Proceedings of the International Symposium on

Sustainable Systems and Technologies, v4 (2016)

END OF LIFE CONSIDERATIONS FOR NONINVASIVE CARBON NANOTUBE ENABLED
GLUCOSE BIOSENSORS
Salman Abbasi Northeastern University, abbasi.s@husky.neu.edu
Hobin Jeong Northeastern University, hobin.jeong84@gmail.com
Adnan Korkmaz Northeastern University, korkmaz.a@husky.neu.edu
Cihan Yilmaz Northeastern University, cihan@coe.neu.edu
Ahmed Busnaina Northeastern University, busnaina@coe.neu.edu
Jacqueline Isaacs Northeastern University, j.isaacs@neu.edu
Abstract. This paper investigates the possible end of life impacts associated with carbon
nanotube (CNT) enabled consumer products with widespread applicability from policy and
regulatory perspectives. As a test case, a CNT enabled glucose sensor meant for diabetes
patients was chosen. Relatively low cost, convenience and wide applicability promises rapid
commercialization of CNT enabled sensors. However, this gives rise to a potentially serious
issue. There are concerns surrounding the use of CNTs in everyday household or medical
applications which warrants a review of waste management practices. Hence, the potential
release of CNTs from sensor devices that could occur in several countries is explored to
compare differences in regulations and general waste management practices.

Proceedings of the International Symposium on Sustainable Systems and Technologies (ISSN 2329-9169) is
published annually by the Sustainable Conoscente Network. Jun-Ki Choi and Annick Anctil, co-editors 2016.
ISSSTNetwork@gmail.com.
Copyright 2016 by Salman Abbasi, Hobin Jeong, Adnan Korkmaz, Cihan Yilmaz, Ahmed Busnaina, Jacqueline
Isaacs Licensed under CC-BY 3.0.

End of life considerations for noninvasive carbon nanotube enabled biosensors

Introduction. Carbon nanotubes (CNTs) are carbon based nanomaterials, mostly cylindrical,
with diameters typically less than 100 nm. A simple way of understanding their structure is to
imagine them as rolled sheets of graphene. There are two major types of CNTs, single walled
(SWCNTs) and multi walled (MWCNTs). SWCNTs usually have diameters between 0.7 to 2.5
nm, and are between 100 to 500 nm in length. MWCNTs have diameters in tens of nanometers
with lengths ranging between 500 nm to half a micron.
CNTs have several attractive properties that make them useful including for medical and health
based applications. They can be functionalized and used for noninvasive measurement of
biomarkers, such as blood glucose level in humans [1]. As these sensors, along with countless
other consumer products, near commercialization, the implications of their widespread use must
be carefully examined. This is because manufacturing, use and disposal of these products can
possibly lead to undesirable/harmful release of nanomaterials.
Due to the increased awareness about the potential risk of nanomaterials, the manufacturing
processes are stringently controlled to limit worker exposure to minimize the associated risk.
Also, most nano-based consumer products are designed so that the nanomaterials are an in
aggregated state during use, which significantly reduces the potential for harm. After carbon
nanotubes agglomerate, their size and aspect ratio dependent toxicity is significantly reduced.
Moreover, nanotubes used in such sensors have a high affinity for the substrate on which they
are assembled, which is then enclosed in a polymer. Therefore, the chance of nanotubes
escaping from the device are minimal especially during the use phase.
The true challenge, which has not received much attention, is the post-use/disposal scenario.
This paper is an effort to draw attention to the post-disposal issues associated with nanoenabled products by focusing on the potential release of CNTs from noninvasive glucose
sensors primarily designed for use by diabetes patients. Although the true toxicity potential of
CNTs is currently unknown, there is growing evidence to suggest that CNTs exhibit asbestoslike carcinogenicity along with other health issues [2] [3]. Until more definitive results are
established, tracking of the fate of CNTs in the sensor is an important consideration, as new
waste management practices could be determined to avoid unintended exposures.

Applicability of CNT-enabled Glucose Sensors According to the International Diabetes

Foundation, there are more than 415 million diabetes patients across the globe; almost half of
which are undiagnosed. The number is expected to grow to 640 million by 2040. Currently, over
12% of the global health care budget is spent on diagnosis and management of diabetes.
Despite sophisticated efforts to minimize the consequences, a human life is lost to this disease
every 6 seconds [4].
Critical to diabetes management, especially Type 1, is the strict monitoring of the blood glucose
level. High levels of glucose in blood can have serious health consequences such as brain
damage, multiple organ damage, and hyperglycemic shock. Currently, blood glucose
measurement requires that blood be drawn from the patient through pricking. This is painful,
inconvenient and does not allow for real time measurements. In addition, most accurate glucose
sensors are not inexpensive. This is a significant problem, because three quarters of the
diabetes patients live in the developing world where healthcare is not easily accessible [4].
Noninvasive CNT enabled sensors can mitigate these issues by allowing for inexpensive and
accurate measurement of blood glucose levels through other bodily fluids such as sweat. The
concentration of glucose in sweat correlates to that in blood [5].

Abbasi. S et al

Sensor Design. Semiconducting carbon nanotubes (CNTs) present an attractive option for
designing non-invasive biosensors for biomarker measurement in humans. Lactate, glucose and
urea can be measured by appropriate functionalization of CNTs assembled on a flexible or hard
substrate. Although several different designs for such sensors have been proposed, issues with
reliability, cost and possible end of life impacts have hindered commercialization. A glucose
sensor that has been designed at the NSF Center for High-Rate Nanomanufacturing (CHN) is
utilized to explore the possible end-of-life impacts by widespread use of CNT enabled sensors.
GOx
CNTs

Au

Au

Figure 1: Sensor Schematic. Side view of a typical sensor device with gold electrodes nanotube assembly with
glucose oxidase functionalization.
At CHN, fluidic and electrophoretic techniques have been developed to uniformly assemble
CNTs on silicon or PEG substrates. Using these techniques, SWCNTs (obtained from SWENT
Inc.) were assembled on a silicon dioxide (SiO2) substrate (for a working sensor, the substrate
would consist of a flexible polymer), followed by the deposition of gold (Au) electrodes. The
nanotubes were functionalized using a two-step process. First, a linker molecule was attached
to the nanotubes. For this purpose, the linker was first dissolved in Dimethylformamide (DMF).
The device was then placed in the solution for 2 hours at room temperature. The linker attaches
to the nanotubes using - stacking mechanism. After 2 hours, the device was removed and
washed carefully with deionized water. The second step was to place the device in a glucose
oxidase (GOx) solution made by dissolving GOx in Phosphate Buffered Saline (PBS). The
device was kept in the solution for 24 hours. Upon removal, the device was washed with DI
water and the resistance of each device was tested. As per the functionality, the change in
conductivity of CNTs after the redox reaction between glucose and glucose oxidase would be
detected using amperometric methods. This change would be used to determine the blood
glucose level. A schematic of the functionalized sensor is portrayed in Figure 1. The dimensions
of the sensor device are about 1 mm by 0.5 mm with a total mass of CNTs between 12 and 20
nanograms.
Risks Associated with CNT Sensors Inhalation and oral uptake are the two most potent ways
in which humans may be exposed to CNTs [6]. Dermal contact may also lead to harmful
exposure [7]. However, the chances of dermal contact with CNTs would be the highest during
manufacturing, which is not a subject of this study. Inhalation and oral uptake are more
significant from a disposal standpoint.
Because carbon nanotubes are hydrophobic, one might imagine that they would not disperse
and settle if they are transported to a water reservoir. However, surfactants in a water reservoir
may play a critical role in dispersing the nanotubes and reversing the agglomerated state that

End of life considerations for noninvasive carbon nanotube enabled biosensors

they usually are in a device/product. This could enhance the chances of resuspension and
escape of CNTs to the environment.
Current standard disposal of CNTs is incineration [8]. If the temperature in the incinerator is high
enough, nanotubes are destroyed and rendered innocuous. However, if the required
temperature is not reached, CNTs end up in the slag in a nano form. In many countries, slag is
used in the construction of roads, bridges etc. [9]. The chance of resuspension of nanotubes
from such structures into the atmosphere is currently unquantified. There are cases reported of
CNTs found in the lung fluid of children, which is a hint to what the potential dangers might be
[10].
The key to safe disposal of CNT containing products is creating traceability. To have
traceability, two steps would be necessary. First, the authority dealing with waste management
(mostly the government) might consider maintaining an inventory of all products that contain
carbon nanotubes. Secondly, the consumer must be made aware that the product they are
trying to dispose of contains nanotubes that should be disposed of in a specific manner to
become innocuous. Expecting a large population of consumers to dispose of the sensors
properly without educating them about what the potential harms might be could be very
challenging.
It is hypothesized that two factors would eventually play a critical role in creating promoting
traceability and safe disposal of nano-enabled products in general and of glucose sensors in
particular. The first is the existence of specific regulations pertaining to sale, use and disposal of
nano-enabled products. The second is the implementation of existing waste regulations and
overall waste management situation in a country.
Discussion. It is hypothesized that local regulations might play a critical role in creating
traceability and safe disposal of the nano-enabled sensors. When reflecting on the end-of-life
impacts for the sensor, medical waste treatment should be considered for countries in
developed and developing parts of the world. The major goal of this effort is to investigate the
current disposal practices of nanomaterials in the selected countries and explore whether and
how their current regulations might aid the disposal of the used sensor strips.
Ensuring the proper disposal of waste requires appropriate characterization. There are several
ways the sensors can be characterized. Usually, medical waste generated at home has specific
disposal guidelines. Home medical waste is usually left-over or expired medicines, syringes and
any waste that may be contaminated with potential pathogens such as blood. In the developed
world, home medical waste is usually turned in to specific waste centers.
Developing World. In many developing countries, waste management is a significant challenge.
The most prominent difficulties include 1) an imbalanced population to resources ratio and 2)
the lack of responsibility and awareness shown by the consumers and the authorities. This often
results in inefficient waste collection and management, especially in urban localities. As a result,
waste may not be accurately characterized and sorted, and may be disposed of incorrectly,
causing pollution.
China presents an interesting case to study in the developing world. The potential for use of
CNT enabled glucose sensors in China is large. Over 109 million people suffer from diabetes in
the country, half of which are undiagnosed. If it is assumed that a quarter of diagnosed patients
use CNT-enabled glucose sensors once a day, almost 14 million strips would have to be

Abbasi. S et al

disposed of in a way to minimize the potential for CNT release into the environment. Recall that
each strip has between 10 to 20 ng of CNTs on it.
Municipal waste collected in the urban localities in China is sorted into three different categories:
organic (mostly kitchen and garden) waste, inorganic waste, and recyclable waste. Recyclable
waste, consisting mostly of plastic, paper and metal, is scavenged from the local waste
collection centers [11]. Because the sensor would have a polymeric substrate, there is some
chance that it might end up being categorized as recyclable waste, which is then further sorted
and prepared for recycling operations. Sorting of this waste might cause dermal and inhalation
exposure to CNTs as reported in literature. In addition, after the polymer enters the recycling
process, the fate of the nanotubes would become even more uncertain.
Although the waste to energy incinerators are on the rise in China, household municipal waste
is typically landfilled. Less than 7% of the total municipal waste was incinerated in 2006 and the
situation has not changed much since [11]. Therefore, if the sensor is not sorted as recyclable, it
is highly probable that it would end up in a landfill. Leaky landfills are a common problem in the
developing world. This indicates that they could possibly contaminate the water table, which
could potentially provide a pathway for CNTs to reach groundwater from where they could be
transported to either water tanks for household consumption or to a water reservoir. An
interesting fact to note is that the contamination of water reservoirs by industrial solvents and
surfactants would aid the dispersion and resuspension of CNTs in the sensor, allowing them to
revert to their original nano form. This could lead to adverse effects on aquatic life, while also
posing a threat to the communities consuming water from the affected reservoirs. By taking a
close look at China, it can be concluded about most of the developing countries that the
mechanism to ensure that the sensors end up in an incinerator as opposed to a landfill is
basically absent without establishing clear regulations and guidelines.
Developed World. Waste management practices in the developed world are usually better
defined and implemented than the developing world. However, ordaining waste management
regulations for nanomaterials is a significant challenge due to a lack of conclusive evidence
regarding their toxicity. Most authorities, such as Food and Drug Authority (FDA) and
Environmental Protection Agency (EPA) in the U.S., maintain that existing regulatory
frameworks suffice to address / avoid any harmful exposures from nanomaterials during use or
disposal. Europe, on the other hand, has more specific and comprehensive regulations with
regards to nano-enabled consumer products. The EUs REACH and RoHS Directives require
inventories for consumer products with nanomaterials. However, medical devices are exempt
from labelling and reporting.
A key difference between the developing and the developed world in terms of waste
management is the method for collecting household medical waste. In most European countries
and the U.S., household medical waste such as expired medicine, blood contaminated towels,
used syringes, are characterized as medical waste and are collected separately through
medical waste collection. In the U.S, medical wastes are usually incinerated at temperatures of
250 C. To destroy CNTs, however, temperatures exceeding 600 C are typically required.
Denmark is an interesting case to consider. Although, there is a much smaller population of
diabetes patients in Denmark than in China, (only half a million people in Denmark suffer from
the disease), Denmark has specific regulations in place for waste that may contain
nanomaterials including a stringent and proactive policy with regard to the use of nanomaterials
in consumer goods. Several legislative measures, both at the local and the EU level, help
protect against the harmful exposure of nanomaterials during use and disposal and track nano-

End of life considerations for noninvasive carbon nanotube enabled biosensors

enabled products downstream. Cosmetics and food products with nanomaterials require to be
labelled with the word nano. Currently, medical products are not included, but as these new
sensing devices become available, we might see the regulatory landscape change in Denmark.
Denmark also a guideline for disposal of waste that could potentially contain nanomaterials.
This guideline is based on the practice of creating inventories of consumer products that contain
nanomaterials. However, this does not, as of now, has medical devices as a possible source of
nano-waste. But it is expected that since a robust tracking and inventorying mechanism is in
place, dealing with potential ramifications of cnt-enabled sensors, and other devices with large
potential magnitude of harm, could be easier and more effective.
Conclusions and Recommendations. Several conclusions can be drawn with respect to CNTenabled medical devices based on the discussion above. First and foremost is that regulations
concerning the labelling or inventorying the CNT devices is critical to bring the benefits of these
devices to the common man. The global regulatory landscape with regards to nano-enabled
consumer products needs to be revised. The method and nature of this revision is up for
discourse. Nevertheless, effective and timely legislative measures are required to ensure the
progress of nanotechnology on medical and/or other fronts is not compromised.
Moreover, United States has made significant contributions to nanotechnology and it goes
without saying that the regulatory response of the US governmental agencies to
nanotechnology could have consequences beyond the USs border. Such an initiative might
trigger similar responses from the developing countries which might help avoid the potential
harm from nano-enabled products even with compromised waste management practices.
The following recommendations can be made based on this study:
1) Mandatory labelling of products should be required for products which might have similar
ramifications as the sensor discussed hereby. The products, rather than being
categorized on broad basis, need to be evaluated on a case-by-case basis to determine
which ones might require mandatory labelling. Although seemingly tedious, this process
could be made much simpler by input from the producer.
2) Programs must be initiated to educate the average consumer regarding the disposal of
nano-enabled products and the risks associated with incorrect disposal.
3) A take-back program similar to printer cartridges could be established. This would
require show of responsibility by the consumer. Another method would be to create a
system similar to that used for prescription drugs, so to increase the traceability. The
consumers may be required to turn in the previous wastes before they are able to get
refills.
4) The producers, consumers and the regulatory authorities must actively share the
responsibility for disposal of nano-enabled products.
Acknowledgements. This work is funded by NSF Award # 1120329.
References.
1.
2.
3.

Balasubramanian, K. and M. Burghard, Biosensors based on carbon nanotubes.

Analytical and Bioanalytical Chemistry, 2006. 385(3): p. 452-468.
Donaldson, K., et al., Carbon nanotubes: a review of their properties in relation to
pulmonary toxicology and workplace safety. Toxicol Sci, 2006. 92.
Wang, Z., et al., Biological and environmental interactions of emerging two-dimensional
nanomaterials. Chemical Society Reviews, 2016. 45(6): p. 1750-1780.

Abbasi. S et al

4.
5.
6.

7.
8.
9.

10.
11.

Cho, N.H. 2015, International Diabetes Foundation.

Jadoon, S., et al., Recent Developments in Sweat Analysis and Its Applications.
International Journal of Analytical Chemistry, 2015. 2015: p. 7.
Oberdrster, G., et al., INHALATION EXPOSURE TO CARBON NANOTUBES (CNT)
AND CARBON NANOFIBERS (CNF): METHODOLOGY AND DOSIMETRY. Journal of
toxicology and environmental health. Part B, Critical reviews, 2015. 18(0): p. 121-212.
Luanpitpong, S., L. Wang, and Y. Rojanasakul, The effects of carbon nanotubes on lung
and dermal cellular behaviors. Nanomedicine (London, England), 2014. 9(6): p. 895-912.
Holder, A.L., et al., Nanomaterial disposal by incineration. Environmental Science:
Processes & Impacts, 2013. 15(9): p. 1652-1664.
Lind, B.B., A.-M. Fllman, and L.B. Larsson, Environmental impact of ferrochrome slag
in road construction, in Waste Management Series, J.J.J.M.G. G.R. Woolley and P.J.
Wainwright, Editors. 2000, Elsevier. p. 247-259.
Kolosnjaj-Tabi, J., et al., Anthropogenic Carbon Nanotubes Found in the Airways of
Parisian Children. EBioMedicine, 2015. 2(11): p. 1697-1704.
Zhang, D.Q., S.K. Tan, and R.M. Gersberg, Municipal solid waste management in
China: Status, problems and challenges. Journal of Environmental Management, 2010.
91(8): p. 1623-1633.