A comparative carbon footprint analysis of disposable and reusable vaginal specula

Donahue, Laura; Hilton, Stephen P.; Bell, Sarah G.; Williams, Brent C.; Keoleian, Gregory A.

doi:10.1016/j.ajog.2020.02.007

Cited by 52 publications

(50 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2008 ), sharps containers ( Grimmond and Reiner 2012 ; McPherson et al. 2019 ), and vaginal specula ( Donahue et al. 2020 ).…”

Section: Resultsmentioning

confidence: 99%

“…HG, Horton General NHS Trust, United Kingdom; JRH, John Radcliffe Hospital, United Kingdom. References: (1) McGain et al 2010 ; (2) McGain et al 2017 ; (3) McGain et al 2012 ; (4) Allison et al 2020 ; (5) Lee et al 2021 ; (6) Schmutz et al 2020 ; (7) Davis et al 2018 ; (8) Liang 2019 ; (9) Eckelman et al 2012 ; (10) Sherman et al 2018 ; (11) Leiden et al 2020 ; (12) Grimmond and Reiner 2012 ; (13) McPherson et al 2019 ; (14) Donahue et al 2020 ; (15) Ison and Miller 2000 ; (16) Vozzola et al 2018 ; (17) Vozzola et al 2020 ; (18) Carre 2008 ; (19) Van den Berghe and Zimmer 2011 ; (20) Rizan et al 2021 ; (21) Ibbotson et al 2013 ; (22) Mikusinska 2012 .…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-eight studies assessed environmental impact contributions from equipment used in surgical settings, including a) general surgical items, such as gowns (Carre 2008;Van den Berghe and Zimmer 2011;, drapes (Vozzola et al 2018), scrubs (Mikusinska 2012), scissors (Ibbotson et al 2013), suction receptacles (Ison and Miller 2000), deep vein thrombosis (DVT) compression sleeves, pulse oximeters, LigaSure devices, harmonic scalpels, endoscopic trocars, arthroscopic shavers, scissor tips (Unger and Landis 2016); b) anesthetic equipment, such as anesthetic drug trays (McGain et al 2010), laryngeal mask airways (LMA; Eckelman et al 2012;Liang 2019), laryngoscope blades and handles (Sherman et al 2018), central venous catheter insertion kits (McGain et al 2012), and anesthetic equipment at two hospitals (McGain et al 2017); c) items specific to particular procedures or specialties, such as titanium alloy knee implants (Lyons et al 2021), custom packs used to deliver newborns (Campion et al 2015), ureteroscopes (Davis et al 2018), spinal fusion instrument sets (Leiden et al 2020), and single-use medical devices and products used during hysterectomy (Unger et al 2017); and d) items used in, but not specific to, surgery, such as personal protective equipment (masks, gloves, aprons, gowns, and face shields; Rizan et al 2021), surgical face masks (Allison et al 2020;Lee et al 2021;Schmutz et al 2020), medical gloves (Weisz et al 2020), urinary catheters (Stripple et al 2008), sharps containers (Grimmond and Reiner 2012;McPherson et al 2019), and vaginal specula (Donahue et al 2020).…”

Section: Equipment and Materialsmentioning

confidence: 99%

See 2 more Smart Citations

Operating in a Climate Crisis: A State-of-the-Science Review of Life Cycle Assessment within Surgical and Anesthetic Care

Drew

Christie

Tyedmers

et al. 2021

Environ Health Perspect

103

View full text Add to dashboard Cite

BACKGROUND: Both human health and the health systems we depend on are increasingly threatened by a range of environmental crises, including climate change. Paradoxically, health care provision is a significant driver of environmental pollution, with surgical and anesthetic services among the most resource-intensive components of the health system. OBJECTIVES: This analysis aimed to summarize the state of life cycle assessment (LCA) practice as applied to surgical and anesthetic care via review of extant literature assessing environmental impacts of related services, procedures, equipment, and pharmaceuticals. METHODS: A state-of-the-science review was undertaken following a registered protocol and a standardized, LCA-specific reporting framework. Three bibliographic databases (Scopus ® , PubMed, and Embase ® ) and the gray literature were searched. Inclusion criteria were applied, eligible entries critically appraised, and key methodological data and results extracted. RESULTS: From 1,316 identified records, 44 studies were eligible for inclusion. The annual climate impact of operating surgical suites ranged between 3,200,000 and 5,200,000 kg CO 2 e. The climate impact of individual surgical procedures varied considerably, with estimates ranging from 6 to 1,007 kg CO 2 e. Anesthetic gases; single-use equipment; and heating, ventilation, and air conditioning system operation were the main emissions hot spots identified among operating room-and procedure-specific analyses. Single-use equipment used in surgical settings was generally more harmful than equivalent reusable items across a range of environmental parameters. Life cycle inventories have been assembled and associated climate impacts calculated for three anesthetic gases (2-85 kg CO 2 e=MAC-h) and 20 injectable anesthetic drugs (0:01-3:0 kg CO 2 e=gAPI). DISCUSSION: Despite the recent proliferation of surgical and anesthesiology-related LCAs, extant studies address a miniscule fraction of the numerous services, procedures, and products available today. Methodological heterogeneity, external validity, and a lack of background life cycle inventory data related to many essential surgical and anesthetic inputs are key limitations of the current evidence base. This review provides an indication of the spectrum of environmental impacts associated with surgical and anesthetic care at various scales.

show abstract

“…2008 ), sharps containers ( Grimmond and Reiner 2012 ; McPherson et al. 2019 ), and vaginal specula ( Donahue et al. 2020 ).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Equipment and Materialsmentioning

confidence: 99%

See 1 more Smart Citation

Operating in a Climate Crisis: A State-of-the-Science Review of Life Cycle Assessment within Surgical and Anesthetic Care

Drew

Christie

Tyedmers

et al. 2021

Environ Health Perspect

103

View full text Add to dashboard Cite

show abstract

“…Clinicians can limit their carbon footprint by engaging in evidence-based care, which foregoes unnecessary tests and procedures as exemplified by the Choosing Wisely campaign (https://www.choosingwisely.org/). Clinicians can advocate for hospitals and centers to achieve the following: (1) use clean, renewable energy and work toward carbon neutrality; (2) reduce energy use for heating, humidity, air conditioning, light, ventilation, and other clinical processes with high energy consumption by adopting conservative measures; and (3) cut waste through purchasing items with minimum packaging, using reusable items, recycling, composting, and proper disposing 119,120 . A recent study compared the carbon footprint of metal and disposable specula, with greenhouse gas emissions decreased by ~75% with stainless specula, with a significant decline in end-of-life solid waste generation as well 120 .…”

Section: What Can Clinicians Do To Mitigate These Health Harms?mentioning

confidence: 99%

Climate Change and Pregnancy: Risks, Mitigation, Adaptation, and Resilience

Fan¹,

Zlatnik

2023

Obstetrical &Amp; Gynecological Survey

View full text Add to dashboard Cite

Importance: Climate change is affecting the earth, resulting in more extreme temperatures and weather, rising sea levels, more frequent natural disasters, and displacement of populations of plants and animals, including people and insects. These changes affect food and housing security, vector-borne illnesses, and access to clean air and water, all of which influence human health.Evidence and Results: There are a number of adverse health outcomes linked to heat, air pollution from wildfires, stress from natural disasters, and other elements of climate change. Pregnant people are especially vulnerable to the health harms resulting from climate change, namely, preterm birth, small for gestational age, hypertensive disorders of pregnancy, and other adverse reproductive health and birth outcomes. Strategies to minimize these harms include mitigation and adaptation.Conclusions and Relevance: Physicians are in a unique position to protect the health of pregnant persons and children by advocating for policy changes that address climate change and providing clinical recommendations for patients to protect themselves from the health impacts of climate hazards.Target Audience: Obstetricians and gynecologists, family physicians.Learning objectives: After participating in this activity, physicians should be better able to describe the adverse health effects and pregnancy outcomes associated with elements of climate change; and identify strategies for patients to minimize the health harms from climate change, including mitigation, adaptations, and building resilience. INTRODUCTION: WHY IS CLIMATE CHANGEA PROBLEM FOR HEALTH? Climate change is affecting the earth. We are now seeing more extreme weather and temperatures, rising sea levels, more frequent natural disasters (including wildfires, hurricanes, droughts, and flooding), and displacement of people, animals, insects, and plants around the world. [1][2][3][4] We are seeing a record number of climate-related disasters, with more than 22,000 disasters in the past 50 years, accounting for 45% of disaster-related deaths and 74% of economic losses. 5 Of the natural disasters, droughts, storms, floods, and extreme weather have led to the highest human losses. Climate change also affects food and housing security, vector-borne illness, and access to clean air and water, all of which influence human health. 6 High heat alone is linked to several adverse health outcomes, including stroke, exhaustion, faints, cramps, and, in severe heat, multiorgan dysfunction. 7 M.G.Z. is supported by funding from NIEHS P30-ES030284. This review article was supported in part by the American Academy of Pediatrics and funded in part by a cooperative agreement with the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry (CDC/ATSDR). The US Environmental Protection Agency (EPA) supports the PEHSUs by providing partial funding to CDC/ATSDR through an interagency agreement. The findings and conclusions presented have not been formally disseminated by CDC/ ATSDR or ...

show abstract

“…Whilst CO2 emissions can be decreased in climate-friendly practices, i.e., turning off unused equipment, optimizing freezer temperature and water usage, and using reusable packaging, current recommendations are typically limited to such steps [ 17 ]. Washing and autoclaving materials for reuse should be considered where possible; whilst such procedures produce greenhouse gas emissions, the overall carbon footprint is lower and can further be reduced by sourcing green energy to power autoclaves [ 18 ].…”

mentioning

confidence: 99%