Reducing Cath Lab’s Carbon Footprint: Is It Time, and Can It Be Done?

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

🔬研究者:Provides a case for applying GHG Protocol scopes in healthcare, useful for studying sector-specific decarbonization strategies.

🏢実務担当者:Offers actionable steps for reducing carbon footprint in cath labs, including waste reduction and recycling, with potential cost savings.

🏛政策担当者:Highlights the need for guidance and standards for healthcare decarbonization, relevant for policy development.

“If you always do what you always did, you’ll always get what you always got.”-Albert Einstein One of the many things I love about the practice of interventional cardiology is the continual need to improve, adapt, and innovate. If need is the mother of invention, we as interventional cardiologists are always in need to make the process better, safer, and faster to achieve the best possible outcome for each individual patient. Our efforts have been patient centric, and in all the progress, we have overlooked an unintended consequence of our accomplishments, the impact on the planet. For those like me who are troubled by the impact of human practices on pollution, greenhouse gas (GHG) emissions, and climate change, it is nearly impossible to ignore the sirens calling for a collective effort to halt our current trajectory and change direction. Climate change has been described as one of the greatest threats to global public health in the 21st century.1Costello A. Abbas M. Allen A. et al.Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission.Lancet. 2009; 373: 1693-1733Abstract Full Text Full Text PDF PubMed Scopus (1515) Google Scholar Though many factors and sectors make unwelcomed contributions, health care does its fair share. The global health care sector is responsible for 4.4% of net planetary GHG emissions,2Pichler P.P. Jaccard I.S. Weisz U. Weisz H. International comparison of health care carbon footprints.Environ Res Lett. 2019; 14064004Crossref Scopus (110) Google Scholar and if it were a country, it would rank fifth on the list of largest emitters of GHG. At the current pace without any intervention, health care’s climate footprint will triple by 2050.3Health Care Without Harm. Global road map for health care decarbonization.https://healthcareclimateaction.org/sites/default/files/2021-06/Health%20Care%20Without%20Harm_Health%20Care%20Decarbonization_Road%20Map.pdfDate accessed: May 16, 2022Google Scholar Unfortunately, the US health care industry, in particular, has the dubious distinction of having the largest footprint of any country and, as such, is responsible for nearly a quarter of global health care GHG emissions.4Eckelman M.J. Huang K. Lagasse R. Senay E. Dubrow R. Sherman J.D. Health care pollution and public health damage in the United States: an update.Health Aff. 2020; 39: 2071-2079Crossref PubMed Scopus (50) Google Scholar The size of the US health care system and the enormous quantities of not only waste but also wasteful practices that are built into the system represent an equally sizable opportunity to reap the rewards when footprint-reducing strategies are considered and implemented. Recently, the National Academy of Medicine announced the “Climate Grand Challenge,” a global initiative focusing on climate change, human health, and equity. It aims to raise awareness about the relationship between climate crisis and public health, develop a roadmap for systematic change to reduce the health sector’s climate footprint, and invest in research to enhance climate, health, and equity.5National Academy of MedicineGrand challenge on climate change, human health, and equity.https://nam.edu/programs/climate-change-and-human-health/Date accessed: May 16, 2022Google Scholar Within the United States, National Academy of Medicine’s Climate Collaborative, an action collaborative between public and private health sectors, looks to address US health care’s climate impact, ensuring that all the scopes within health care are working toward a common goal of decarbonization across the spectrum of health care delivery.6National Academy of Medicine. Action collborative on decarbonizing the U.S. health sector.https://nam.edu/programs/climate-change-and-human-health/action-collaborative-on-decarbonizing-the-u-s-health-sector/Date accessed: May 16, 2022Google Scholar For example, the supply chain is responsible for 80% of the sector's carbon output,7Dzau V.J. Levine R. Barrett G. et al.Decarbonizing the U.S. Heatlh Sector-a call to action.N Engl J Med. 2021; 385: 2117-2119Crossref PubMed Scopus (11) Google Scholar and emissions related to both upstream and downstream operations represent a complex target for decarbonization. To this end, many European pharmaceutical companies and several US companies are targeting substantial reduction in emissions and efforts to be completely carbon neutral over the next decade.8Lavelle E. Frey M. Gibney M. Path to net-zero: EU pharma accelerates pledges while US plays catch-up. S&P Global Market Intelligence.https://www.spglobal.com/marketintelligence/en/news-insights/latest-news-headlines/path-to-net-zero-eu-pharma-accelerates-pledges-while-us-plays-catch-up-67928165Date: December 17, 2021Date accessed: May 16, 2022Google Scholar Similarly, the Harvard Global Health Institute announced the “decarbonize health care initiative,” which involves partnership between 7 Boston area hospitals to identify ways hospital systems can lead the charge toward decarbonization.9Harvard medical school teaching hospitals and clinical institutes sign joint commitment to decarbonize. Harvard Global Health Institute.https://globalhealth.harvard.edu/harvard-medical-school-teaching-hospitals-and-clinical-institutes-sign-joint-commitment-to-decarbonize/Date: December 19, 2018Date accessed: May 16, 2022Google Scholar These types of large-scale initiatives and commitment are examples of the colossal effort being undertaken to avail what could represent the most important opportunity in health care in this century. Currently, over 1 million cath procedures are performed annually in the United States alone without any guidance, education, or expectation about “our” carbon footprint. Recent society documents describing “best practices” in the cath lab mention bleeding avoidance strategies but miss the opportunity to mention the urgent need to consider “footprint-reducing strategies.”10Naidu S.S. Abbott J.D. Bagai J. et al.SCAI expert consensus update on best practices in the cardiac catheterization laboratory.Catheter Cardiovasc Interv. 2021; 98: 255-276Crossref PubMed Scopus (5) Google Scholar Similarly, a discussion outlining pathways to “operational efficiencies” in the cath lab can be enhanced by considering best practices with the smallest footprint.11Reed G.W. Tushman M.L. Kapadia S.R. Operational efficiency and effective management in the catheterization laboratory: JACC review topic of the week.J Am Coll Cardiol. 2018; 72: 2507-2517Crossref PubMed Scopus (4) Google Scholar In addition to performing life-saving interventions for our patients, we also must prioritize interventions aimed at making all aspects of patient care in the cath lab more sustainable (Figure 1). The GHG protocol12Greenhouse Gas Protocol.https://ghgprotocol.orgDate accessed: May 16, 2022Google Scholar is a tool used to measure and report carbon output across both private and government sectors. It defines 3 scopes of emissions: scope 1 includes direct emission from the defined space; scope 2 is indirect emissions due to electricity and heating consumption, and scope 3 includes remainder of indirect usage related to supply chain and waste disposal. Models to measure and report cath lab–specific usage could identify appropriate benchmarks and targets for optimization and reduction. Prioritizing all 3 components is key to sustainability. Reducing usage starts with striving for 0% waste. Ensuring that all materials used are essential and aiming for “minimalist cath” can help shrink the footprint. Premade procedure packs can be turned in as “green packs” to ensure that all materials have been considered for use in the most effective way. Cath lab practice is heavy in use of single-use, disposable plastic items. There are ample opportunities to substitute repurposed and resterilized items to minimize landfill waste and reuse materials when possible. And lastly, efforts to recycle 100% of appropriate materials and ensuring that hospital systems have an adequate recycling chain and programs in place would significantly shift waste from landfills to being part of a circular economy without any risk for jeopardizing or compromising patient care. Many aspects of non–patient-related cath lab practice also can benefit from a “carbon assessment.” For example, break rooms are much needed places of refueling in the cath lab. Promoting use of compostable and recyclable products and ensuring adequate access to recycling can help lessen the output. Other examples of areas with potential impact include ensuring sustainable scrub services, paper use audits, promoting and incentivizing carpooling, and cath lab staff leading initiatives in other parts of the hospital to promote sustainability. Not only do steps toward decarbonization come with benefits to human health and the environment, they also come with financial rewards. There is a common misconception that interventions aimed at sustainability will come at a financial cost. In reality, even simple interventions to be more sustainable will come with positive financial implications. A study conducted by the Commonwealth Fund examined data from hospitals that had implemented interventions such as energy use reduction, waste reduction (increasing recycling, reduction in daily landfill waste), and more efficient purchasing of operating room (OR) supplies (increase reprocessing and reuse of medical devices when appropriate and reformulating OR packs). After standardizing estimated cost savings across hospitals nationwide, their analysis predicted over $5 billion savings over 5 ​years and $15 billion over 10 ​years.13Kaplan S. Sadler B. Little K. Franz C. Orris P. Can sustainable hospitals help bend the health care cost curve?.Issue Brief (Commonw Fund). 2012; 29: 1-14PubMed Google Scholar There are many such examples across different specialties with similar results, leaving little doubt about the positive financial impact of impl

• openalex https://doi.org/10.1016/j.jscai.2022.100371first seen 2026-08-02 17:37:30