P62 The environmental impact of skin cancer surgery

Abstract

Abstract The climate crisis has been described as the greatest global health threat by the World Health Organization. In 2019, healthcare-related emissions accounted for 25 mega-tonnes CO2 equivalent (CO2e), 10% of which was related to staff and patient travel. In the UK, 3.5% of road use is related to the National Health Service. The healthcare sector must recognize its role in contributing to carbon emissions and commit to taking decisive action to reduce these. Health-care generates a significant proportion of global emissions; a 2021 report by the Lancet estimated that the healthcare sector contributes to 4.9% of greenhouse gas emissions. As the impact of these numbers is coming to the fore, sustainable health care is becoming a necessity. This study aimed to determine the reduction in CO2e from same-day surgery for patients at skin cancer clinics. CO2e from travel by patients undergoing surgical procedures in a 6-month period (July–December 2020) were calculated. Data collected included age, diagnosis, site of lesion and total number of visits. The distance from the patient’s address was calculated using Google Maps. Total CO2e was calculated using an online calculator recommended by the Environmental Protection Agency of Ireland. A total of 299 patients had 319 procedures between July and December 2020. The median (SD) patient age was 68 (18.5) years (range 16–97). The total distance travelled by patients was 26 069 km, with a mean of 86 km travelled per patient (range 1.2–789). This generated 4.47 tonnes of CO2e emissions (range 0.0–0.6 tonnes). In total, 225/299 patients (75.2%) had surgery on the same day as their clinic appointment. They travelled a total average distance of 72 km (range 1.2–464), with a median of one hospital visit (range 1–2). Seventy-four of 299 patients (24.7%) had alternative day surgery, travelling an average distance of 129 km (range 8.4–789 km), with a median of two hospital visits (range 1–5). The mean CO2e for patients attending for same-day procedures was 0.017 tonnes (range 0–0.6) vs. 0.024 tonnes (range 0–0.16) for alternate-day procedures, a reduction of 0.007 tonnes (30%) per patient (P = 0.3). The introduction of same-day surgery for patients resulted in a 2.93-tonne (55%) reduction in CO2e, the equivalent to driving from the north to the south of Ireland 13 times (8000 km). We have demonstrated a reproducible innovative approach to the reduction of the carbon footprint generated by the management of skin cancer. With ever-increasing demands on the healthcare system, it is vital that we use innovative ways to reduce the carbon footprint generated. The actions of the healthcare sector now will affect the health and wellbeing of generations to come.