, he met Jan Gabriels, an orthopaedic surgeon, who asked him what happened to the metal implants he spent his working life attaching to patients.

Verberne had no idea, so he did some research and he found out that they were thrown away. "They were basically buried," he says.

The value of implants collected from a crematorium is only a fraction of their value before surgery, but they are made from good quality metal that is worth recycling.

"The operation to provide a new hip may cost you around £5,000 ($8,000. 6,000 euros)," he explains.

"But the return value as scrap is maybe, per kilo, around £10 ($16, 12 euros). And there are five hips per kilo!"

In 1997, Gabriels and Verberne founded OrthoMetals. Fifteen years later the company recycles more than 250 tons of metal from cremations annually, which gets used to make things like cars, planes, and even wind turbines.

The company works by collecting the metal implants for nothing, sorting them and then selling them - taking care to see that they are melted down, rather than reused.

After deducting costs, 70-75% of the proceeds are returned to the crematoria, for spending on charitable projects.

"In the UK for example," he says. "We ask for letters from charities that have received money from the organisation we work with in the UK and we see that the amount we transferred to them has been given to charity. This is a kind of controlling system that we have."

surgical implants being sorted

Henry Keizer oversees a charitable memorial fund named after the first Dutch person ever cremated - a Dr Vaillant - back in 1913.

He says the fund has helped Dutch crematoria distribute money received from OrthoMetals to support everything from cancer research to school libraries.

The ethical argument

Does recovering metal from cremated corpses contravene that most important of ethical principles - respect for human life?

It depends partly on the purpose of the intervention on the corpse. Medical students dissecting a corpse in order to learn anatomy, done respectfully, is ethical. Using a corpse in a display as a form of entertainment is not.

To be acceptable, I believe the prior consent of the dead person or of the surviving spouse or next-of-kin is required.

The fact that what is recovered is a prosthesis and not "human remains" is also relevant. It makes the process more likely to be seen as ethical, as does giving some of the profits to charity.

Margaret Somerville, Centre for Medicine, Ethics and Law, McGill University, Montreal

"I think the recycling of implants, and artificial joints, is an excellent idea," he says. "Now we get to use them for good purposes, for funds for people that do social things that are extremely important."

Michael Donohue, director of the Donohue Funeral Home in the US state of Pennsylvania, found OrthoMetals through a Google search, when the home recently built its own cremation facility.

"Before we actually started to get up and operating, our biggest thing was - what are we going to do with the metal remains that are left at the end of the process?" says Donohue.

Now, recovered surgical implants go back to Holland for recycling.

Donohue says his staff are candid with loved ones about this. "We are honest with them, and tell them that whatever money is given to us goes to local organisations, and they love knowing that something from their loved one is being used in a great capacity."

Relatively few people are cremated in the US by international standards - the figure currently stands at 40%, though the trend is upwards and there are some big geographical variations.

Start Quote

In earlier days the family would visit a grave to see dad or mum - nowadays they want no obligations”

End Quote Ruud Verberne

Recent figures show Hawaii and Nevada up near 70%, but Mississippi at less than 10%. That could be a mark of socio-economic status, says Verberne. Statistics tend to show poorer people prefer in-ground burials.

In Verberne's native Holland, some 57% of all bodies are cremated. Britain is the biggest cremator in Europe with 73%. And since the Catholic church eased its opposition to cremation, the company has seen growth in places such as Italy and Spain. In all, it operates in 15 countries.

He has some thoughts on why cremation rates are increasing in many parts of the world.

"Two reasons are space and cost," he says. A traditional burial can cost four times as much as cremation. And regarding space, one survey showed 750 burials taking up an acre of ground.

Verberne also identifies some cultural changes. "In earlier days the family would visit a grave to see dad or mum," he says. "Nowadays they scatter the ashes and they are free. They want no obligations."

Mr Verberne has no metal implants himself, but he points out his business partner's wife, who is helping sort out bits of metal at the recycling plant.

"She has two titanium hips", he says. "And she was once asked: "Isn't it strange that you know that one day your hips will run along this conveyor belt?'"

"She said, 'No, it's just a part of life. You're going to die, and I know that reusing metals is a very good thing, so it is no problem at all.'"

She added "'My mother's hip was on here too!'"

Listen to more on this story at PRI's The World, a co-production of the BBC World Service, Public Radio International, and WGBH in Boston.

 

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  • rate this
    +9

    Comment number 33.

    Does recovering metal from cremated corpses contravene respect for human life?
    Surely, we're talking about dead people, aren't we? Surely these metals are being recovered after cremation, aren't they? So human life is over - left are memories, ashes - & (on resale), not-so-valuable-metallic parts.
    I can't even see a reason for consent.

  • rate this
    -35

    Comment number 32.

    What next I wonder, removing these items from a body prior to burial ? I am surprised so many people agree with this sort of grave robbing. It is no better than what the nazis did with the people they murdered. Our local crematorium collects all the bits and buries them in the grounds on the basis of they were part of the person in life

  • rate this
    +4

    Comment number 31.

    21.Rebecca Riot Cremation is available to anyone who wants it in the UK, surely?

  • rate this
    +17

    Comment number 30.

    With the spectra of vast open cast mines, destroying hectares of hither too untouched countryside, now spreading malignantly across the globe, surely we must concentrate our efforts into salvaging as many metals, precious or otherwise, as possible. Death, after all, is the most complete form of recycling we know.

  • rate this
    +3

    Comment number 29.

    Maybe the metallic remains could be offered to the relatives to be smelted down and fashioned into some form of trinket?

    That would be ok unless you had not got on so well with your close relatives in later life. Your metallic parts could end up being fashioned into some everlasting metal dog poo and placed on the mantelpiece.

    "There he is. Told him I'd get even some day".

  • rate this
    +6

    Comment number 28.

    @22. papyrus

    I don't think that would work. If the part goes through the cremation process, it's effectively receiving a heat treatment. This could bring down it's tensile strength and hardness, meaning it could fail while in service.

  • rate this
    0

    Comment number 27.

    This is almost getting to be like in that sci fi film 'Dune' where water was so scarce that when someone died, they took the water out of the dead body too. Perhaps the next step will be like in another sci fi film 'Soylent Green' where dead bodies were taken to the local rubbish, er recycling plant and their bodies turned into food crackers! Is this a shortages trend?

  • rate this
    -2

    Comment number 26.

    Sproutaholic

    Yes you can ask for the ashes back and most folk do. Did you not read about the elderly lady who carried her husbands ashes around in her handbag. Lots of people do that. Some folk put the ashes into a pot and place it on the mantelpiece to remind them of their loved one.

  • rate this
    +8

    Comment number 25.

    I work in an Alloy foundry, supply the makers of new Cobalt-Chrome implants, we have used, in the past the recycled parts back into new metal, melted and refined of course! Industry practice to "revert" scrap or ex-service parts be they aerospace or medical!!

  • rate this
    +5

    Comment number 24.

    I think a slightly more "fun" alternative would be to melt and shape the artificial bodypart into a plaque for the grave marker, or even into a stylish metallic urn.

  • rate this
    +2

    Comment number 23.

    I see no problem with this; it's not as you were born with a titanium joint or spectacles or hearing aid.

    Out of curiosity, what happens to removed joints / amputated limbs ? Are they cremated and can you ask for the ashes back - not that I would want to.

  • rate this
    -3

    Comment number 22.

    Why not re-use them instead of recycling? Unless they got damaged by the heat, with a bit of polishing they should be good to go! I'd be OK with a second-hand (or leg) piece...

  • rate this
    -3

    Comment number 21.

    No cremations where I come from in Mid Wales. Everyone gets buried in local churchyard, so ironmongery will get buried with them. It is illegal to dig up bodies so there it will remain.

    Generations buried with large black tombstones marking the spot, inscribed in Welsh and English, sometimes with a poem or brief account of persons achievments. It is all very reassuring, & I have booked my plot

  • rate this
    +1

    Comment number 20.

    If your dear old granny pops off, do you now call the doctor, the undertaker, or the local scrappie? There are now as many hazards due to replacement parts at cremation time as there are opportunities for recycling. Mercury vapour from tooth fillings, pacemaker batteries etc. Hopefully there won't be any yobs nicking little old ladies in the dead of night.

  • rate this
    -9

    Comment number 19.

    forget the steal from the hips etc you should be talking about the gold silver etc etc at the end of the day the ovens get cleaned and so do the dead//////// from their valuables. theirs a saying from a song //// the world is full of kings and queens who blind your eyes and steal your dreams.....

  • rate this
    0

    Comment number 18.

    Good idea. Shame there's no easy way to remove tooth filling mercury before cremation. I believe it mostly vapourises during the process. But I think I've heard about mercury capture systems. If I didn't just imagine that, I think the govenment should mandate it for all crematoriums as a matter of urgency.

  • rate this
    +3

    Comment number 17.

    "The government received more money than it spent in January leaving it with its highest monthly surplus in four years."

    Could we open up a HYS on this? It seems the gov., plans are working!

  • rate this
    -17

    Comment number 16.

    If we're going for recycling efficiencies, why not cut ot the middleman and recycle everyone who needs any surgical procedures of this nature in the first place? Save operating theatre and surgeon time and all the power and energy needed to mine and work the metal. I'm sure if we ground down inadequate humans the composite minerals and chemicals should be worth a coule of quid. Give it to charity.

  • rate this
    +21

    Comment number 15.

    Just because Lelboy and Lemog found this article to be a waste of their precious time I - and it appears several others - found it very interesting & informative. I had a complete knee replcement last year & am delighted to learn that it is likely to be recycled & put to good use. Just keep your moans to yourselves.

  • rate this
    +22

    Comment number 14.

    @ 13. lelboy There is nothing wrong with the software. There is more than one person rating comments. If you give a comment a positive rating and at the same time, two people rate it down, the overall rating will go down. This has been explained several times, to people who don't seem to be able to get it.

    On point, this is a very interesting article on a topic I'd never previously considered.

 

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