Lancet Planetary Health最新文献

{"title":"Sustainable diets and cancer: a systematic review and meta-analysis","authors":"Marina Kasper ,&nbsp;Mirna al Masri ,&nbsp;Tilman Kühn ,&nbsp;Sabine Rohrmann ,&nbsp;Katharina Wirnitze ,&nbsp;Michael Leitzmann ,&nbsp;Carmen Jochem","doi":"10.1016/j.lanplh.2025.101351","DOIUrl":"10.1016/j.lanplh.2025.101351","url":null,"abstract":"<div><h3>Background</h3><div>Modern food systems contribute to environmental degradation, while prevailing unhealthy eating behaviours exacerbate the global cancer burden, creating a dual synergistic crisis for both planetary and human health. Investigating the impact of sustainable diets on cancer is therefore essential.</div></div><div><h3>Methods</h3><div>Following the 2020 PRISMA guidelines for reporting systematic reviews and meta-analysis, observational studies on cancer incidence and mortality among adults, assessing the sustainability of their diets using various metrics, were examined. Effect measures were pooled to compare the highest versus lowest adherence to sustainable dietary patterns. Summary effect estimates for cancer incidence and mortality were calculated using random-effects models. Subgroup analyses were conducted by sex, geographical region, study design, sustainability metric used, dietary assessment indexes reflecting sustainability, and cancer type. E-values were used to evaluate the robustness of associations against potential unmeasured confounding. The study was pre-registered in PROSPERO (ID CRD42024545102).</div></div><div><h3>Findings</h3><div>19 effect estimates from 17 studies, encompassing over 2·2 million participants, revealed a significant reduction in cancer incidence (hazard ratio 0·93, 95% CI 0·88−0·98, I² 84·67%) and cancer mortality (hazard ratio 0·88; 95% CI 0·85–0·92, I² 21·25%) associated with higher adherence to sustainable diets. Subgroup analyses indicated that the overall effect was modified by study design, sustainability metrics, and dietary assessment index.</div></div><div><h3>Interpretation</h3><div>These findings support evidence linking sustainable diets with reduced cancer incidence and mortality, underscoring their potential role in cancer prevention while providing concurrent environmental benefits. The notable variability in sustainability metrics highlights the need for standardised approaches in future research.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 ","pages":"Article 101351"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health co-benefits of sustainable urban transport: an umbrella review with GRADE assessment","authors":"Alessio Perilli ,&nbsp;Simona Vecci ,&nbsp;Manuela De Sario ,&nbsp;Francesca De' Donato ,&nbsp;Andrea Adduci ,&nbsp;Walter Ricciardi ,&nbsp;Paola Michelozzi","doi":"10.1016/j.lanplh.2025.101355","DOIUrl":"10.1016/j.lanplh.2025.101355","url":null,"abstract":"<div><h3>Background</h3><div>Sustainable transport reduces climate change impacts while offering direct health benefits through increased physical activity and indirect benefits via air pollution reduction. In this study, we aimed to synthesise evidence on health benefits of sustainable transport and barriers to its adoption.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, a systematic search was conducted in April 2024 across MEDLINE, Embase, and Web of Science. Systematic reviews examining sustainable transport and health outcomes were included, synthesised, and assessed using AMSTAR-2 and GRADE.</div></div><div><h3>Findings</h3><div>Of 40 included systematic reviews, 13 focused on active transport. Meta-analyses showed health co-benefits associated with active transport for total mortality (hazard ratio 0·91, 95% CI 0·85–0·97), cardiovascular mortality (0·85, 0·73–0·97) and morbidity, as well as reduced obesity and endometrial cancer risk in adults. In adult populations, walkability was associated with reduced diabetes, obesity, and hypertension, and public transport initiation was associated with lower BMI. Traffic management interventions appeared to reduce accidents. Evidence certainty was generally very low, mainly due to study design, risk of bias, and heterogeneity. Active transport interventions were consistently cost effective. Absence of protected routes, long distances, lack of infrastructure, adverse weather, and costs were identified as barriers to adopting sustainable modes of transport.</div></div><div><h3>Interpretation</h3><div>Active transport shows the health benefits, particularly for adults. Due to heterogeneity and low-quality evidence, further research is needed, especially regarding subgroups who might benefit most. These findings support integrating public health objectives into urban mobility policies.</div></div><div><h3>Funding</h3><div>The study was developed within the project “Health and equity co-benefits in support of plans to respond to climate change in Italy – COBENEFIT” funded by the National Plan for Complementary Investments of the Ministry of Health.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 ","pages":"Article 101355"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating infectious health-care waste management at a university dental clinic","authors":"Tamás Demeter ,&nbsp;Csilla Erdei ,&nbsp;Andrea Fanni Vass ,&nbsp;Krisztina Márton","doi":"10.1016/j.lanplh.2025.101365","DOIUrl":"10.1016/j.lanplh.2025.101365","url":null,"abstract":"<div><h3>Background</h3><div>Infectious health-care waste (IHW) contributes substantially to the environmental burden of health-care institutions. This study aimed to assess and compare the composition of daily generated IHW and waste segregation awareness among clinical specialists’ (STR) and clinical educational treatment rooms (ETR) at the dental clinic of Semmelweis University Faculty of Dentistry, with special focus on single-use plastics (SUP) and personal protective equipment (PPE) used in patient care.</div></div><div><h3>Methods</h3><div>Three waste audits were conducted in 2023 to quantify and analyse the complete daily production of IHW during dental care. Collected clinical waste were analysed and categorised; fractions were weighed using kitchen scales. Measurement data of the three audits were summarised and averaged. Independent samples t-test (significance level: p&lt;0·05) was used to compare waste quantities among STRs and ETRs.</div></div><div><h3>Findings</h3><div>The average daily amount of IHW generated in the dental centre weighed 59 596 g in total and 93 g per patient. The heaviest fractions were medical gloves (22 197 g), paper towels (12 107 g), and disposable patient bibs (5673 g). Discarded PPE and SUP used in patient care were responsible for 34 154 g (57%) 59 596 g IHW weight. Significantly more IHW was produced per patient in ETRs than in STRs (p=0·007).</div></div><div><h3>Interpretation</h3><div>Excessive use of SUP and PPE in dentistry, together with overproduction, inappropriate collection, and mismanagement of dental IHW has negative planetary health consequences. Switching to reusable, sterilisable utensils; implementing sustainable procurement and circular economy strategies; and educating stakeholders about proper waste disposal might help to mitigate the negative effects of SUP and PPE use.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 ","pages":"Article 101365"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging green finance to mitigate zoonotic risk: an Investor Alliance model for sustainable land use and Lassa fever control in Nigeria","authors":"Emmanuel Ifechukwude Benyeogor ,&nbsp;Akanimo Iniobong","doi":"10.1016/j.lanplh.2025.101363","DOIUrl":"10.1016/j.lanplh.2025.101363","url":null,"abstract":"<div><h3>Background</h3><div>Lassa fever, a rodent-borne zoonotic disease endemic to Nigeria, is closely linked to environmental degradation driven by agricultural expansion. Deforestation and land fragmentation in high-rainfall zones (900–2100 mm annually) create ideal habitats for <em>Mastomys natalensis</em>, increasing human–rodent contact and outbreak risk. This study explores a business-oriented solution: an international Investor Alliance model that mobilises green financing to reduce Lassa fever risk through sustainable land-use practices.</div></div><div><h3>Methods</h3><div>We conducted a spatial overlay analysis of Sentinel-2 deforestation imagery (2023–24), Lassa fever epidemiological data (National Centre for Disease Control), and rainfall distribution to identify ecological hot spots. Investment flows from Japan, South Korea, Malaysia, and Singapore were reviewed for alignment with sustainability goals. A blended finance model was developed linking investor returns to health and environmental co-benefits.</div></div><div><h3>Results</h3><div>Outbreaks peaked during dry seasons, coinciding with rodent migration and land clearance. Regions with high investment potential overlapped with high-risk zones. Practices such as agroforestry, ecological buffers, and zero-deforestation certification schemes offer viable entry points for green financing.</div></div><div><h3>Interpretation</h3><div>The Investor Alliance model reframes zoonotic disease prevention as an investable opportunity. Asian investors bring capital and environmental, social, and governance frameworks, while Nigerian partners ensure local ownership. By aligning planetary health outcomes with private sector incentives, this model provides a scalable strategy to reduce zoonotic spillover, support sustainable agriculture, and strengthen health system resilience in line with global biodiversity and climate targets.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 ","pages":"Article 101363"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological guidance for selecting buffers in greenspace–health studies","authors":"Mohammad Javad Zare Sakhvidi PhD ,&nbsp;Matthew H E M Browning PhD ,&nbsp;Karl Samuelsson PhD ,&nbsp;S M Labib PhD ,&nbsp;Achilleas Psyllidis PhD ,&nbsp;Adeladza Kofi Amegah PhD ,&nbsp;Prof Thomas Astell-Burt PhD ,&nbsp;Albert Bach PhD ,&nbsp;Prof Michael Jerrett PhD ,&nbsp;Gregory N Bratman PhD ,&nbsp;Matilda van den Bosch MD PhD ,&nbsp;Kees de Hoogh PhD ,&nbsp;Sjerp de Vries PhD ,&nbsp;Angel M Dzhambov MD DSc ,&nbsp;Rohollah Fallah Madvari ,&nbsp;Prof Xiaoqi Feng PhD ,&nbsp;Amanda Fernandes PhD ,&nbsp;Elaine Fuertes PhD ,&nbsp;Vincenzo Giannico PhD ,&nbsp;Prof Nelson Gouveia PhD ,&nbsp;Prof Payam Dadvand MD PhD","doi":"10.1016/j.lanplh.2025.101370","DOIUrl":"10.1016/j.lanplh.2025.101370","url":null,"abstract":"<div><div>Greenspace can promote health via diverse pathways. A common approach to assessing greenspace exposure is to estimate vegetation availability within buffers surrounding locations where people reside or spend time. However, no clear framework for informed buffer selection exists, and choices made show considerable heterogeneity, impeding evidence synthesis and causal inference. In this Personal View conducted by an interdisciplinary panel of experts, we aimed to establish a framework for informed buffer selection for epidemiological studies on greenspace. We began by reviewing available approaches for the selection of buffer types, which range from single fixed-location approaches to high-resolution mobility-based activity-space approaches, as well as different buffer sizes. We then summarised the determinants of buffer type and size selection including health outcomes and underlying mechanisms, study population, contextual factors, and data characteristics. Finally, based on these determinants, we developed recommendations for future research. Buffer type and size selection should be hypothesis driven, reflecting presumed greenspace–health mechanisms. Buffer selection should target activity-based approaches where feasible, and multiple buffer sizes should be tested. Overall, the assessment of greenspace exposure should shift from ad-hoc approaches to personalised, multiscale, and context-specific methods. We call for standardising and reporting the rationale for buffer selection to minimise bias and enhance comparability and evidence synthesis across studies.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 11","pages":"Article 101370"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seeds of change: a longitudinal evaluation of the impact of the Planetary Health Report Card impact on institutional action","authors":"Allison Dana Chhor ,&nbsp;Anthony James Goodings ,&nbsp;Stephanie Howe ,&nbsp;Alex Sy ,&nbsp;Yasmine Zenmi ,&nbsp;Hela Kabani ,&nbsp;Sydney Ruller ,&nbsp;Husein Moloo","doi":"10.1016/j.lanplh.2025.101349","DOIUrl":"10.1016/j.lanplh.2025.101349","url":null,"abstract":"<div><h3>Background</h3><div>The Planetary Health Report Card (PHRC) is an institutional advocacy tool designed to encourage medical schools to integrate planetary health into their curricula, research, and operations. The primary objective of this study was to assess the 3-year impact of the PHRC on promoting institutional changes at the Faculty of Medicine, University of Ottawa. The secondary objective was to identify facilitators and barriers to planetary health work.</div></div><div><h3>Methods</h3><div>Quantitative data was retrospectively collected from the PHRCs published in 2022, 2023, and 2024. We examined outcomes in five domains: Curriculum, Interdisciplinary Research, Community Outreach and Advocacy, Institutional Support, and Campus Sustainability.</div></div><div><h3>Findings</h3><div>Over 3 years, there was a 13·9% increase in overall PHRC score. In the Curriculum domain, there has been a sustained effort to implement a longitudinal planetary health programme. Establishment of the Planetary Health Research Lab has facilitated progress in Interdisciplinary Research. Community Outreach and Advocacy has improved through new community partnerships. However, Institutional Support has declined due to lack of student engagement. The Campus Sustainability domain has remained consistent. Increased student-faculty collaboration through the Planetary Health Director role has facilitated institutional improvements; however, a lack of faculty awareness of planetary health is a barrier.</div></div><div><h3>Interpretation</h3><div>By comparing 3 years of PHRC implementation and institutional changes, areas of progress and opportunities for further development were identified. The PHRC is effective in driving change and can inform future efforts to enhance institutional engagement with planetary health.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 ","pages":"Article 101349"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scope sustainability: slashing single-use plastic bottles","authors":"Hilalion (San) Ahn ,&nbsp;Allison Williams ,&nbsp;Karlie Kelly ,&nbsp;Husein Moloo","doi":"10.1016/j.lanplh.2025.101364","DOIUrl":"10.1016/j.lanplh.2025.101364","url":null,"abstract":"<div><h3>Background</h3><div>The health-care sector is a substantial contributor to greenhouse gas emissions, with single-use plastic sterile water bottles generating considerable waste. To address this issue, our endoscopy programme implemented a multistep quality improvement initiative replacing sterile water in disposable plastic bottles with tap water in reusable containers for upper and lower endoscopic procedures, excluding endoscopic retrograde cholangiopancreatography.</div></div><div><h3>Methods</h3><div>We first performed a scoping review that identified no clinical difference between sterile water and tap water in upper and lower endoscopic procedures, highlighting both economic and environmental benefits. A multidisciplinary team, including representatives from infection prevention, infectious diseases, hospital facilities, patient safety, ethics, and endoscopy quality improvement, collaborated to ensure safety and feasibility of using tap water. Institutional approval was obtained, and implementation is being evaluated using an interrupted time series analysis, tracking complications at 1 week and 30 days post procedure. Ongoing surveys collect feedback to refine the process.</div></div><div><h3>Findings</h3><div>Each 1 L sterile water bottle generates approximately 0·575 kg CO₂ and contains 240 000 microplastics and nanoplastics. Within the first 2 weeks of using tap water, usage of 480 bottles was discontinued, reducing CO₂ emissions by 276 kg and preventing the release of 115 million microplastics and nanoplastics. Annual cost savings from all three hospital sites are projected at CAD 47 145, based on eliminating 15 715 bottles used for colonoscopies. No increase in complications has been observed.</div></div><div><h3>Interpretation</h3><div>This initiative effectively reduced plastic waste and emissions while maintaining patient safety. It provides a replicable model for sustainable health-care practices, promoting environmental stewardship and mitigating potential health risks from microplastic exposure.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 ","pages":"Article 101364"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting substitution models in nutritional epidemiology: the case for the protective role of NOVA 1 foods over the risk of NOVA 4","authors":"Francesco Visioli ,&nbsp;Daniele Del Rio ,&nbsp;Vincenzo Fogliano ,&nbsp;Franca Marangoni ,&nbsp;Andrea Poli","doi":"10.1016/j.lanplh.2025.101331","DOIUrl":"10.1016/j.lanplh.2025.101331","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 11","pages":"Article 101331"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolution of news coverage about climate change as a health issue: a decadal analysis in China, India, and the USA","authors":"Prof Melinda R Weathers PhD ,&nbsp;Deepti Ganapathy PhD ,&nbsp;Marceleen M Mosher MA ,&nbsp;Teresa Myers PhD ,&nbsp;Neha Gour MA ,&nbsp;Mulin Jiang MA ,&nbsp;Qianying Ye MA ,&nbsp;Prof Fei Shen PhD ,&nbsp;John Kotcher PhD ,&nbsp;Prof Edward W Maibach PhD","doi":"10.1016/j.lanplh.2025.101335","DOIUrl":"10.1016/j.lanplh.2025.101335","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Climate change harms human health and wellbeing, and climate solutions often have public health benefits. Previous research has shown how news media engages and shapes public understanding of climate change, yet few studies have examined how news media reports on climate change as a public health issue. Understanding how and how much news media reports on the public health implications of climate change can shed light on public engagement in climate change, which has been deemed a public health crisis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Using online databases, articles were collected from five mainstream newspapers and one news agency for each of the three countries—China, India, and the USA—between Jan 1, 2012, and Dec 31, 2023. The headline or lead paragraph of all articles were searched by newspaper and within years using both climate change and public health keywords. Articles having at least one keyword from both sets (ie, climate change and public health) were included in the study, resulting in a total of 5173 articles: 1473 from China, 1487 from India, and 2213 from the USA. A detailed content analysis was then done on a randomly selected 20% of the 5173 public health-related climate change articles, which provided a dataset of 1027 articles for analysis: 294 from China, 295 from India, and 438 from the USA. Articles were then thoroughly reviewed and discarded if they were not substantively focused on climate change and public health or were non-articles (eg, obituaries, sports sections, content summaries, or letters to the editors), providing a final dataset of 3234 public health-focused climate change articles for in-depth analysis: 50 from China, 137 from India, and 137 from the USA. Each article was then coded for four sets of variables: public health impacts; vulnerable populations; solutions; and health experts as sources.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Across all countries and all years, 64 073 (0·3%) of 22 562 365 articles had a climate change keyword in their lead paragraph or title, although this varied significantly by country (p&lt;0·0001) and time (p&lt;0·0001). 5173 (8·1%) of 64 073 articles also included public health keywords, which also varied by country (p&lt;0·0001). Among the randomly sampled 20% of articles (1025 of 5173), 3234 (31·5%) were determined to be public health-focused climate change articles. Thus, 1626 (&lt;0·1%) of 22 562 365 articles in the total newshole (all articles published in these countries over the past decade) focused on the public health relevance of climate change, a proportion that varied by country (p&lt;0·0001) and time (p&lt;0·0001). 321 (99·1%) of 324 public health-focused articles reported at least one health impact, most commonly general public health (252 [77·8%] articles); extreme heat (166 [51·2%] articles); extreme weather (142 [43·8%] articles); poor air quality (115 [35·5%] articles); and food insecurity (80 [24·7%] articles). Rates of reporti","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 11","pages":"Article 101335"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental impact of minimally invasive procedures: lifecycle assessment of two hospital care pathways","authors":"Eva Sayone Cohen ,&nbsp;Lisanne HJA Kouwenberg ,&nbsp;Hannah V Dürager ,&nbsp;Lynn E Snijder ,&nbsp;Jesse Lammerts ,&nbsp;Martijn van Bodegraven ,&nbsp;Dionne S Kringos ,&nbsp;Nicolaas H Sperna Weiland ,&nbsp;Wouter JK Hehenkamp","doi":"10.1016/j.lanplh.2025.101348","DOIUrl":"10.1016/j.lanplh.2025.101348","url":null,"abstract":"<div><h3>Background</h3><div>If the health-care sector were a country, it would rank as the fifth-largest environmental polluter globally. Minimally invasive procedures are particularly resource-intensive and energy-intensive, highlighting the importance of assessing their environmental impact in addition to their clinical benefits. In this study, we quantified the environmental impacts of two minimally invasive, clinically equivalent treatments for uterine fibroids: uterine artery embolisation (non-surgical) and total laparoscopic hysterectomy (surgical).</div></div><div><h3>Methods</h3><div>This study was conducted at a tertiary hospital in the Netherlands. Using comparative lifecycle assessment, we evaluated care pathways from outpatient appointments to follow-up visits, based on 40 waste inventories, considering material production, energy use, pharmaceutical production, sterilisation, transport, waste disposal, and recycling.</div></div><div><h3>Findings</h3><div>The embolisation procedure generated a median of 3·9 kg waste and 39 kg CO₂-equivalents (CO₂-eq), compared to 7·9 kg of waste and 120 kg of CO₂-eq generated by the hysterectomy procedure. When accounting for both hospitalisation and outpatient visits, 9 kg of waste and 215 kg of CO₂-eq were generated by the embolisation procedure and 6 kg of waste and 186 kg of CO₂-eq were generated by the hysterectomy pathway. Key contributors to environmental impact included patient and staff travel; electricity consumption for heating, ventilation and air-conditioning; and single-use items.</div></div><div><h3>Interpretation</h3><div>This study reveals the overall environmental footprint of two minimally invasive treatments in gynaecology and identifies key areas for mitigation strategies within each care pathway. Comprehensive environmental impact assessments can offer valuable insights for health-care systems that aim to balance clinical effectiveness with environmental sustainability.</div></div><div><h3>Funding</h3><div>Amsterdam University Medical Centre Doctoral School.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 ","pages":"Article 101348"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}