Cross-sector collaboration for carbon reduction and offsetting in cataract surgery

Unofficial AI-generated summary based on the public title and abstract. Not an official translation.

🔬研究者:Provides empirical carbon footprint data for a common surgical procedure and a methodology for scope-based assessment with uncertainty analysis.

🏢実務担当者:Offers a practical framework for healthcare providers and suppliers to collaborate on carbon measurement, reduction, and offsetting, including cost implications.

🏛政策担当者:Highlights the feasibility of carbon neutral healthcare pathways and the need for cross-sector partnerships to achieve net-zero targets.

Dear Editor Healthcare is responsible for up to 10 per cent of greenhouse gas (GHG) emissions from developed nations1. These pollutants cause direct harm to population health, partly stimulating national and international policies to reduce their emission1. In the UK healthcare sector, this is most prominently acknowledged in the National Health Service (NHS) commitment to reduce its direct carbon footprint by 80 per cent within 10 years2. Real-world empirical evidence to highlight interventions that healthcare providers can make is urgently required if this policy is to be delivered. Rizan et al.3 exemplified the pragmatic evidence required, with recent recommendations on how to lower the carbon footprint of surgical instrument sterilization, an incremental improvement with great potential impact owing to its applicability across the NHS. As one of the most common surgical procedures, cataract surgery offers another impactful example of how NHS providers might realize the net-zero strategic goal, although real-world carbon neutral cataract surgery has yet to be reported2. It is also a surgical pathway with established and accessible means of context-specific carbon footprint assessment, facilitating the wide accessibility of informal assessments of a provider’s surgical carbon footprint4. This letter reports a cross-sector initiative with a commitment to reduce emissions by 20 per cent on a per-cataract operation basis between 2021 and 2025 and to offset residual associated GHG emissions. A large UK NHS provider, Newcastle upon Tyne Hospitals NHS Foundation Trust (NuTH), a manufacturer of ophthalmic surgical equipment, Alcon™, a climate science consultancy, Carbon Footprint Ltd, and a Certification Body, NQA Certification Ltd, collaborated to rigorously calculate, offset, reduce, and independently verify the carbon footprint of local cataract surgery. The assessment included both direct and indirect emissions, and was described in terms of carbon dioxide equivalents (CO2e). A simple error analysis was also performed using estimated percentages of measurement uncertainty for each element, e.g. 50% uncertainty for building energy and 10% for transport of materials, and aggregating those uncertainties proportionally to reflect their contribution to total emissions. The total carbon footprint of each operation was found to be 72.27 (+/–22.31) kg CO2e. The large confidence intervals derive from inability to attribute departmental heating requirements to individual operating theatres. Major contributors to the total were the materials procured for the procedure (42.9 per cent) and the building energy (41.5 per cent) (Table 1). Constituents of total greenhouse gas emissions from cataract surgery at Newcastle upon Tyne Hospitals NHS Foundation Trust Constituents are categorized by the scopes defined in the World Resources Institute Greenhouse Gas Protocol. CO2e, carbon dioxide equivalents. Constituents of total greenhouse gas emissions from cataract surgery at Newcastle upon Tyne Hospitals NHS Foundation Trust Constituents are categorized by the scopes defined in the World Resources Institute Greenhouse Gas Protocol. CO2e, carbon dioxide equivalents. This assessment has already identified impactful and feasible interventions to reduce the carbon footprint of cataract surgery at NuTH, for which changes have already begun and will continue over the next 3 years. These opportunities include a transition to LED lighting, updating the boilers to improve theatre heating efficiency, and streamlining equipment procurement processes to lower the number of suppliers. Alongside NHS strategy, this collaboration acknowledges that offsetting should not prevent the primary reduction of GHG emissions. However, to expedite impact while changes are explored and actioned, Alcon™ has offset the as-yet unavoidable carbon footprint by investing in projects limiting Brazilian deforestation (VCS981) and distributing carbon-efficient technologies in Malawi (GS7312. Although various factors lead NHS tariffs and offsetting costs to vary, in the present setting £1.15 (€1.30 at 1.13 rate on 2 February 2023; 0.14 per cent) of the average £823 reimbursement per cataract operation was required to offset the carbon footprint of each procedure5. The rigorous means of carbon footprint assessment described here incurred additional costs, but qualifies NuTH and Alcon™ for the use of Carbon Footprint Standard branding. By sharing this experience, the authors aimed to demonstrate a model for mutually beneficial cross-sector collaboration to neutralize surgical GHG emissions. Further scaling and spread of such collaborations will be required for primary reduction of healthcare GHG emissions to better the health of our environments and populations. Sandro Di Simplicio Cherubini (conceptualization, supervision, writing—original draft, writing—review and editing), Stuart Fowler (data curation), and Stephen Burt (conceptualization, data curation, investigation), H. D. Jeffry Hogg (validation, writing—original draft, writing—review and editing). The authors have no funding to declare Sandro Di Simplicio is a consultant for Alcon, but has no financial interest in this project. Stuart Fowler and Stephen Burt are employees of their respective companies and Jeff Hogg has no conflict of interest to declare. Data available upon request.

• openalex http://dx.doi.org/10.1093/bjs/znad024first seen 2026-08-02 16:52:37 · last seen 2026-08-02 16:53:55