Sustainability Prize 1 Green Endoscopy to reduce CO2e generated by endoscopic waste – the GECO2e interventional study

Abstract

Abstract Aims Endoscopy is healthcare's third-largest waste-generating procedure. This study aimed to measure a single unit's waste carbon footprint and to perform a pioneer evaluation applying the principles of green endoscopy towards a more sustainable unit. Methods This was a 3-stage, prospective study. Stage 1: 4-week observational audit, during which daily endoscopic waste (landfill, biohazard) was weighed. Stage 2: 1-week intervention with presentation of retrieved data and education of the team towards waste handling. Recycling bins were placed in endoscopy rooms, and landfill and biohazard bins were relocated. Stage 3: 4-week post-interventional period, during which daily endoscopic waste was weighed. An engineer-calibrated scale was used. Equivalence of 1kg of landfill waste to 1kg carbon dioxide equivalent (CO2e) and 1kg of biohazard waste to 3kgCO2e was applied. Paired samples T-tests were used for comparisons before and after the intervention. The opinion of the staff was collected. Results Total waste and biohazard waste were diminished by 12.2% (p=0.166) and 41.4% (p=0.010), respectively, whereas landfill waste (p=0.059) and recycling waste increased (paper: p=0.001; plastic: p=0.007). In terms of CO2e, a total decrease of 31.6% (138.8kgCO2e) was found (mean kgCO2e 109.7 vs 74.9, pre- vs post-intervention, p=0.018). Mean endoscopy load was similar (46.2 vs 44.5, p=0.275). The endoscopy unit may achieve an estimated annual reduction of 1665.6kgCO2e. The personnel agreed “the project did not disturb daily work”. Conclusions In this interventional study applying green endoscopy principles to a real-world scenario, biohazard waste reduction and daily recycling were achieved, without compromising endoscopy productivity.