ENVIRONMENTAL FOOTPRINT AND MATERIAL COMPOSITION COMPARISON OF SINGLE-USE AND REUSABLE DUODENOSCOPES.

BACKGROUND: Infection outbreaks associated with contaminated reusable duodenoscopes (RDs) have induced the development of novel single-use duodenoscopes (SDs). This study aims to analyse the material composition and life cycle assessment (LCA) of RDs and SDs to assess the sustainability of global and partial SD implementation. METHODS: A single-centre study evaluated material composition analysis and LCA of one RD and two SDs from different manufacturers (A, B). Material composition analysis was performed to evaluate the thermochemical properties of the duodenoscope components. Carbon footprint was calculated using environmental software. We compared the sustainability strategies of universal use of RDs, frequent use of RDs with occasional SDs, and universal use of SDs over the lifetime of one RD. RESULTS: RDs were substantially heavier (3489 g) than SD-A (943 g) and SD-B (715.5 g). RDs were mainly metallic alloys (95%), whereas SDs were mainly plastic polymers and resins (70-81%). The LCA demonstrated the sustainability of RDs, with a lifecycle carbon footprint 62-82 times lower compared to the universal use of SDs (151.7 vs. 10512-12640 kg CO2-eq) and 10 times lower compared to the occasional use of SDs (151.7 vs. 1417.3-1676.6 kg CO2-eq). Differences were observed between SD-A and SD-B (7.9 vs. 6.6 kg CO2-eq per endoscope). End-of-life incineration emissions for SDs were the most environmental contributors. CONCLUSIONS: Widespread adoption of SD has greater environmental challenges; it requires a balance between infection control and environmental responsibility. Carbon footprint labelling can help healthcare institutions make sustainable choices and promote environmentally responsible healthcare practices.

Perspectives and awareness of endoscopy healthcare professionals on sustainable practices in gastrointestinal endoscopy: results of the LEAFGREEN survey.

BACKGROUND: Gastrointestinal (GI) endoscopy is one of healthcare's main contributors to climate change. We aimed to assess healthcare professionals' attitudes and the perceived barriers to implementation of sustainable GI endoscopy. METHODS: The LEAFGREEN web-based survey was a cross-sectional study conducted by the European Society of Gastrointestinal Endoscopy (ESGE) Green Endoscopy Working Group. The questionnaire comprised 39 questions divided into five sections (respondent demographics; climate change and sustainability beliefs; waste and resource management; single-use endoscopes and accessories; education and research). The survey was available via email to all active members of the ESGE and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) in March 2023. RESULTS: 407 respondents participated in the survey (11% response rate). Most participants (86%) agreed climate change is real and anthropogenic, but one-third did not consider GI endoscopy to be a significant contributor to climate change. Improvement in the appropriateness of endoscopic procedures (41%) and reduction in single-use accessories (34%) were considered the most important strategies to reduce the environmental impact of GI endoscopy. Respondents deemed lack of institutional support and knowledge from staff to be the main barriers to sustainable endoscopy. Strategies to reduce unnecessary GI endoscopic procedures and comparative studies of single-use versus reusable accessories were identified as research priorities. CONCLUSIONS: In this survey, ESGE and ESGENA members acknowledge climate change as a major threat to humanity. Further improvement in sustainability beliefs and professional attitudes, reduction in inappropriate GI endoscopy, and rational use of single-use accessories and endoscopes are critically required.

Materials Science Toolkit for Carbon Footprint Assessment: A Case Study for Endoscopic Accessories of Common Use.

Ironically, healthcare systems are key agents in respiratory-related diseases and estimated deaths because of the high impact of their greenhouse gas emissions, along with industry, transportation, and housing. Based on safety requirements, hospitals and related services use an extensive number of consumables, most of which end up incinerated at the end of their life cycle. A thorough assessment of the carbon footprint of such devices typically requires knowing precise information about the manufacturing process, which is rarely available in detail because of the many materials, pieces, and steps involved during the fabrication. Yet, the tools most often used for determining the environmental impact of consumer goods require a bunch of parameters, mainly based on the material composition of the device. Here, we report a basic set of analytical methods that provide the information required by the software OpenLCA to calculate the main outcome related to environmental impact, greenhouse gas emissions. Through thermogravimetry, calorimetry, infrared spectroscopy, and elemental analysis, we proved that obtaining relevant data for the calculator in the exemplifying case of endoscopy tooling or accessories is possible. This routine procedure opens the door to a broader, more accurate analysis of the environmental impact of everyday work at hospital services, offering potential alternatives to minimize it.