A change of climate for climate change: the environmental benefit of specialty outreach clinics

O’Connor, Cathal; Kiely, Lisa; O’Riordan, Anthony; O’Connell, Garrett; Bennett, Mary; O’Shea, Sally J.; Murphy, Linda; Bourke, John; Murphy, Michelle

doi:10.1136/bmj.m1410

Cited by 4 publications

(3 citation statements)

References 3 publications

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“…Patients residing outside metropolitan areas could travel 180 km from large rural areas (population > 25,000–99,999) to more than 360 km for those in remote areas (population < 5000) in order to see a dermatologist. No data exists for the carbon footprint reduction of an Australian dermatology outreach clinic, but data from Ireland 32 estimated a saving of 26,180 kg of CO 2 e (based on a 142 km average round trip for the medical team) and data from Canada estimated a saving of 47,000 kg of CO 2 e per clinic per annum (based on median distance of 327 km of travel) 33 Avoid single‐use surgical instruments and purchase durable tungsten carbide instruments …”

Section: Recommendationsmentioning

confidence: 99%

Sustainable dermatology—A practical guide for the Australian dermatologist

Tan

2023

Aust J Dermatology

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Globally, healthcare systems can account for up to 10% of national CO2 emissions. There is increasing awareness of the need to act to reduce the impact on our planet by living sustainably in our personal and professional lives. Literature on sustainability can be complex, and with so many demands on our attention and time, it is challenging for the practising dermatologist to grasp where to begin. This manuscript provides a practical guide with quantifiable impacts for each action. With mindful use of resources, both profitability and the well‐being of patients and doctors can align with environmental protection.

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Section: Recommendationsmentioning

confidence: 99%

Sustainable dermatology—A practical guide for the Australian dermatologist

Tan

2023

Aust J Dermatology

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“…Dermatology outreach clinics can significantly spare individual patients the need to travel vast distances to access dermatologic care. A dermatology outreach clinic in southern Ireland saw 1022 patients in 44 outreach clinics resulting in a reduction of travel by 144 789 km, saving 26.18 tonnes of CO 2 e 36 . In this example, a single patient in remote Australia with a return trip of 360 km would result in CO 2 e emission of 101.37 kg per skin excision.…”

Section: Recommendationsmentioning

confidence: 99%

Carbon footprint of dermatologic surgery

Tan¹,

Lim²

2020

Aust J Dermatology

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Healthcare is a potent emitter of greenhouse gases amounting up to 7% of total estimated greenhouse gas emissions (CO 2 e) for Australia. Australia has one of the highest incidences of skin cancer in the world but there is a paucity of data on the ecological impact of skin cancer excision/dermatologic surgery. The authors reviewed the various impact inventories in order to perform a life cycle assessment of skin cancer excision. A total of 8641 tonnes of estimated CO 2 e are produced from dermatologic surgery annually in Australia (6751 tonnes from private clinical rooms and 1890 tonnes from hospitals) and the waste generated contributes significantly to terrestrial ecotoxicity and acidification of land and water. Various means can be carried out to reduce this impact, ranging from simple behavioural changes to larger, policy changes.

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“…Our group has previously highlighted the environmental benefit of dermatology outreach clinics. 2 We performed a cross‐sectional study to assess the environmental benefits of an enforced transition to teledermatology during the first national COVID‐19 lockdown in Ireland.…”

mentioning

confidence: 99%

Every cloud has a silver lining: the environmental benefit of teledermatology during the COVID‐19 pandemic

O’Connell

O’Connor

Murphy

2021

Clin Experimental Derm

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which took in government restrictions during the second wave pandemic.Data on the second wave pandemic were prospectively collected in order to exclude any possible bias related to a retrospective study. Statistical analysis was performed using all the collected data and were analysed with the Mann-Whitney U-test in SPSS software (V26; IBM SPSS, Armonk, NY, USA). P < 0.05 was considered statistically significant.The total number of patients requiring consultation decreased significantly (P < 0.05) from 1328 in the prepandemic period to 483 in the pandemic period (Fig. 1), with a drop from a mean of 110.66 to 40.25 weekly visits in the pandemic period. The number of justified and unjustified emergencies decreased from 418 to 213 (P < 0.05) and from 910 to 270 (P < 0.05), respectively. Interestingly, the percentage of justified visits increased from 31.99% (pre-pandemic) to 45.47% (pandemic). Our data corroborate that previously reported about the misuse of ESs in the Italian national health system. 1,3 The global trend of patients requiring ES consultation was also mapped and a trend toward a decline in the number of patients referring to our emergency service was observed (Fig. 1a,b), corroborating literature data. 3 These changes in ES visits during the pandemic needs some consideration. The decrease in the global number of patients may have been due to the theoretical risk of infection from COVID-19 during a hospital consultation. The panic generated by the second wave 4 may have discouraged people from requiring ES consultation if not urgently necessary. Consequently, the percentage of justified access increased from 31.99% in the pre-COVID-19 period to 45.47% in the COVID-19 pandemic. Nevertheless, the number of acute illnesses decreased from 418 to 213 (P < 0.05), suggesting in some instances, even people with acute dermatological conditions may have avoided hospital.To conclude, our data highlight that a thorough redefinition of ES function is required; for example, increasing the number of outpatient departments for chronic conditions and starting an educational campaign encouraging people to access ES only if their dermatological diseases is acute, in order to ease the pressure on hospitals.

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A change of climate for climate change: the environmental benefit of specialty outreach clinics

Cited by 4 publications

References 3 publications

Sustainable dermatology—A practical guide for the Australian dermatologist

Sustainable dermatology—A practical guide for the Australian dermatologist

Carbon footprint of dermatologic surgery

Every cloud has a silver lining: the environmental benefit of teledermatology during the COVID‐19 pandemic

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