Surgery and the NHS carbon footprint

Whiting, A; Tennison, Imogen; Roschnik, Sonia; Collins, Maxwell D.

doi:10.1308/rcsbull.2020.152

Cited by 27 publications

(18 citation statements)

References 3 publications

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“…Although waste production and disposal are one of the key and easy-to-note carbon footprint drivers, there are many other contributors to account for. Both these studies raise awareness to the fact that energy (total heating, ventilation, and air conditioning) and single use consumables represent approximately 90% of the carbon footprint, in these specific settings 23 24. These data might be extrapolated to the field of endoscopy, not only because it is a very energy-intensive healthcare area, but also due to the large number of single-use consumables used in every endoscopic procedure.…”

Section: Discussionmentioning

confidence: 99%

“…According to Chua et al waste disposal represented approximately 2% of the carbon footprint generated by interventional radiology procedures 23. Similarly, Whiting et al study on the carbon footprint generated per hour of surgery (excluding anaesthetic gases), concluded that waste was responsible for less than 1% of the total carbon footprint 24. Although waste production and disposal are one of the key and easy-to-note carbon footprint drivers, there are many other contributors to account for.…”

Section: Discussionmentioning

confidence: 99%

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Targeted intervention to achieve waste reduction in gastrointestinal endoscopy

Neves¹,

Roseira

Queirós

et al. 2022

Gut

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ObjectiveEndoscopy is healthcare’s third largest generator of medical waste in hospitals. This prospective study aimed to measure a single unit’s waste carbon footprint and perform a pioneer intervention towards a more sustainable endoscopy practice. The relation of regulated medical waste (RMW; material fully contaminated with blood or body fluids or containing infectious agents) versus landfill waste (non-recyclable material not fully contaminated) may play a critical role.DesignIn a four-stage prospective study, following a 4-week observational audit with daily weighing of both waste types (stage 1), stage 2 consisted of a 1-week intervention with team education of waste handling. Recycling bins were placed in endoscopy rooms, landfill and RMW bins were relocated. During stages 3 (1 month after intervention) and 4 (4 months after intervention), daily endoscopic waste was weighed. Equivalence of 1 kg of landfill waste to 1 kg carbon dioxide equivalent (CO2e) and 1 kg of RMW to 3kgCO2e was assumed. Paired samples t-tests for comparisons.ResultsFrom stage 1 to stage 3, mean total waste and RMW were reduced by 12.9% (p=0.155) and 41.4% (p=0.010), respectively, whereas landfill (p=0.059) and recycling waste increased (paper: p=0.001; plastic: p=0.007). While mean endoscopy load was similar (46.2 vs 44.5, p=0.275), a total decrease of CO2e by 31.6% (138.8kgCO2e) was found (mean kgCO2e109.7 vs 74.9, p=0.018). The annual reduction was calculated at 1665.6kgCO2e. All these effects were sustained 4 months after the intervention (stage 4) without objections by responsible endoscopy personnel.ConclusionIn this interventional study, applying sustainability measures to a real-world scenario, RMW reduction and daily recycling were achieved and sustained over time, without compromising endoscopy productivity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Targeted intervention to achieve waste reduction in gastrointestinal endoscopy

Neves¹,

Roseira

Queirós

et al. 2022

Gut

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“…Only one study calculated the carbon impact of common imaging modalities, finding that the attributional carbon footprint of an MRI was 22.4 kg CO 2 e, similar to our 17.9 kg CO 2 e. 22 There are other studies that have focussed primarily on the power consumption of scanners, with our study's results on consumption falling broadly in line in comparison to these other studies. 23 …”

Section: Discussionmentioning

confidence: 99%

“…Of note, our results should draw attention to the carbon impacts of imaging in comparison to other carbon hotspots which have received much attention. For example, anaesthesia is a recognised carbon hotspot, 23 yet one MRI has approximately equivalent emissions to one gaseous general anaesthetic. 24 Thus far, however, the carbon emissions from imaging have received little attention.…”

Section: Discussionmentioning

confidence: 99%

The carbon footprint of hospital diagnostic imaging in Australia

McAlister

McGain

Breth-Petersen

et al. 2022

The Lancet Regional Health - Western Pacific

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“…In the European Union, healthcare industry contributes to a 4.7% share of global net emissions, and ranks as the third biggest contributor worldwide in terms of healthcare industry carbon emissions, after the United States and China [5,6]. In the United Kingdom, anaesthetic gases represent 5% of the hospital care carbon footprint, and 42% of the perioperative carbon emissions [7] with desflurane identified as the most carbon intensive [8]. Therefore, while global rising temperatures are the biggest health threat expected for this century [9], healthcare systems should lead by example [10].…”

Section: Introductionmentioning

confidence: 99%

The green anaesthesia dilemma: to which extent is it important to preserve as many drugs available as possible

Gonzalez-Pizarro

Muret²,

Brazzi

2023

Current Opinion in Anaesthesiology

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Purpose of reviewThis article aims to summarize the current literature describing the availability of different anaesthetic drugs, and to discuss the advantages and limitations of a self-imposed restriction on the scarcely existing anaesthetic drugs.Recent findingsEarth temperature has risen 1.2°C since the beginning of industrial age, and it is expected to exceed a 1.5°C increase by 2050. The Intergovernmental Panel on Climate Change depicts five different scenarios depending on how these increased temperatures will be controlled in the future. The European Commission has formulated a proposal to regulate fluorinated greenhouse gases (F-gases), among which desflurane, isoflurane and sevoflurane belong to, due to their high global warming potential. This proposal shall ban, or severely restrict, the use of desflurane starting January 2026. It is not clear what might happen with other F-gas anaesthetics in the future. Due to climate change, a higher number of health crisis are expected to happen, which might impair the exiting supply chains, as it has happened in previous years with propofol scarcity.SummaryThere are just a handful number of available anaesthetics that provide for a safe hypnosis. Major stakeholders should be consulted prior making such severe decisions that affect patient safety.

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Surgery and the NHS carbon footprint

Abstract: Finding the right pathway to increase sustainable practices in healthcare.

Cited by 27 publications

References 3 publications

Targeted intervention to achieve waste reduction in gastrointestinal endoscopy

Targeted intervention to achieve waste reduction in gastrointestinal endoscopy

The carbon footprint of hospital diagnostic imaging in Australia

The green anaesthesia dilemma: to which extent is it important to preserve as many drugs available as possible

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