Operating rooms biggest contributors of carbon emissions in healthcare industry, research says

One of the most feasible changes to make would be around waste reduction, scientists say

File: Workers dispose off waste at a hospital during a government-imposed nationwide lockdown as a preventive measure against the coronavirus infection in Srinagar, India (AFP via Getty)

Operating rooms are the biggest source of greenhouse gasses from hospitals, generating three to six times more carbon than other healthcare systems, according to new research that suggests new ways to combat the problem.

Scientists say the healthcare industry accounts for about 8.5 per cent of all greenhouse gas emissions in the US, with surgery being one of the biggest culprits in this space.

“Surgery unfortunately plays a disproportionate role in the carbon output and the waste we produce in medicine,” Victor Agbafe, a co-author of the research from the University of Michigan Medical School in the US said in a statement.

In the analysis, published recently in the Journal of Clinical Oncology, scientists say cancer care, in particular, is a potential target for greener efforts within surgery since it involves intense levels of care over a short period of time.

With minimally invasive surgeries requiring a lot of energy, including robotic-assisted operations, they say such procedures have become common treatments for cancers ranging from colorectal and uterine cancer to head and neck cancer.

Citing an example, scientists say robotic-assisted hysterectomy produces as much carbon as driving more than 2,200 miles (3,450km) in a car.

For lowering the greenhouse gas output in this sector, they say one of the most feasible changes to make would be around waste reduction.

Since over 90 per cent of operation room waste does not meet the necessary standards for the type of trash it ends up in, a simple first step would be to ensure anything thrown away before or during surgery is properly categorised and labelled, researchers say.

Switching to reusable or reprocessed devices and surgical gowns could also be helpful, they add.

Researchers recommend the installation of energy-efficient lighting, scheduling preventive maintenance, and minimising air flow into rooms that aren’t being used as easy ways to green the systems.

They believe the surgical supply chain could also be optimised for efficiency with estimates suggesting that nearly 90 per cent of surgical instruments laid out for an operation are rarely used.

Coming up with standardised lists of the necessary tools for surgeries that occur regularly could cut down on cost, waste, and the energy needed to sterilise and repackage those instruments, scientists write. Moving manufacturing of surgical supplies closer to hospitals could also reduce the carbon footprint of operation rooms.

Scientists added that telemedicine could provide a great opportunity to lower the health sector’s climate impact and improve the quality.

Inhaled gases regularly used for anesthesia, such as nitrous oxide, are A-list offenders when it comes to greenhouse gas production, researchers say, adding that it is a direct ozone depleter and does not dissipate from the atmosphere for more than a century after it’s produced.

“If we have, for example, 10 liters going, we’re blowing a lot of anesthetic into the scavenging and waste and atmospheric systems that doesn’t need to be there,” George Mashour, chair of the Department of Anesthesiology at the University of Michigan Medical School, said.

Researchers say some inhaled anesthetics, like sevoflurane have lesser environmental impact than nitrous oxide, and could be alternatives.

“The overall goal is to shift away from some of these egregious culprits and start making better choices about which drug we use and then also how we use it,” Dr Mashour said.

“We could be doing better. Right now, we’re starting the conversations, getting people on board and making structural choices in the department to help make it easy for people to do the right thing,” he added.