ABSTRACTObjectivesUse of Personal Protective Equipment (PPE) has been central to controlling spread of SARS-CoV2. This study aims to quantify the environmental impact of this, and to model strategies for its reduction.MethodsLife cycle assessment was used to determine environmental impacts of PPE supplied to health and social care in England during the first six months of the COVID-19 pandemic. The base scenario assumed all products were single-use, air freighted, and disposed via clinical waste. Scenario modelling was used to determine the effect of 1) switching mode of, or eliminating, international travel during supply, 2) reducing glove use 3) using reusable alternatives, 4) maximal recycling.ResultsThe carbon footprint of PPE supplied during the study period totalled 158,838 tonnes CO2e, with greatest contributions from gloves, aprons, face shields, and Type IIR surgical masks. The estimated damage to human health was 314 DALYs (disability adjusted life years), impact on ecosystems was 0.67 species.year (loss of local species per year), and impact on resource depletion costing US $ 20.4 million.Scenario modelling indicated one-third of the carbon footprint could be avoided through switching to shipping, and by 41% through manufacturing PPE in the UK. The carbon footprint was reduced by 83% compared with the base scenario through a combination of UK manufacturing, reducing glove use, using reusable gowns and reuse of face shields, and maximal recycling, estimated to save 259 DALYS, 0.54 species.year, and US $ 15 million due to resource depletion.ConclusionsThe environmental impact of PPE could be reduced through shipping supplies or domestic manufacture, rationalising glove use, using reusables where possible, and optimising waste management.SUMMARY BOXWhat is already known on this topicThe current COVID-19 pandemic has seen a massive global increase in the use and manufacture of PPE which has contributed, with other measures, to the reduction in transmission of the virus in many countries.What this study addsThe carbon footprint of PPE supplied to health and social care in England in the first six months of the COVD-19 pandemic was 158,848 tonnes CO2e, equivalent to around 65,500 return flights from London to New York.The environmental impact of PPE could be reduced through shipping supplies or domestic manufacture, rationalising glove use, using reusables where possible, and optimising waste processing.