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

ABSTRACT

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.