A cradle-to-grave life cycle assessment of the endoscopic sinus surgery considering materials, energy, and waste.

IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY International Forum of Allergy & Rhinology Pub Date : 2024-10-27 DOI:10.1002/alr.23474
Zeinab Mousania, Darpan Kayastha, Ryan A Rimmer, John D Atkinson
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Abstract

Background: Operating rooms generate 1.8 million tons of waste annually, or 20%‒30% of the total healthcare waste in the United States. Our objective was to perform a life cycle assessment (LCA) for endoscopic sinus surgeries (ESSs) in order to analyze its environmental impact.

Methods: A comprehensive LCA of ESS was performed considering energy, climate, and water use impacts associated with the materials and processes used. It focuses on the ESS performed at a large tertiary academic hospital and then extends the impacts to consider annual US surgeries. The assessment considers end-of-life waste management at both landfills and incinerators.

Results: Single-use instrument production constitutes 89%‒96% of the total impacts throughout the life cycle of an ESS. Waste-to-energy incineration is shown to be a preferred end-of-life destination, as it recovers much of the input production energy of plastic items, ultimately reducing the input to 36%, although this is done at the expense of higher greenhouse gas emissions. For multi-use items, decontamination dominates environmental impact (>99% of totals), but consideration of reusable items reduces overall energy consumption and global warming potential (GWP) by 25%‒33%.

Conclusion: Single-use items dominate the total environmental impact of ESS. While multi-use items require additional decontamination over their lifetimes, results show that their incorporation reduces energy consumption and GWP by 25%‒33%, demonstrating the clear environmental benefit.

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对内窥镜鼻窦手术进行从摇篮到坟墓的生命周期评估,考虑材料、能源和废物。
背景:手术室每年产生 180 万吨废物,占美国医疗废物总量的 20%-30%。我们的目标是对内窥镜鼻窦手术(ESS)进行生命周期评估(LCA),以分析其对环境的影响:对 ESS 进行了全面的生命周期评估,考虑了与所用材料和工艺相关的能源、气候和用水影响。评估重点是在一家大型三级学术医院进行的 ESS,然后将影响范围扩大到美国的年度手术。评估考虑了垃圾填埋场和焚化炉的报废废物管理:结果:一次性使用器械的生产占ESS整个生命周期总影响的89%-96%。结果表明,废物变能源焚烧是寿命终结时的首选处理方式,因为它可以回收塑料制品生产过程中的大部分输入能源,最终将输入能源减少到 36%,但这是以更高的温室气体排放为代价的。对于多用途物品,去污在环境影响中占主导地位(超过总量的 99%),但考虑到可重复使用的物品,总体能耗和全球升温潜能值(GWP)降低了 25%-33%:结论:一次性物品在 ESS 对环境的总影响中占主导地位。结论:一次性物品对环境的总影响占主导地位。虽然多用途物品在其生命周期内需要额外的净化,但结果表明,将其纳入其中可将能耗和全球升温潜能值降低 25%-33%,从而显示出明显的环境效益。
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来源期刊
CiteScore
11.70
自引率
10.90%
发文量
185
审稿时长
6-12 weeks
期刊介绍: International Forum of Allergy & Rhinologyis a peer-reviewed scientific journal, and the Official Journal of the American Rhinologic Society and the American Academy of Otolaryngic Allergy. International Forum of Allergy Rhinology provides a forum for clinical researchers, basic scientists, clinicians, and others to publish original research and explore controversies in the medical and surgical treatment of patients with otolaryngic allergy, rhinologic, and skull base conditions. The application of current research to the management of otolaryngic allergy, rhinologic, and skull base diseases and the need for further investigation will be highlighted.
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