Improving environmental sustainability in outpatient clinics: Lessons from a waste audit

Taylor, Anita Lowe; Levin, Josh; Chan, James C.; Lee, Michelle; Kasitinon, Donald; Miller, Emily; Fox, Paige M.

doi:10.1016/j.joclim.2021.100070

Cited by 6 publications

(4 citation statements)

References 15 publications

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“…53 In the US, healthcare is the second largest waste producing industry disposing of more than four billion pounds of waste annually. 54 Between 30% and 70% of waste generated by healthcare organizations stems from activities in operating rooms and labor and delivery. 55 In the operating room, liquid waste, including blood and body fluids, is usually collected in disposable suction canisters.…”

Section: Surgical Wastementioning

confidence: 99%

“…In a 2011 report, the United Nations Human Rights Council deemed improper medical waste management to be a human rights violation referencing a 2009 systematic literature review that estimated that over half of the global population faces resultant environmental, public health, and occupational risk 53 . In the US, healthcare is the second largest waste producing industry disposing of more than four billion pounds of waste annually 54 …”

Section: Observations: the Surgical And Anesthesia Device Lifecyclementioning

confidence: 99%

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Lifecycle of surgical devices: Global, environmental, and regulatory considerations

Wahlstedt,

Rosenberg

et al. 2024

World j. surg.

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BackgroundTechnological advancements, improved surgical access, and heightened demand for surgery have fueled unprecedented device and supply turnover impelling wealthy hospitals to upgrade continually and sell, donate, recycle, or dispose of used, expired, antiquated, or surplus goods. This paper reviews the issues related to device and supply lifecycles and discusses the opportunities and challenges they present for sustainable surgical growth in low‐ and middle‐income (LMICs) countries.ObservationsThis review found, in LMICs countries, regulatory disparities persist that limit effective harmonization secondary to highly variable national policies and a lack of prioritized enforcement. Heterogeneity in the regulatory landscape, specifically in the classification, nomenclature, and identification of medical devices, encumbers effective regulation and distribution. Once devices are sold, donated, or reused in LMICs countries, complexities arise in regulatory compliance, maintenance, and appropriate use of these technologies. At the end of the lifecycle, waste management poses significant obstacles with limited resources hindering the implementation of best practices.ConclusionThere are major disparities in access to quality surgical equipment and supplies around the world. Improved communication between relevant stakeholders and harmonization of manufacture and disposal regulations will be needed to ensure adequate and appropriate responses to these challenges.Trial registration number: Not applicable.

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Section: Surgical Wastementioning

confidence: 99%

Section: Observations: the Surgical And Anesthesia Device Lifecyclementioning

confidence: 99%

Lifecycle of surgical devices: Global, environmental, and regulatory considerations

Wahlstedt,

Rosenberg

et al. 2024

World j. surg.

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“…In outpatient GI clinics, single-use medical supplies, such as gloves, gowns, personal protective equipment, and syringes, contribute to the overall waste. The mean weight of waste produced per clinic visit is 101.6 g AE 28.33 g. 31 Prepackaged procedure kits generate a mean of 459 g AE 126 g of waste per procedure. 31 Use of prepackaged procedural kits instead of individual item selection results in an estimated additional 819.5 kg of waste annually.…”

Section: Carbon Footprint Mitigation Strategies From Gi Clinical Prac...mentioning

confidence: 99%

“…The mean weight of waste produced per clinic visit is 101.6 g AE 28.33 g. 31 Prepackaged procedure kits generate a mean of 459 g AE 126 g of waste per procedure. 31 Use of prepackaged procedural kits instead of individual item selection results in an estimated additional 819.5 kg of waste annually. This increased waste production contributes to more than 1550 kg of CO 2 annually.…”

Section: Carbon Footprint Mitigation Strategies From Gi Clinical Prac...mentioning

confidence: 99%

Environmentally sustainable gastroenterology practice: Review of current state and future goals

Sonaiya,

Marino,

Agollari

et al. 2023

Digestive Endoscopy

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BackgroundThe healthcare sector contributes 4.6% of global greenhouse gas (GHG) emissions, with gastroenterology playing a significant role due to the widespread use of gastrointestinal endoscopy.MethodologyA comprehensive search of PubMed, Embase, and Cochrane Library was conducted to explore the carbon footprint in gastroenterology practice, focusing on endoscopy, in‐patient and outpatient settings, and recruitment practices. Recommendations for mitigating the carbon footprint were derived.ResultsThis narrative review analyzed 34 articles on the carbon footprint in gastroenterology practice. Carbon footprint of endoscopy in the USA is approximately 85,768 metric tons of CO2 emission annually, equivalent to 9 million gallons of gasoline consumed, or 94 million pounds of coal burned. Each endoscopy generates 2.1 kg of disposable waste (46 L volume), of which 64% of waste goes to the landfill, 28% represents biohazard waste, and 9% is recycled. The per‐case manufacturing carbon footprint for single‐use devices and reusable devices is 1.37 kg CO2 and 0.0017 kg CO2 respectively. Inpatient and outpatient services contributed through unnecessary procedures, prolonged hospital stays, and excessive use of single‐use items. Fellowship recruitment and GI conferences added to the footprint, mainly due to air travel and hotel stays.ConclusionGI endoscopy and practice contribute to the carbon footprint through the use of disposables such as single‐use endoscopes, and waste generation. To achieve environmental sustainability, measures such as promoting reusable endoscopy equipment over single‐use endoscopes, calculating institutional carbon footprints, establishing benchmarking standards, and embracing virtual platforms such as telemedicine and research meetings should be implemented.

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The carbon footprint of epidural steroid injections: A pilot study

Fogarty,

Wilson,

Godambe

et al. 2024

PM&R

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IntroductionEpidural steroid injections are common procedures in PM&R practice. However, their environmental impact has not been characterized.ObjectiveThe primary aim is to estimate and compare the carbon footprint of two standard injection kits utilized to perform epidural steroid injections at a single academic institution. Secondary objectives were 1) to create a step‐by‐step guide for estimating the carbon footprint of materials and 2) to survey physicians on practice patterns and identify areas for improvement.DesignPilot study.SettingAcademic medical center.Participants N/AInterventions N/AOutcome measuresCarbon emissions measured in CO2 equivalents (CO2 eq).MethodsUsing guidance from the Greenhouse Gas Protocol (GGP), the carbon footprint of the two kits was estimated by taking the sum of carbon emissions resulting from the production of the kit materials and the carbon emissions resulting from the waste disposal of the kit materials.ResultsThe carbon footprint of the transforaminal epidural steroid injection (TFESI) kit was estimated at 1.328 kg CO2 eq. The carbon footprint of the interlaminar epidural steroid injection (ILESI) kit was estimated at 2.534 kg CO2 eq. For both kits, the carbon emissions resulting from the production of the kits were greater than the emissions resulting from disposal. The survey of interventionalists performing TFESI revealed all respondents required materials in addition to those provided in the standard epidural kit. Despite this, kit materials were typically wasted in 62% of respondents.ConclusionCreating a methodology for quantifying carbon emissions is the first step to reducing carbon emissions. Once emissions are measured, the healthcare industry can determine the most effective strategies for reducing its impact. Our analysis has shown that it is feasible to perform emissions calculations and delineates a clear method with publicly available resources. Solutions to reduce epidural injection carbon footprint waste may include improved kit customization.This article is protected by copyright. All rights reserved.

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Improving environmental sustainability in outpatient clinics: Lessons from a waste audit

Cited by 6 publications

References 15 publications

Lifecycle of surgical devices: Global, environmental, and regulatory considerations

Lifecycle of surgical devices: Global, environmental, and regulatory considerations

Environmentally sustainable gastroenterology practice: Review of current state and future goals

The carbon footprint of epidural steroid injections: A pilot study

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