Comparative Study on Environmental Impacts of Reusable and Single-use Bronchoscopes

The introduction of single-use alternatives has stressed the need for environmental comparisons between reusable and single-use devises in the healthcare sector. Discarding of single-use devices intuitively causes concern among staff in hospitals, other users and people with environmental concerns as to whether the single use is environmentally friendly. This study aims to compare carbon dioxide (CO2)-equivalent emissions and resource consumption from a single-use bronchoscope (Ambu® aScopeTM 4) to a reusable flexible bronchoscope. The comparison is made using a simplified life-cycle-assessment methodology. The analysis shows that the materials used for the cleaning operations of the reusable scopes are a key factor affecting the impact factors assessed; energy consumption, emission of CO2-equivalent and consumption of scarce resources. Initially, it is assumed that each reusable scope is cleaned using one set of personal protective equipment (PPE) per cleaning operation, but since cleaning practice may vary the consequence of cleaning more scopes with one set of PPE is also assessed. Using one set of protective wear per operation and the materials for cleaning and disinfection determine that reusable scopes have comparable or higher material and energy consumption as well as higher emissions of CO2-equivalents and values of resource consumption. Cleaning two or more reusable scopes per set of PPE makes the impacts fairly comparable. Other aspects that may impact the results are also assessed, including energy consumption for washing and drying units, differences in use of PPE and differences in the disposal of PPE or single-use scopes. As the three assessed parameters are highly dependent on cleaning procedures and the use of protective equipment, it cannot be concluded from these results which type of bronchoscope affects the environmental factors investigated here the most.