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
    -1

    Comment number 53.

    26 Rebecca
    Thanks for the response but it was the bits of living people e.g. amputated limbs, & their disposal.
    Is it just clinical waste or are they properly respectfully cremated?

    A bit like the question of what do dentists do with all the extracted teeth.

  • rate this
    -18

    Comment number 52.

    This type of recyling is not new, like a great many other immoral things we learned from the NAZI'S this practice is so wrong! Question, are these things offered to the deceased relatives? If anything any profit derived should be given to the NHS, period!

  • rate this
    +1

    Comment number 51.

    I had an operation to correct scoliosis and have several titanium bolts in my back and, until they broke, two titanium rods. One surgeon "joked" that I would have to have a special urn if was cremated, because the titanium was designed to withstand much higher heat than the bog-standard crematorium would burn at! Just one in a few examples of orthopaedic surgeons bedside manners...

  • rate this
    +1

    Comment number 50.

    When I worked on a Thames River Boat I saw Hindu's 'doing the Ashes' every day..that is scattering the ashes of a deceased relative into a river. Never once did I hear the plop of something metal making a splash, now I know where these things go!

  • rate this
    -3

    Comment number 49.

    I am not sure that black humour is appropriate here? You wait til it's your turn. You will hear singing when the appointed time comes! Your hour glass run out of trickling sand, the sickle swings. Read Terry Pratchet, Deaths Apprentice.

  • rate this
    -5

    Comment number 48.

    37.Proletarian Revolutionary. Check your history sunshine. Hair used to caulk torpedoes, Teeth pulled out of corpses for the gold fillings and anything else that could be used usefully. That is recycling is it not?

  • rate this
    +4

    Comment number 47.

    I think this is a good idea. It's not money grabbing, it's ethical and it's good to recycle these parts if they are not being used. If the crematoriums are telling the families about the process, there shouldn't be a problem. If the family doesn't want it to happen, they should say (or maybe have something on the donor cards to include these implants)...

    @Simon (43) - I completely agree with you!

  • rate this
    0

    Comment number 46.

    Interesting article. I feel there is something more fulfilling about being buried and knowing that creatures will benefit from the nutrients from your body; it feels like I am giving something back to the earth, that I am part of the cycle of life that exists on this planet. Being burnt only produces dust, its too final and abrupt, it doesnt seem to benefit anyone or anything.

  • rate this
    +3

    Comment number 45.

    #40 is correct. The amount of energy used in a cremation? You're probably looking at around 150-200MJ as standard, or around a gallon of diesel equivalent. But the energy it takes to make aluminium from scratch? 220MJ/kg. And to recycle it? About 5% of the energy it took to make it in the first place. The numbers for titanium are even larger. So recycling left over bits? Environmentally spot on.

  • rate this
    -1

    Comment number 44.

    thedaver64

    Yes cremation is available in Wales and does go on in urban areas such as Swansea. But out in the country places it is not tradition to cremate. Family burial alongside each other is what happens. Placing flowers at Easter. Loads of space in my village cemetery and its next to Church where I attend when back in Wales to see parents. I am already booked in and so are parents.

  • rate this
    +8

    Comment number 43.

    Israel Dalven, you are so far off the mark. I have lost many friends and family. All were cremated and I certainly have not forgotten about them just because there isn't a grave in a gloomy churchyard. In fact I believe I think about them more because I relate to happier moments in life rather than standing by a bit of stone. Burial is wasteful.

  • rate this
    -4

    Comment number 42.

    I would have thought it would be simple in your will to specify what you want to happen to your non-biological body parts including bequething them on to relatives. In the absence of a specific clause in the will , they should be returned with the ashes or buried with them
    A touch macbre though for relatives to polish them up and put them on the mantle piece.

  • rate this
    0

    Comment number 41.

    Good alternative business plan in this hard times, why did i not think of this!!. Just hope metal scarvengers dont go digging up graves for the bling

  • rate this
    +5

    Comment number 40.

    I doubt very much that this company were 'the first to recycle implants'. I know for a fact that my local crematorium was sending these off for recycling in 1996, because that's the year I inspected it for stack emissions whilst working for the local council. An entirely sensible practice, the recycling of scarce metals. Offsets the impacts of cremation to a considerable degree.

  • rate this
    -1

    Comment number 39.

    Have you seen "Soylent Green"?

  • rate this
    -1

    Comment number 38.

    If you enjoyed this article, here is the link to a BBC article, on (possibly) the next stage in disposal and metal recovery, you may have missed.

    http://www.bbc.co.uk/news/science-environment-14114555

  • Comment number 37.

    All this user's posts have been removed.Why?

  • rate this
    +1

    Comment number 36.

    " "They're some people walking around with hardly anything they started out with"

    Hancock's joke is in fact true. Very little of our early body has not been replaced during the course of our lives.

  • rate this
    +2

    Comment number 35.

    As Tony Hancock commented in the Blood donor, "They're some people walking around with hardly anything they started out with". Seems this is now so in death. I've not got metal implants apart from in my teeth, but I'm quite happy for my "parts" to be distributed. They don't come with any guarantee. More an eBay opportunity.

    It is quite appropriate this all started by a Dutchman. No hangups there!

  • rate this
    -17

    Comment number 34.

    This is a sad comment to the secular modernist culture.
    "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."Could it be that this is part of the reason for the population among Liberal secularist? Why have children who will forget you as soon as the the inheritance money clears the bank?

 

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