Targeted intervention to achieve waste reduction in gastrointestinal endoscopy

• Published in: Gut Vol. 72; no. 2; pp. 306 - 313
• Main Authors: Cunha Neves, João A, Roseira, Joana, Queirós, Patrícia, Sousa, Helena Tavares, Pellino, Gianluca, Cunha, Miguel F
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and British Society of Gastroenterology 01.02.2023; BMJ Publishing Group LTD
• Subjects: Body fluids; Carbon dioxide; Carbon footprint; Colonoscopy; Endoscopy; Endoscopy, Gastrointestinal; Environmental impact; Hospitals; Humans; Landfill; Medical Waste - prevention & control; Medical wastes; Nursing; Prospective Studies; Recycling; Registration; Seminars; Waste Disposal Facilities; endoscopy
• ISSN: 0017-5749; 1468-3288
• DOI: 10.1136/gutjnl-2022-327005

ObjectiveEndoscopy is healthcare’s third largest generator of medical waste in hospitals. This prospective study aimed to measure a single unit’s waste carbon footprint and perform a pioneer intervention towards a more sustainable endoscopy practice. The relation of regulated medical waste (RMW; material fully contaminated with blood or body fluids or containing infectious agents) versus landfill waste (non-recyclable material not fully contaminated) may play a critical role.DesignIn a four-stage prospective study, following a 4-week observational audit with daily weighing of both waste types (stage 1), stage 2 consisted of a 1-week intervention with team education of waste handling. Recycling bins were placed in endoscopy rooms, landfill and RMW bins were relocated. During stages 3 (1 month after intervention) and 4 (4 months after intervention), daily endoscopic waste was weighed. Equivalence of 1 kg of landfill waste to 1 kg carbon dioxide equivalent (CO2e) and 1 kg of RMW to 3kgCO2e was assumed. Paired samples t-tests for comparisons.ResultsFrom stage 1 to stage 3, mean total waste and RMW were reduced by 12.9% (p=0.155) and 41.4% (p=0.010), respectively, whereas landfill (p=0.059) and recycling waste increased (paper: p=0.001; plastic: p=0.007). While mean endoscopy load was similar (46.2 vs 44.5, p=0.275), a total decrease of CO2e by 31.6% (138.8kgCO2e) was found (mean kgCO2e109.7 vs 74.9, p=0.018). The annual reduction was calculated at 1665.6kgCO2e. All these effects were sustained 4 months after the intervention (stage 4) without objections by responsible endoscopy personnel.ConclusionIn this interventional study, applying sustainability measures to a real-world scenario, RMW reduction and daily recycling were achieved and sustained over time, without compromising endoscopy productivity.