Carbon footprint and cost–effectiveness of cataract surgery

Venkatesh, Rengaraj; Landingham, Suzanne W. van; Khodifad, Ashish; Haripriya, Aravind; Thiel, Cassandra L.; Ramulu, Pradeep Y.; Robin, Alan L.

doi:10.1097/icu.0000000000000228

Cited by 61 publications

(39 citation statements)

References 31 publications

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“…The health care sector could also reduce carbon emissions that occur in the global production chain of medical goods and pharmaceuticals by applying green procurement strategies. Expenditures could be reallocated to less carbon intensive forms of health care provision by changing medical procedures [34][35][36][37], or by using functionally equivalent drugs and medical devices with lower carbon intensity of production and packaging [38][39][40][41].…”

Section: Discussionmentioning

confidence: 99%

International comparison of health care carbon footprints

Pichler

Jaccard

Weisz

et al. 2019

Environ. Res. Lett.

369

238

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Climate change confronts the health care sector with a dual challenge. Accumulating climate impacts are putting an increased burden on the service provision of already stressed health care systems in many regions of the world. At the same time, the Paris agreement requires rapid emission reductions in all sectors of the global economy to stay well below the 2°C target. This study shows that in OECD countries, China, and India, health care on average accounts for 5% of the national CO 2 footprint making the sector comparable in importance to the food sector. Some countries have seen reduced CO 2 emissions related to health care despite growing expenditures since 2000, mirroring their economy wide emission trends. The average per capita health carbon footprint across the country sample in 2014 was 0.6 tCO 2 , varying between 1.51 tCO 2 /cap in the US and 0.06 tCO 2 /cap in India. A statistical analysis shows that the carbon intensity of the domestic energy system, the energy intensity of the domestic economy, and health care expenditure together explain half of the variance in per capita health carbon footprints. Our results indicate that important leverage points exist inside and outside the health sector. We discuss our findings in the context of the existing literature on the potentials and challenges of reducing GHG emissions in the health and energy sector.

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Section: Discussionmentioning

confidence: 99%

International comparison of health care carbon footprints

Pichler

Jaccard

Weisz

et al. 2019

Environ. Res. Lett.

369

238

View full text Add to dashboard Cite

show abstract

“…The Royal College of Ophthalmologists emphasized the role of electronic systems and telemedicine to minimize unnecessary visits, as a method to improve sustainability . Waste disposal contributes a small percentage of the footprint of cataract surgery, so recycling will not have a substantial impact (but promotes a discussion and culture of sustainability) . Ophthalmologists can advocate to surgical suppliers to minimize waste and packaging and unnecessary disposable equipment, although these decisions are often devolved from ophthalmologists to theatre managers and cost is the dominant consideration (c.f.…”

Section: Discussionmentioning

confidence: 99%

“…Health services in the United States were estimated to contribute 10% of national greenhouse gases . Ophthalmological practice is a net contributor due to busy centralized outpatient clinics and high cataract surgery rates, and is well placed to improve sustainability …”

Section: Introductionmentioning

confidence: 99%

New Zealand ophthalmologists' opinions and behaviours on climate, carbon and sustainability

Chandra

Gale

Murray

2020

Clinical Exper Ophthalmology

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Importance: Ophthalmology faces imperatives to improve sustainability, but there is uncertainty about how to respond. Background: We sought New Zealand ophthalmologists' opinions on climate change, sustainability and the role of ophthalmologists in responding to these issues, as well as information on the extent that ophthalmology practices are acting on sustainability.Design: Anonymous online survey of New Zealand fellows and trainees (178) of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) was conducted. Participants: Forty-seven respondents (response rate 26%) were included in the study. Methods: Respondents were asked their level of agreement with statements on climate, health and sustainability and invited to comment. Current sustainability activities were collected from clinical leaders and directors of hospital departments and private practices.Main Outcome Measure: Distribution of agreement scores was the main outcome measure.Results: Agreement with mainstream positions on climate change was as expected. A minority of up to 19% expressed the opinion that climate change was not due to human activity, and did not require mitigation. Younger ophthalmologists tended to have greater agreement with the need for broad-based political action on climate mitigation than those aged over 50 years. Most practices had room to improve on reducing waste, travel and carbon footprints. Conclusions andRelevance: The majority of New Zealand ophthalmologists are concerned about anthropogenic climate change. Currently, sustainability is not a performance indicator for New Zealand district health boards, so there is limited incentive to drive improvements. These data form a reference point to compare future opinions and ophthalmology carbon footprinting. K E Y W O R D S carbon footprint, climate change, greenhouse gas, ophthalmologist, sustainability, waste

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“…8,17–19 Aravind, with its assembly-line model for surgery and its use of reusable instruments, serves as an example of more sustainable, efficient cataract surgery. This study analyzes Aravind’s material use from phaco-emulsification cataract surgery and quantifies the resulting environmental effects and costs through environmental lifecycle assessment (LCA).…”

mentioning

confidence: 99%

Cataract surgery and environmental sustainability: Waste and lifecycle assessment of phacoemulsification at a private healthcare facility

Thiel¹,

Schehlein²,

Ravilla³

et al. 2017

Journal of Cataract and Refractive Surgery

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156

143

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Purpose To measure the waste generation and lifecycle environmental emissions from cataract surgery via phacoemulsification in a recognized resource-efficient setting. Setting Two tertiary care centers of the Aravind Eye Care System in southern India. Design Observational case series. Methods Manual waste audits, purchasing data, and interviews with Aravind staff were used in a hybrid environmental lifecycle assessment framework to quantify the environmental emissions associated with cataract surgery. Kilograms of solid waste generated and midpoint emissions in a variety of impact categories (eg, kilograms of carbon dioxide equivalents). Results Aravind generates 250 grams of waste per phacoemulsification and nearly 6 kilograms of carbon dioxide-equivalents in greenhouse gases. This is approximately 5% of the United Kingdom’s phaco carbon footprint with comparable outcomes. A majority of Aravind’s lifecycle environmental emissions occur in the sterilization process of reusable instruments because their surgical system uses largely reusable instruments and materials. Electricity use in the operating room and the Central Sterile Services Department (CSSD) accounts for 10% to 25% of most environmental emissions. Conclusions Results show that surgical systems in most developed countries and, in particular their use of materials, are unsustainable. Ophthalmologists and other medical specialists can reduce material use and emissions in medical procedures using the system described here.

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Carbon footprint and cost–effectiveness of cataract surgery

Abstract: Cataract surgery has a high value to patients. The relative environmental impact and cost of different types of cataract surgery should be considered as this treatment becomes even more broadly available globally and as new technologies are developed and implemented.

Cited by 61 publications

References 31 publications

International comparison of health care carbon footprints

International comparison of health care carbon footprints

New Zealand ophthalmologists' opinions and behaviours on climate, carbon and sustainability

Cataract surgery and environmental sustainability: Waste and lifecycle assessment of phacoemulsification at a private healthcare facility

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