Environmental impact of pediatric ENT surgery: A STROBE analysis

Introduction

Increasing emissions of greenhouse gases contribute to climate change. The healthcare sector, and particularly the operating room, is a significant emitter of greenhouse gases. In head-and-neck surgery, pediatric procedures are very common, but few studies have assessed their ecological impact. Our objective was to quantify the carbon footprint of common pediatric head-and-neck surgeries (tonsillectomy, adenoidectomy, and transtympanic tube placement).

Methods

An eco-epidemiological study was conducted in December 2022 in a tertiary hospital center. The carbon footprint of 10 pediatric head-and-neck surgeries (tonsillectomies, adenoidectomies, transtympanic tube placements) was calculated, as the sum of carbon dioxide (CO₂eq) emissions generated by patient and medical staff transport, waste production, energy consumption in operating rooms, manufacturing and transport of disposable and reusable medical devices (MDs), medication production, and sterilization of reusable MDs.

Results

The carbon footprint of 1 pediatric head-and-neck surgery was 57.86 kgCO₂eq. Disposable MDs were the most polluting item with 30.82 kgCO₂eq (53.3%). Patient transport accounted for 27.4%, medication for 12.6% and reusable MDs for 2.9%.

Conclusions

Pediatric head-and-neck surgeries generate a significant quantity of CO₂, mostly due to the production and delivery of disposable MDs. These observations could serve as a starting point for ecological actions consistent with an environmentally sustainable and climate-resilient health system.