From the outside, Cologuard® test kit shipping boxes look like easily recyclable cardboard. 
Inside, though, lies a thoughtful design that helps the test kit make a safe trip to the patient’s home and then, once completed, arrive intact at the Exact Sciences lab. A plastic tray holds the sample container and tube securely in place. And a robust bag insert and absorbent pad help guard the box against any leaks. 
The box design is effective. It also makes recycling an enormous challenge, as each box has to be disassembled and separated to recycle the different material types. Most recycling partners take plastic or cardboard. Few places want both, says Travis Stiff, an Exact Sciences facilities engineer. 
Today, Exact Sciences processes millions of Cologuard tests each year. So the company needed to find a workable solution for the box waste. 
Teams had already created recycling programs for the plastic whole stool containers — those are the kits’ white lidded buckets — and the pipettes used for testing specimens in the lab. Those are shredded and sterilized, then sent for recycling. This new challenge built on the success of those programs, Stiff says. 

Studying the environmental effect 

When it comes to managing large-scale waste, it’s rarely as easy as simply choosing a trash basket or recycling bin. A single type of waste can generate so many questions for facilities managers: How do you store the waste once it’s created and before it’s disposed of? Do you have enough space to store it safely? How might that storage affect your other operations?  
Then: Who will transport the waste? How? To where? Can that happen in a timely manner, and is it affordable?  
Also: Recycling always feels like a preferred option, but does data support that? Might you unintentionally create more waste or a negative environmental effect by choosing a multistep recycling process over simply sending items to the landfill? 
Stiff conducted an emissions study that examined the impact of different options. The study considered factors such as emissions created by transporting waste and by what happened at its final destination. 
The best option proved to be converting kits boxes into fuel pellets. In early 2024, an industrial baler was installed in Madison, Wis., where all Cologuard kits are processed. Now, the full box, including the plastic insert, is compacted, baled with others, and sent to a fuel pellet manufacturer. That company then distributes pellets as an alternative energy source to fossil fuels, Stiff says. 
As a result, “we expect a reduction of 4 million to 5 million pounds of carbon dioxide emissions each year,” he says. “With this process, we are generating fewer emissions than before and also preventing emissions from being generated.” 
A great accomplishment for Exact Sciences’ real estate and facilities teams feels especially sweet to Stiff, who started down the sustainability path with a ninth-grade research paper on renewable energy and alternative fuel sources.  
He’s excited to see the facilities engineering team serving on the committee that is exploring how to redesign future test kit boxes to maximize their sustainability.  
“This waste-to-energy project is a stepping stone toward a fully recyclable kit box one day,” Stiff says. 

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