Ramjohan Rammohan, MD, a gastroenterology fellow at Nassau University Medical Center in East Meadow, N.Y., led a two-phase study of endoscopic procedures performed at the facility over one year and reported its findings at the American College of Gastroenterology's 2024 convention.
The study measured the environmental impacts of the procedures before and after applying specific interventions. Here are eight things to know about the study:
1. The study included 1,367 colonoscopies, 1,338 endoscopies and 39 endoscopic retrograde cholangiopancreatographies at a clinic that averages 53 procedures per week.
2. In the first phase of the study, investigators assessed the carbon output from consumables, energy and transport from June to December 2023. These categories are "vital" in calculating the carbon footprint and the global warming potential of the center's endoscopy procedures.
3. Dr. Rammohan noted the "challenges in quantifying carbon output included [difficulty] gathering accurate data on consumables and assessing the direct and indirect emissions from energy and transport."
4. Staff were then trained on methods to reduce the environmental impact of endoscopy procedures, which focused on using reusable instruments when possible, implementing more efficient sterilization techniques that used fewer chemical and less energy, correctly separating waste, using sustainable consumables, minimizing plastics, and locally sourcing materials when possible.
5. The second phase of the study ran from January to June 2024. Researchers calculated carbon data and measured the GWP using the Bilan Carbone protocol and data from the U.S. Energy Information Administration. They calculated annual footprints and paired tests to analyze the difference in pre- and post-training periods.
6. Researchers found that interventions resulted in a significant reduction in carbon emissions from electricity, from 5,760 kilograms to 3,100 kilograms.
7. This collectively reduced the overall carbon footprint from 2,387,708 metric tons to 1,311,308 metric tons of carbon-dioxide equivalent.
8. Dr. Rammohan said that the size and type of center might influence the scalability and impact of such green initiatives.
"Targeted interventions that do not compromise patient care but significantly contribute to sustainability are important," Dr. Rammohan said. "The crucial factor is commitment across all staff levels and embedding sustainable practices into routine procedures."