Estimated Global Disease Burden From US Health Care Sector Greenhouse Gas Emissions.

An up-to-date assessment of environmental emissions in the US health care sector is essential to help policy makers hold the health care industry accountable to protect public health. We update national-level US health-sector emissions. We also estimate state-level emissions for the first time and examine associations with state-level energy systems and health care quality and access metrics. Economywide modeling showed that US health care greenhouse gas emissions rose 6percent from 2010 to 2018, reaching 1,692 kg per capita in 2018-the highest rate among industrialized nations. In 2018 greenhouse gas and toxic air pollutant emissions resulted in the loss of 388,000 disability-adjusted life-years. There was considerable variation in state-level greenhouse gas emissions per capita, which were not highly correlated with health system quality. These results suggest that the health care sector's outsize environmental footprint can be reduced without compromising quality. To reduce harmful emissions, the health care sector should decrease unnecessary consumption of resources, decarbonize power generation, and invest in preventive care. This will likely require mandatory reporting, benchmarking, and regulated accountability of health care organizations.

<scp>AORN</scp> Position Statement on Environmental Responsibility

Given adverse health effects of climate change and contributions of the US health care sector to greenhouse gas (GHG) emissions, environmentally sustainable delivery of care is needed. We applied life cycle assessment to quantify GHGs associated with processing a gastrointestinal biopsy in order to identify emissions hotspots and guide mitigation strategies. The biopsy process at a large academic pathology laboratory was grouped into steps. Each supply and reagent was catalogued and postuse treatment noted. Energy consumption was estimated for capital equipment. Two common scenarios were considered: 1 case with 1 specimen jar (scenario 1) and 1 case with 3 specimen jars (scenario 2). Scenario 1 generated 0.29 kg of carbon dioxide equivalents (kg CO2e), whereas scenario 2 resulted in 0.79 kg CO2e-equivalent to 0.7 and 2.0 miles driven, respectively. The largest proportion of GHGs (36%) in either scenario came from the tissue processor step. The second largest contributor (19%) was case accessioning, mostly attributable to production of single-use disposable jars. Applied to more than 20 million biopsies performed in the US annually, emissions from biopsy processing is equivalent to yearly GHG emissions from 1,200 passenger cars. Mitigation strategies may include modification of surveillance guidelines to include the number of specimen jars.

The Negative Bidirectional Interaction Between Climate Change and the Prevalence and Care of Liver Disease: A Joint BSG, BASL, EASL, and AASLD Commentary

Effect of Radiation Schedule on Transportation-Related Carbon Emissions: A Case Study in Rectal Cancer

Aluminum production is a major energy consumer and important source of greenhouse gas (GHG) emissions globally. Estimation of the energy consumption and GHG emissions caused by aluminum production in China has attracted widespread attention because China produces more than half of the global aluminum. This paper conducted life cycle (LC) energy consumption and GHG emissions analysis of primary and recycled aluminum in China for the year 2020, considering the provincial differences on both the scale of self-generated electricity consumed in primary aluminum production and the generation source of grid electricity. Potentials for energy saving and GHG emissions reductions were also investigated. The results indicate that there are 157,207 MJ of primary fossil energy (PE) consumption and 15,947 kg CO2-eq of GHG emissions per ton of primary aluminum ingot production in China, with the LC GHG emissions as high as 1.5–3.5 times that of developed economies. The LC PE consumption and GHG emissions of recycled aluminum are very low, only 7.5% and 5.3% that of primary aluminum, respectively. Provincial-level results indicate that the LC PE and GHG emissions intensities of primary aluminum in the main production areas are generally higher while those of recycled aluminum are lower in the main production areas. LC PE consumption and GHG emissions can be significantly reduced by decreasing electricity consumption, self-generated electricity management, low-carbon grid electricity development, and industrial relocation. Based on this study, policy suggestions for China’s aluminum industry are proposed. Recycled aluminum industry development, restriction of self-generated electricity, low-carbon electricity utilization, and industrial relocation should be promoted as they are highly helpful for reducing the LC PE consumption and GHG emissions of the aluminum industry. In addition, it is recommended that the central government considers the differences among provinces when designing and implementing policies.

Climate And Health.

This study estimates the reduction in greenhouse gas (GHG) emissions resulting from 840 telemedicine consultations completed in a 6-month time period. Our model considers GHG emissions for both vehicle and videoconferencing unit energy use. Cost avoidance factors are also discussed. Travel distances in kilometers were calculated for each appointment using postal code data and Google Maps™ Web-based map calculator tools. Including return travel, an estimated 757,234 km were avoided, resulting in a GHG emissions savings of 185,159 kg (185 metric tons) of carbon dioxide equivalents in vehicle emissions. Approximately 360,444 g of other air pollutant emissions was also avoided. The GHG emissions produced by energy consumption for videoconference units were estimated to be 42 kg of carbon dioxide equivalents emitted for this sample. The overall GHG emissions associated with videoconferencing unit energy is minor when compared with those avoided from vehicle use. In addition to improved patient-centered care and cost savings, environmental benefits provide additional incentives for the adoption of telemedicine services.

Life cycle assessment of primary energy demand and greenhouse gas (GHG) emissions of four propylene production pathways in China

Total Intravenous Anesthetic Versus Inhaled Anesthetic: Pick Your Poison.

The US health care sector accounts for about 8.5% of national greenhouse gas (GHG) emissions. Reliable estimates of emissions associated with health care-related travel are essential for informing policy changes. To generate a comprehensive national estimate of carbon emissions due to patient health care-related travel in the US. This cross-sectional study used data from the 2022 National Household Travel Survey (NHTS), conducted from January 2022 to January 2023. Participants were selected using an address-based sample from the US Postal Service Delivery Sequence File. Participating households reported all trips taken within 24 hours by all household members aged 5 years or older. Approximate emissions per mile were obtained from typical vehicle emissions data provided by US government institutions. Data were analyzed between March 11 and May 29, 2024. Estimated annual CO2 equivalent (CO2e) emissions from patient health care-related travel per year, per patient, per trip, and per mile. A survey-weighted λ regression analysis was used to identify factors associated with higher CO2e emissions per trip. An alternative scenario analysis estimated reductions if 30% or 50% of private vehicle users switched to electric vehicles. The sample included 16 997 participants with a weighted total of 3 506 325 536 US health care trips. Of these trips, 52.0% were reported by female travelers, 80.1% were made in urban areas, and 19.9% were made in rural areas. These trips accounted for 84 057 963 340 miles, resulting in weighted annual estimated emissions of 35.7 megatons (Mt) (95% CI, 27.5-43.9 Mt) CO2e. Each mile traveled generated an estimated 424 g (95% CI, 418-428 g) CO2e. Emissions per trip were higher (exponentiated coefficient [exp(β)], 2.19; 95% CI, 1.51-2.86; P < .001) for rural patients compared with urban patients. However, 69.3% of emissions were attributable to urban patients and 30.7% to rural patients. Patients with annual median household incomes of $50 000 to $99 999 generated higher trip emissions (exp[β], 1.92; 95% CI, 1.09-2.76; P = .003) compared with those with incomes of $25 000 or less. A 30% shift to electric vehicles was estimated to reduce health care-related carbon emissions to 27.6 Mt (95% CI, 20.7-34.6 Mt) CO2e, and a 50% shift was estimated to lower emissions to 22.3 Mt (95% CI, 16.0-28.6 Mt) CO2e. This cross-sectional study estimated that annual patient health care-related travel in the US generated 35.7 Mt CO2e, which accounts for a small but important proportion of total health care-related emissions in the US. These findings are essential for informing health care policy decisions and suggest that strategies such as telehealth and the adoption of electric vehicles may contribute to a small but significant reduction in health care-related GHG emissions.

BackgroundSustainable purchasing can reduce greenhouse gas (GHG) emissions at healthcare facilities (HCF). A previous study found that converting from disposable to reusable sharps containers (DSC, RSC) reduced sharps waste stream GHG by 84% but found transport distances impacted significantly on GHG outcomes and recommended further studies where transport distances are large. This case-study examines the impact on GHG of nation-wide transport distances when a large US health system converted from DSC to RSC.MethodsThe study’s scope was to examine life cycle GHG emissions during 12 months of facility-wide use of DSC and RSC at Loma Linda University Health (LLUH). The facility is an 1100-bed US, 5-hospital system where: the source of polymer was distant from the RSC manufacturing plant; both manufacturing plants were over 3,000 km from the HCF; and the RSC processing plant was considerably further from the HCF than was the DSC disposal plant. Using a “cradle to grave” life cycle GHG tool we calculated the annual GHG emissions of CO2, CH4 and N2O expressed in metric tonnes of carbon dioxide equivalents (MTCO2eq) for each container system. Primary energy input data was used wherever possible and region-specific energy-impact conversions were used to calculate GHG of each unit process over a 12-month period. The scope included Manufacture, Transport, Washing, and Treatment & disposal. GHG emissions from all unit process within these four life cycle stages were summed to estimate each container-system’s carbon footprint. Emission totals were workload-normalized and analysed using CHI2test with P ≤ 0.05 and rate ratios at 95% CL.ResultsConverting to RSC, LLUH reduced its annual GHG by 162.4 MTCO2eq (−65.3%; p < 0.001; RR 2.27–3.71), and annually eliminated 50.2 tonnes of plastic DSC and 8.1 tonnes of cardboard from the sharps waste stream. Of the plastic eliminated, 31.8 tonnes were diverted from landfill and 18.4 from incineration.DiscussionUnlike GHG reduction strategies dependent on changes in staff behavior (waste segregation, recycling, turning off lights, car-pooling, etc), purchasing strategies can enable immediate, sustainable and institution-wide GHG reductions to be achieved. This study confirmed that large transport distances between polymer manufacturer, container manufacturer, user and processing facilities, can significantly impact the carbon footprint of sharps containment systems. However, even with large transport distances, we found that a large university health system significantly reduced the carbon footprint of their sharps waste stream by converting from DSC to RSC.

Introducing demand to supply ratio as a new metric for understanding life cycle greenhouse gas (GHG) emissions from rainwater harvesting systems

Impacts of alternative fuel combustion in cement manufacturing: Life cycle greenhouse gas, biogenic carbon, and criteria air contaminant emissions

Plug-in hybrid electric vehicles (PHEVs) have potential to reduce greenhouse gas (GHG) emissions in the U.S. light-duty vehicle fleet. GHG emissions from PHEVs and other vehicles depend on both vehicle design and driver behavior. We pose a twice-differentiable, factorable mixed-integer nonlinear programming model utilizing vehicle physics simulation, battery degradation data, and U.S. driving data to determine optimal vehicle design and allocation for minimizing lifecycle greenhouse gas (GHG) emissions. The resulting nonconvex optimization problem is solved using a convexification-based branch-and-reduce algorithm, which achieves global solutions. In contrast, a randomized multistart approach with local search algorithms finds global solutions in 59% of trials for the two-vehicle case and 18% of trials for the three-vehicle case. Results indicate that minimum GHG emissions is achieved with a mix of PHEVs sized for around 35 miles of electric travel. Larger battery packs allow longer travel on electric power, but additional battery production and weight result in higher GHG emissions, unless significant grid decarbonization is achieved. PHEVs offer a nearly 50% reduction in life cycle GHG emissions relative to equivalent conventional vehicles and about 5% improvement over ordinary hybrid electric vehicles. Optimal allocation of different vehicles to different drivers turns out to be of second order importance for minimizing net life cycle GHGs.