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1.
Hum Vaccin Immunother ; 20(1): 2335722, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38698759

RESUMO

We provide estimates for (I) annual herpes zoster (HZ) cases, (II) carbon costs related to healthcare utilization, and (III) annual carbon emissions due to HZ among ≥50 years of age (YOA) United States (US) population. We estimated the annual number of HZ cases in the US based on available incidence data and demographic data of individuals ≥50 YOA. Both the healthcare resource utilization (HCRU) associated with HZ cases and the unit carbon dioxide equivalent (i.e. CO2e) costs associated with each type of HCRU in the US were estimated based on literature and studies available online. The carbon footprint associated with HZ annually among US adults ≥50 YOA was estimated by multiplying the unit carbon estimates by the HCRU. In the US population aged ≥50 YOA in 2020 (i.e. approximately 118 million), approximately 1.1 million cases of HZ occur annually assuming no vaccination. Based on 2 sources of HCRU the average kgCO2e per HZ patient ranged from 61.0 to 97.6 kgCO2e, with values by age group ranging from 40.9 kgCO2e in patients aged 50-59 to 195.9 kgCO2e in patients ≥80 YOA. The total annual HZ associated carbon ranged between 67,000 and 107,000 tons of CO2e in the US population aged ≥50 YOA. The impact of HZ on carbon footprint in the US results in considerable greenhouse gas (GHG)emissions. Assuming no vaccination, the burden of HZ is projected to rise over the coming years with the aging populations consequently worsening its impact on GHG emissions. (Figure 1).


Assuntos
Pegada de Carbono , Herpes Zoster , Humanos , Herpes Zoster/epidemiologia , Estados Unidos/epidemiologia , Idoso , Pegada de Carbono/estatística & dados numéricos , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Masculino , Feminino , Incidência , Dióxido de Carbono/análise
2.
Crit Care ; 28(1): 154, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38725060

RESUMO

Healthcare systems are large contributors to global emissions, and intensive care units (ICUs) are a complex and resource-intensive component of these systems. Recent global movements in sustainability initiatives, led mostly by Europe and Oceania, have tried to mitigate ICUs' notable environmental impact with varying success. However, there exists a significant gap in the U.S. knowledge and published literature related to sustainability in the ICU. After a narrative review of the literature and related industry standards, we share our experience with a Green ICU initiative at a large hospital system in Texas. Our process has led to a 3-step pathway to inform similar initiatives for sustainable (green) critical care. This pathway involves (1) establishing a baseline by quantifying the status quo carbon footprint of the affected ICU as well as the cumulative footprint of all the ICUs in the healthcare system; (2) forming alliances and partnerships to target each major source of these pollutants and implement specific intervention programs that reduce the ICU-related greenhouse gas emissions and solid waste; and (3) finally to implement a systemwide Green ICU which requires the creation of multiple parallel pathways that marshal the resources at the grass-roots level to engage the ICU staff and institutionalize a mindset that recognizes and respects the impact of ICU functions on our environment. It is expected that such a systems-based multi-stakeholder approach would pave the way for improved sustainability in critical care.


Assuntos
Unidades de Terapia Intensiva , Humanos , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/tendências , Cuidados Críticos/métodos , Cuidados Críticos/tendências , Desenvolvimento Sustentável/tendências , Pegada de Carbono , Hospitais/tendências , Hospitais/normas , Texas
3.
BMJ Open ; 14(4): e078464, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38688670

RESUMO

OBJECTIVE: Given the demand for net-zero healthcare, the carbon footprint (CF) of healthcare systems has attracted increasing interest in research in recent years. This systematic review investigates the results and methodological transparency of CF calculations of healthcare systems. The methodological emphasis lies specifically on input-output based calculations. DESIGN: Systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. DATA SOURCES: PubMed, Web of Science, EconBiz, Scopus and Google Scholar were initially searched on 25 November 2019. Search updates in PubMed and Web of Science were considered until December 2023. The search was complemented by reference tracking within all the included studies. ELIGIBILITY CRITERIA: We included original studies that calculated and reported the CF of one or more healthcare systems. Studies were excluded if the specific systems were not named or no information on the calculation method was provided. DATA EXTRACTION AND SYNTHESIS: Within the initial search, two independent reviewers searched, screened and extracted information from the included studies. A checklist was developed to extract information on results and methodology and assess the included studies' transparency. RESULTS: 15 studies were included. The mean ratio of healthcare system emissions to total national emissions was 4.9% (minimum 1.5%; maximum 9.8%), and CFs were growing in most countries. Hospital care led to the largest relative share of the total CF. At least 71% of the methodological items were reported by each study. CONCLUSIONS: The results of this review show that healthcare systems contribute substantially to national carbon emissions, and hospitals are one of the main contributors in this regard. They also show that mitigation measures can help reduce emissions over time. The checklist developed here can serve as a reference point to help make methodological decisions in future research reports as well as report homogeneous results.


Assuntos
Pegada de Carbono , Atenção à Saúde , Humanos
4.
Environ Int ; 186: 108632, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38583296

RESUMO

Plastic fragments are widely found in the soil profile of terrestrial ecosystems, forming plastic footprint and posing increasing threat to soil functionality and carbon (C) footprint. It is unclear how plastic footprint affects C cycling, and in particularly permanent C sequestration. Integrated field observations (including 13C labelling) were made using polyethylene and polylactic acid plastic fragments (low-, medium- and high-concentrations as intensifying footprint) landfilling in soil, to track C flow along soil-plant-atmosphere continuum (SPAC). The result indicated that increased plastic fragments substantially reduced photosynthetic C assimilation (p < 0.05), regardless of fragment degradability. Besides reducing C sink strength, relative intensity of C emission increased significantly, displaying elevated C source. Moreover, root C fixation declined significantly from 21.95 to 19.2 mg m-2, and simultaneously root length density, root weight density, specific root length and root diameter and surface area were clearly reduced. Similar trends were observed in the two types of plastic fragments (p > 0.05). Particularly, soil aggregate stability was significantly lowered as affected by plastic fragments, which accelerated the decomposition rate of newly sequestered C (p < 0.05). More importantly, net C rhizodeposition declined averagely from 39.77 to 29.41 mg m-2, which directly led to significant decline of permanent C sequestration in soil. Therefore, increasing plastic footprint considerably worsened C footprint regardless of polythene and biodegradable fragments. The findings unveiled the serious effects of plastic residues on permanent C sequestration across SPAC, implying that current C assessment methods clearly overlook plastic footprint and their global impact effects.


Assuntos
Pegada de Carbono , Plásticos , Solo , Solo/química , Carbono/análise , Atmosfera/química , Ciclo do Carbono , Ecossistema , Plantas , Sequestro de Carbono , Monitoramento Ambiental/métodos
5.
Water Sci Technol ; 89(7): 1741-1756, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38619900

RESUMO

Wastewater treatment plants (WWTPs) have positive and negative impacts on the environment. Therefore, life cycle impact assessment (LCIA) can provide a more holistic framework for performance evaluation than the conventional approach. This study added water footprint (WF) to LCIA and defined ϕ index for accounting for the damage ratio of carbon footprint (CF) to WF. The application of these innovations was verified by comparing the performance of 26 WWTPs. These facilities are located in four different climates in Iran, serve between 1,900 and 980,000 people, and have treatment units like activated sludge, aerated lagoon, and stabilization pond. Here, grey water footprint (GWF) calculated the ecological impacts through typical pollutants. Blue water footprint (BWF) included the productive impacts of wastewater reuse, and CF estimated CO2 emissions from WWTPs. Results showed that GWF was the leading factor. ϕ was 4-7.5% and the average WF of WWTPs was 0.6 m3/ca, which reduced 84%, to 0.1 m³/ca, through wastewater reuse. Here, wastewater treatment and reuse in larger WWTPs, particularly with activated sludge had lower cumulative impacts. Since this method takes more items than the conventional approach, it is recommended for integrated evaluation of WWTPs, mainly in areas where the water-energy nexus is a paradigm for sustainable development.


Assuntos
Águas Residuárias , Purificação da Água , Humanos , Esgotos , Eliminação de Resíduos Líquidos/métodos , Pegada de Carbono
6.
J Environ Manage ; 358: 120936, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38652989

RESUMO

Manure replacing synthetic fertilizer is a viable practice to ensure crop yield and increase soil organic carbon (SOC), but its impact on greenhouse gas (GHG) emissions is inconsistent, thus remains its effect on CF unclear. In this study, a 7-year field experiment was conducted to assess the impact of replacing synthetic fertilizer with manure on crop productivity, SOC sequestration, GHG emissions and crop CF under winter wheat-summer maize cropping system. Five treatments were involved: synthetic nitrogen, phosphorus, and potassium fertilizer (NPK) and 25%, 50%, 75%, and 100% of manure replacing synthetic N (25%M, 50%M, 75%M, and 100%M). Compared with NPK treatment, 25%M and 50%M treatments maintained annual yield (winter wheat plus summer maize) and sustainable yield index (SYI), but 75%M and 100%M treatments significantly decreased annual yield, and 100%M treatment also significantly reduced annual SYI. The SOC content exhibited a significant increasing trend over years in all treatments. After 7 years, SOC storage in manure treatments increased by 3.06-11.82 Mg ha-1 relative to NPK treatment. Manure treatments reduced annual GHG emissions by 14%-60% over NPK treatment. The CF of the cropping system ranged from 0.16 to 0.39 kg CO2 eq kg-1 of grain without considering SOC sequestration, in which the CF of manure treatments lowered by 18%-58% relative to NPK treatment. When SOC sequestration was involved in, the CF varied from -0.39 to 0.37 kg CO2 eq kg-1 of grain, manure treatments significantly reduced the CF by 22%-208% over NPK treatment. It was concluded that replacing 50% of synthetic fertilizer with manure was a sound option for achieving high crop yield and SYI but low CF under the tested cropping system.


Assuntos
Pegada de Carbono , Fertilizantes , Esterco , Solo , Triticum , Zea mays , Zea mays/crescimento & desenvolvimento , Triticum/crescimento & desenvolvimento , Solo/química , Carbono , Estações do Ano , Nitrogênio , Produtos Agrícolas/crescimento & desenvolvimento , Agricultura/métodos , Gases de Efeito Estufa
7.
Br Dent J ; 236(7): 545-551, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38609622

RESUMO

Background Health care is a significant contributor to climate change. Global pressure for a change towards a more sustainable way of providing dental health care has resulted in the creation of the Green Impact Toolkit, which is comprised of a list of suggested changes that dental practices can make to become more sustainable in a number of categories, such as procurement, waste and water.Aims To compare the effectiveness of changes suggested by the Green Impact Toolkit.Materials and methods A comparative life cycle assessment (LCA) was conducted using the Ecoinvent database v3.8 and these data were processed using OpenLCA v1.10.3 software.Results The carbon footprint per patient was significantly reduced after the recommendations were implemented. For instance, using water from a rainwater collection tank instead of the mains supply saved 30 g CO2eq (carbon dioxide equivalents) per patient, a 90% reduction in carbon footprint.Discussion This comparative LCA identified some effective changes which can be easily made by a dental practice. Nevertheless, some actions require some initial financial investment and may be difficult to implement in a busy modern dental practice setting.Conclusion The findings from this study can be used to guide dental practices to making choices which are more sustainable and eco-friendly in the future.


Assuntos
Pegada de Carbono , Água , Humanos , Animais , Software , Estágios do Ciclo de Vida
8.
PLoS One ; 19(4): e0302034, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38635590

RESUMO

Most South Asian countries' economies have grown dramatically during the past few decades. However, in light of their environmental sustainability goals, the quality of such growth performances by South Asian nations is called into doubt by the concurrent degradation in environmental quality. Consequently, reducing the environmental challenges these nations encounter is prioritized on the agendas of the relevant authorities. This study aimed to analyze the effect of the top 11 most polluted countries' levels of financial inclusion, technological innovation, consumption of renewable energy, and adoption of climate technology on environmental deterioration from 2000 to 2022. Therefore, this research aims to use cutting-edge panel data econometric techniques to investigate the factors contributing to high carbon footprints in the world's most polluted nations. The results support an inverted U-shaped relationship between economic growth and carbon footprints, crediting the environmental Kuznets curve concept. In addition, it has been shown that TECH, REC, and CT can reduce carbon footprints in both the short and long term, while GDP and financial inclusion only affect carbon footprints in the long term. The results further endorsed the pollution haven hypothesis by showing that GDP positively affects carbon footprint. As a result, leading polluting economies need to strengthen their financial sectors, create green technology, migrate to renewable energy, and limit financial inclusion to improve environmental quality.


Assuntos
Desenvolvimento Econômico , Tecnologia , Humanos , Energia Renovável , Povo Asiático , Pegada de Carbono , Dióxido de Carbono
9.
Singapore Med J ; 65(4): 204-210, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38650058

RESUMO

ABSTRACT: Climate change is an existential threat to humanity. While the healthcare sector must manage the health-related consequences of climate change, it is a significant contributor to greenhouse gas emissions, responsible for up to 4.6% of global emission, aggravating global warming. Within the hospital environment, the three largest contributors to greenhouse gas emissions are the operating theatre, intensive care unit and gastrointestinal endoscopy. Knowledge of the health-related burden of climate change and the potential transformative health benefits of climate action is important to all health professionals, as they play crucial roles in effecting change. This article summarises the available literature on the impact of healthcare on climate change and efforts in mitigation, focusing on the intrinsic differences and similarities across the operating theatre complex, intensive care unit and gastrointestinal endoscopy unit. It also discusses strategies to reduce carbon footprint.


Assuntos
Pegada de Carbono , Mudança Climática , Humanos , Gases de Efeito Estufa , Unidades de Terapia Intensiva , Atenção à Saúde , Salas Cirúrgicas , Endoscopia Gastrointestinal , Aquecimento Global , Conservação dos Recursos Naturais , Efeito Estufa
10.
Sci Adv ; 10(15): eadh1077, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38598638

RESUMO

Achieving sustainable dietary change is essential for safeguarding human and environmental health. However, dietary recommendations based on broad food groups may not accurately reflect real-world realities because individuals select and consume dishes with multiple food items influenced by diverse context-specific factors. Therefore, here we explored the sustainability trade-offs of dietary choices at the dish level through an optimization modeling approach tested in Japan. We estimated the nutritional quality, price, and carbon footprint of major Japanese dishes and examined 16 dietary scenarios to identify options that meet the nutritional requirements and minimize carbon footprint. Overall, mixed diets contain more combinations of dishes that meet nutritional requirements with lower carbon footprints compared to more restrictive dietary scenarios. We argue that the approach developed here enables a better understanding of dietary trade-offs, complements existing methods, and helps identify sustainable diets by offering nuanced information at the national and sub-national levels.


Assuntos
Pegada de Carbono , Dieta , Humanos , Alimentos , Necessidades Nutricionais , Nutrientes
11.
Glob Chang Biol ; 30(4): e17277, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38634544

RESUMO

More than half of the world's population is nourished by crops fertilized with synthetic nitrogen (N) fertilizers. However, N fertilization is a major source of anthropogenic emissions, augmenting the carbon footprint (CF). To date, no global quantification of the CF induced by N fertilization of the main grain crops has been performed, and quantifications at the national scale have neglected the CO2 assimilated by plants. A first cradle-to-grave life cycle assessment was performed to quantify the CF of the N fertilizers' production, transportation, and application to the field and the uses of the produced biomass in livestock feed and human food, as well as biofuel production. We quantified the direct and indirect inventories emitted or sequestered by N fertilization of main grain crops: wheat, maize, and rice. Grain food produced with N fertilization had a net CF of 7.4 Gt CO2eq. in 2019 after excluding the assimilated C in plant biomass, which accounted for a quarter of the total CF. The cradle (fertilizer production and transportation), gate (fertilizer application, and soil and plant systems), and grave (feed, food, biofuel, and losses) stages contributed to the CF by 2%, 11%, and 87%, respectively. Although Asia was the top grain producer, North America contributed 38% of the CF due to the greatest CF of the grave stage (2.5 Gt CO2eq.). The CF of grain crops will increase to 21.2 Gt CO2eq. in 2100, driven by the rise in N fertilization to meet the growing food demand without actions to stop the decline in N use efficiency. To meet the targets of climate change, we introduced an ambitious mitigation strategy, including the improvement of N agronomic efficiency (6% average target for the three crops) and manufacturing technology, reducing food losses, and global conversion to healthy diets, whereby the CF can be reduced to 5.6 Gt CO2eq. in 2100.


Assuntos
Pegada de Carbono , Nitrogênio , Humanos , Fertilizantes/análise , Biocombustíveis , Agricultura , Solo , Produtos Agrícolas , Grão Comestível/química , China , Carbono/análise
12.
Stud Health Technol Inform ; 313: 81-86, 2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38682509

RESUMO

BACKGROUND: Telemedicine has emerged as a potential solution to mitigate the significant greenhouse gas emissions of the healthcare sector. A comprehensive evaluation is required to quantify the environmental benefits of its implementation. OBJECTIVES: The study aims to compare the environmental sustainability of in-person and virtual examinations for heart failure patients. METHODS: A standard life cycle assessment has been applied to quantify the equivalent CO2 of direct and indirect activities required to release a medical examination (virtual or physical) for a patient in an Italian hospital. Inputs of the analysis include electronic devices of hospital and patients, energy consumption, wastes, internet usage and patient travel. Depending on the type of visit (virtual or physical), inputs have been processed differently, considering actual consumption and utilization. RESULTS: Televisit reduces emissions from 9.77 kgCO2e to 0.41 kgCO2e. Transport and internet data use are key inputs for in-person (i.e., 98%) and telemedicine visits (i.e., 72%), respectively. DISCUSSION: Given the frequent car travels, telemedicine emerges as a tool to improve environmental benefits and reduce time for patients and caregivers.


Assuntos
Telemedicina , Humanos , Itália , Insuficiência Cardíaca/terapia , Pegada de Carbono , Dióxido de Carbono/análise
14.
Proc Natl Acad Sci U S A ; 121(15): e2318425121, 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38557182

RESUMO

Corrugated packaging for express grew by 90 times to 16.5 Mt y-1 in China, where 81% of recent global express delivery growth occurred. However, the environmental impacts of production, usage, disposal, and recycling of corrugated boxes under the entire supply chain remain unclear. Here, we estimate the magnitudes, drivers, and mitigation potentials of cradle-to-grave life-cycle carbon footprint (CF) and three colors of water footprints (WFs) for corrugated cardboard packaging in China. Over 2007 to 2021, CF, blue and gray WFs per unit package decreased by 45%, 60%, and 84%, respectively, while green WF increased by 23% with growing imports of virgin pulp and China's waste ban. National total CF and WFs were 21 to 102 folded with the scale effects. Only a combination of the supply chain reconstruction, lighter single-piece packaging, and increased recycling rate can possibly reduce the environmental footprints by 24 to 44% by 2035.


Assuntos
Carbono , Água , Pegada de Carbono , Reciclagem , China
15.
Environ Sci Technol ; 58(17): 7325-7334, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38621688

RESUMO

Carbon footprint assessment of retail is necessary to optimize procurement strategies and adopt sustainable shopping habits. However, estimating carbon footprints is a complex task, given the diversity of existing distribution channels. Average values for carbon emissions of "conventional" retail (i.e., purchasing and receiving the product directly at the physical point of sale) found in most studies mask a heterogeneous reality: different retail strategies entail diverse shopping behavior for consumers, as well as varied procurement processes for outlets. In this paper, we propose a methodology to assess greenhouse gas (GHG) impacts of different distribution systems related to the consumption of goods in the Paris Region by coupling traditional transport modeling with a life-cycle assessment (LCA) approach. We model and compare six distribution systems, including five traditional retail formats (hypermarkets, supermarkets, small generalist retail, small food retail, and small nonfood retail) and E-commerce home deliveries. Our model includes warehouse activity, shop and home delivery, shop energy consumption, consumer mobility, and goods packaging. Overall, we conclude that E-commerce emits fewer GHG emissions than retail outlets per kilogram of product purchased. This result is in line with the existing literature on the topic. However, the carbon footprint varies greatly within the case study depending on the characteristics of the logistics procurement processes of outlets, the behavior of shoppers, and spatial characteristics.


Assuntos
Pegada de Carbono , Comércio , Gases de Efeito Estufa , Paris , Gases de Efeito Estufa/análise
16.
Lancet Gastroenterol Hepatol ; 9(6): 550-563, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38554732

RESUMO

Gastrointestinal practices, especially endoscopy, have a substantial environmental impact, marked by notable greenhouse gas emissions and waste generation. As the world struggles with climate change, there emerges a pressing need to re-evaluate and reform the environmental footprint within gastrointestinal medicine. The challenge lies in finding a harmonious balance between ensuring clinical effectiveness and upholding environmental responsibility. This task involves recognising that the most significant reduction in the carbon footprint of endoscopy is achieved by avoiding unnecessary procedures; addressing the use of single-use endoscopes and accessories; and extending beyond the procedural suites to include clinics, virtual care, and conferences, among other aspects of gastrointestinal practice. The emerging digital realm in health care is crucial, given the potential environmental advantages of virtual gastroenterological care. Through an in-depth analysis, this review presents a path towards sustainable gastrointestinal practices, emphasising integrated strategies that prioritise both patient care and environmental stewardship.


Assuntos
Pegada de Carbono , Mudança Climática , Humanos , Endoscopia Gastrointestinal , Gastroenterologia
17.
J Med Internet Res ; 26: e53437, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38536065

RESUMO

BACKGROUND: Digital health and telemedicine are potentially important strategies to decrease health care's environmental impact and contribution to climate change by reducing transportation-related air pollution and greenhouse gas emissions. However, we currently lack robust national estimates of emissions savings attributable to telemedicine. OBJECTIVE: This study aimed to (1) determine the travel distance between participants in US telemedicine sessions and (2) estimate the net reduction in carbon dioxide (CO2) emissions attributable to telemedicine in the United States, based on national observational data describing the geographical characteristics of telemedicine session participants. METHODS: We conducted a retrospective observational study of telemedicine sessions in the United States between January 1, 2022, and February 21, 2023, on the doxy.me platform. Using Google Distance Matrix, we determined the median travel distance between participating providers and patients for a proportional sample of sessions. Further, based on the best available public data, we estimated the total annual emissions costs and savings attributable to telemedicine in the United States. RESULTS: The median round trip travel distance between patients and providers was 49 (IQR 21-145) miles. The median CO2 emissions savings per telemedicine session was 20 (IQR 8-59) kg CO2). Accounting for the energy costs of telemedicine and US transportation patterns, among other factors, we estimate that the use of telemedicine in the United States during the years 2021-2022 resulted in approximate annual CO2 emissions savings of 1,443,800 metric tons. CONCLUSIONS: These estimates of travel distance and telemedicine-associated CO2 emissions costs and savings, based on national data, indicate that telemedicine may be an important strategy in reducing the health care sector's carbon footprint.


Assuntos
Telemedicina , Viagem , Estados Unidos , Humanos , Telemedicina/estatística & dados numéricos , Telemedicina/métodos , Telemedicina/economia , Viagem/estatística & dados numéricos , Estudos Retrospectivos , Dióxido de Carbono/análise , Poluição do Ar , Pegada de Carbono/estatística & dados numéricos
18.
J Cardiothorac Vasc Anesth ; 38(6): 1314-1321, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38490897

RESUMO

OBJECTIVES: To quantify and compare the emissions for deep sedation with total intravenous anesthesia (TIVA) and general anesthesia with inhaled agents during the transcatheter aortic valve replacement procedure. DESIGN: A retrospective study. SETTING: A tertiary hospital in Boston, Massachusetts. PARTICIPANTS: The anesthesia records of 604 consecutive patients who underwent the transcatheter aortic valve replacement procedure between January 1, 2018, and March 31, 2022, were reviewed and analyzed. INTERVENTIONS: Data were examined and compared in the following 2 groups: general anesthesia with inhaled agents and deep sedation with TIVA. MEASUREMENTS AND MAIN RESULTS: The gases, drugs, airway management devices, and anesthesia machine electricity were collected and converted into carbon dioxide emissions (CO2e). The carbon emissions of intravenous medications were converted with the CO2e data for anesthetic pharmaceuticals from the Parvatker et al. study. For inhaled agents, inhaled anesthetics and oxygen/air flow rate were collected at 15-minute intervals and calculated using the anesthetic gases calculator provided by the Association of Anesthetists. The airway management devices were converted based on life-cycle assessments. The electricity consumed by the anesthesia machine during general anesthesia was estimated from the manufacturer's data (Dräger, GE) and local Energy Information Administration data. The data were analyzed in the chi-squared test or Wilcoxon rank-sum test. There were no significant differences in the patients' demographic characteristics, such as age, sex, weight, height, and body mass index. The patients who received general anesthesia with inhaled agents had statistically higher total CO2e per case than deep sedation with TIVA (16.188 v 1.518 kg CO2e; p < 0.001), primarily due to the inhaled agents and secondarily to airway management devices. For deep sedation with TIVA, the major contributors were intravenous medications (71.02%) and airway management devices (16.58%). A subgroup study of patients who received sevoflurane only showed the same trend with less variation. CONCLUSIONS: The patients who received volatile anesthesia were found to have a higher CO2e per case. This difference remained after a subgroup analysis evaluating those patients only receiving sevoflurane and after accounting for the differences in the duration of anesthesia. Data from this study and others should be collectively considered as the healthcare profession aims to provide the best care possible for their patients while limiting the harm caused to the environment.


Assuntos
Anestesia por Inalação , Anestesia Intravenosa , Pegada de Carbono , Substituição da Valva Aórtica Transcateter , Humanos , Estudos Retrospectivos , Masculino , Feminino , Idoso , Anestesia por Inalação/métodos , Idoso de 80 Anos ou mais , Anestesia Intravenosa/métodos , Substituição da Valva Aórtica Transcateter/métodos , Anestésicos Inalatórios/administração & dosagem
19.
Environ Sci Pollut Res Int ; 31(18): 27192-27202, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38509310

RESUMO

Increased global attention is being paid to the food-health-climate trilemma. In this study, we evaluate the climate impacts of Mexico's food consumption patterns by creating a high-resolution (262 sectors) Environmentally Extended Input-Output (EEIO) model called MXEEIO. We focus on the differences between food away from home (FAFH) and food at home (FAH) and compare Mexico's results with those of the USA. The results show that the main components of food spending in Mexico were meat, baked products, and beverages, raising concerns about their potential negative health effects if consumed excessively. Mexico's total greenhouse gas (GHG) emissions from food consumption were estimated at 149 million metric tons (MMT) in 2013, as opposed to 797 MMT for the USA. Meat and dairy products were the main contributors to Mexico's food-related GHG emissions, accounting for 57% of total emissions. Mexico spent a much smaller proportion of food-related income on FAFH than the USA (13% vs. 52%), suggesting great potential for growth as Mexico's per capita GDP continues to rise. Detailed contribution analysis shows that reducing Mexico's food-related GHG emissions would benefit most from a transition to low-carbon cattle farming, but mitigation efforts in other sectors such as crop cultivation and electricity generation are also important. Overall, our study underscores the significance of food-related GHG emissions in Mexico, especially those from meat and dairy products, and the mitigation challenges these sectors face.


Assuntos
Pegada de Carbono , Gases de Efeito Estufa , México , Gases de Efeito Estufa/análise , Humanos , Modelos Teóricos , Alimentos
20.
J Environ Manage ; 355: 120455, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38437745

RESUMO

Mitigation actions in all sectors of society, including sports, to limit global warming have become an increasingly hot topic in public discussions and sports management. However, so far, there has been a lack of understanding and practical examples of how these organizations, especially in team sports, can holistically assess and reduce their climate impacts to achieve carbon neutrality. This paper presents a carbon footprint assessment, implemented actions for GHG emission reduction, and offers the example of a professional Finnish ice hockey team that achieved carbon neutrality. The study is based on a life cycle assessment method. The Results show that the team's carbon footprint was reduced from 350 tCO2eq by more than 50% between seasons 2018-2019 and 2021-2022 in the assessed categories. The most GHG emission reductions were achieved in the team's and spectators' mobility and ice hall energy consumption. Furthermore, the team compensated for their remaining emissions to achieve carbon neutrality. Multiple possibilities for further GHG emission reductions were recognized. The majority of the GHG emissions were linked to the Scope 3 category, indicating that co-operation with partners and stakeholders was a key to success in attaining carbon neutrality. This paper also discusses the possible limitations and challenges that sport organizations face in assessing climate impacts and reducing GHG emissions, as well as the prospects of overcoming them. Since there are many opportunities for sports to contribute to climate change mitigation, relevant targets and actions to reduce GHG emissions should be integrated into all sport organizations' management.


Assuntos
Pegada de Carbono , Hóquei , Humanos , Efeito Estufa , Finlândia , Carbono
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