Environmental impacts of Australia's largest health system

Malik, Arunima; Padget, Michael; Carter, Sarah; Wakiyama, Takako; Maitland-Scott, Isis; Vyas, Aditya; Boylan, Sinéad; Mulcahy, Georgina; Li, Mengyu; Lenzen, Manfred; Charlesworth, Kate; Geschke, Arne

doi:10.1016/j.resconrec.2021.105556

Cited by 28 publications

(14 citation statements)

References 38 publications

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“…This indicator provides a quantitative assessment of the total (direct plus indirect) CO 2 -equivalent emissions embodied in Australia's health system. This indicator builds on previous work 88,89 by constructing a time series of subnational multiregional tables from 2015 to 2017, featuring all Australian jurisdictions. As such, the findings presented in this indicator are based on different input-output databases from the ones used by previous studies in this space.…”

Section: Mitigation In the Health Care Sectormentioning

confidence: 99%

“…Australia's health system accounts for about 5.5% of the country's greenhouse gas emissions. 89 Multiple studies assessing the environmental impacts of health systems identify hospitals, pharmaceuticals and medicinal goods as key contributors for the bulk of the emissions of the health system 90,91 (Supporting Information 3.10).…”

Section: Mitigation In the Health Care Sectormentioning

confidence: 99%

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The 2021 report of theMJA–LancetCountdown on health and climate change: Australia increasingly out on a limb

Beggs

Zhang

McGushin

et al. 2021

Medical Journal of Australia

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Hobart) that exceeded the moderate, high and extreme Heat Stress Risk threshold as defined by the 2021 Sports Medicine Australia Extreme Heat Policy 13 2 Annual number of National Aerial Firefighting Centre (NAFC) aircraft services and volunteer firefighters and support staff in Australia from 2007-08 to 2020-21 NAFC aircraft services represent the number of aircraft in Australia available to fight bushfires. It should be noted that some aircraft double up for the north and south of the country; for example, an aircraft may run in Queensland then move to Tasmania as a separate service. A service is usually exclusive to NAFC use, mostly for 84 or 96 days each summer (some services run longer). Data sources: NAFC and Australian Government Productivity Commission. ◆ MJA 215 (9) ▪

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Section: Mitigation In the Health Care Sectormentioning

confidence: 99%

Section: Mitigation In the Health Care Sectormentioning

confidence: 99%

The 2021 report of theMJA–LancetCountdown on health and climate change: Australia increasingly out on a limb

Beggs

Zhang

McGushin

et al. 2021

Medical Journal of Australia

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“…A recent Australian study by Malik et al investigating the carbon footprint caused by the whole health system of the state of New South Wales found that pathology and diagnostic imaging together accounted for approximately 9% of this healthcare footprint, 8 with the demand for imaging services per 100 people in Australia increasing by 9% over a five-year period. 9 The carbon impacts of pathology testing have been reported, 10 , 11 but to date there has not been a detailed analysis of the carbon impacts of the most commonly used diagnostic imaging modalities using a standard methodology.…”

Section: Introductionmentioning

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 Australia, unnecessary Vitamin D testing (> 3 million tests per year) cost Medicare more than $87 million in 2020 and a carbon burden equivalent to 28,000–42,000 kg CO 2 e or driving approximately 160,000–230,000 km in a standard, petrol-fueled, passenger car, yet provided no net health benefit for patients [ 21 ]. Lastly, pathology and diagnostic imaging account for approximately 9% of healthcare’s carbon footprint in Australia [ 22 ]. Opportunities for intervening in this context include turning off scanners to reduce emissions from standby power and reducing ordering of unnecessary imaging or substituting high-impact imaging (e.g., MRI and CT) with lower-impact imaging (e.g., X-Ray and ultrasound) to reduce carbon and costs [ 15 ].…”

mentioning

confidence: 99%

“…Despite the recent emergence of multiple studies estimating the carbon footprint of clinical activity and suggesting emissions reduction strategies via behaviour change [ 22 , 33 , 34 ], no reviews, to our knowledge, have explored the effectiveness of implemented behavioural change interventions, targeting clinicians, to reduce carbon emissions in health settings. To design and implement effective carbon reduction interventions in clinical care in the future, it is essential to identify and understand the nature and scope of existing initiatives internationally and the impact of those interventions have had on healthcare emissions.…”

mentioning

confidence: 99%

Behavioural change interventions encouraging clinicians to reduce carbon emissions in clinical activity: a systematic review

Batcup

Breth-Petersen

Dakin

et al. 2023

BMC Health Serv Res

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Background Clinical activity accounts for 70–80% of the carbon footprint of healthcare. A critical component of reducing emissions is shifting clinical behaviour towards reducing, avoiding, or replacing carbon-intensive healthcare. The objective of this systematic review was to find, map and assess behaviour change interventions that have been implemented in healthcare settings to encourage clinicians to reduce greenhouse gas emissions from their clinical activity. Methods Studies eligible for inclusion were those reporting on a behaviour change intervention to reduce carbon emissions via changes in healthcare workplace behaviour. Six databases were searched in November 2021 (updated February 2022). A pre-determined template was used to extract data from the studies, and risk of bias was assessed. The behaviour change techniques (BCTs) used in the interventions were coded using the BCT Taxonomy. Results Six full-text studies were included in this review, and 14 conference abstracts. All studies used a before-after intervention design. The majority were UK studies (n = 15), followed by US (n = 3) and Australia (n = 2). Of the full-text studies, four focused on reducing the emissions associated with anaesthesia, and two aimed at reducing unnecessary test ordering. Of the conference abstracts, 13 focused on anaesthetic gas usage, and one on respiratory inhalers. The most common BCTs used were social support, salience of consequences, restructuring the physical environment, prompts and cues, feedback on outcome of behaviour, and information about environmental consequences. All studies reported success of their interventions in reducing carbon emissions, prescribing, ordering, and financial costs; however, only two studies reported the magnitude and significance of their intervention’s success. All studies scored at least one item as unclear or at risk of bias. Conclusion Most interventions to date have targeted anaesthesia or pathology test ordering in hospital settings. Due to the diverse study outcomes and consequent inability to pool the results, this review is descriptive only, limiting our ability to conclude the effectiveness of interventions. Multiple BCTs were used in each study but these were not compared, evaluated, or used systematically. All studies lacked rigour in study design and measurement of outcomes. Review registration The study was registered on Prospero (ID number CRD42021272526) (Breth-Petersen et al., Prospero 2021: CRD42021272526).

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Environmental impacts of Australia's largest health system

Cited by 28 publications

References 38 publications

The 2021 report of theMJA–LancetCountdown on health and climate change: Australia increasingly out on a limb

The 2021 report of theMJA–LancetCountdown on health and climate change: Australia increasingly out on a limb

The carbon footprint of hospital diagnostic imaging in Australia

Behavioural change interventions encouraging clinicians to reduce carbon emissions in clinical activity: a systematic review

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