DECARBONISATION
Pioneering the transition to all-electric hospitals
Healthcare facilities produce a significant proportion of the world’s carbon emissions, which means that decarbonisation in the sector is absolutely crucial, as Jim Crabb, PE, LEED AP, principal at Mazzetti, explains.
The need for decarbonisation in healthcare is becoming increasingly critical. Healthcare represents almost 20 per cent of the US national economy, 8.5% of US carbon emissions, and 5% of global carbon emissions, with these figures continuing to grow. Traditionally, healthcare is known for its principle of ‘doing no harm’; however, it significantly contributes to the carbon footprint. The built environment, which includes healthcare facilities, is a major contributor to global greenhouse gas (GHG) emissions, accounting for almost 40% of total energy-related emissions. Decarbonising hospitals is an essential step towards a low-carbon future and meeting global climate goals.
Major health organisations, including the World Health
Northeast Georgia Medical Center Braselton, USA.
Organization (WHO) and the International Hospital Federation, emphasise the urgency of addressing climate change to prevent a rapidly expanding public health crisis. Similarly, engineering and design organisations such as the International Federation of Healthcare Engineering (IFHE) and American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASRAE) advocate for significant reductions in the collective carbon footprint by 2030. This means not only halting the increase in carbon emissions but also reducing existing emissions by 50%. The transition to all-electric systems in hospitals is a
crucial part of this decarbonisation effort. Traditionally, hospitals rely on natural gas for heating, hot water, and steam, while simultaneously using chiller plants to remove heat from buildings and reject it to the atmosphere. A more efficient and less carbon-intensive approach involves using heat pumps and heat recovery chillers. These systems, which run solely on electricity, require zero on-site combustion and recover waste heat from within the building to be repurposed for other heating needs.
Current reliance on fossil fuels in hospitals Most hospitals heavily rely on fossil fuels for their energy needs, particularly for heating and hot water systems. In 2012, the Integrated Design Lab at the University of Washington published a study titled Targeting 100! which found that 50-60% of hospital source energy is thermal, derived from fossil fuels either on-site or from a district heating plant, with the remaining 40-50% being electric. This reliance on fossil fuels not only contributes to GHG emissions but also increases the vulnerability of hospitals to fluctuations in fuel prices and supply disruptions. The combustion of natural gas and other fossil fuels
for heating and power generation in hospitals leads to significant emissions of carbon dioxide (CO2
) and other
GHGs. These emissions contribute to climate change, which in turn affects human health by increasing the frequency and severity of heatwaves, storms, and other extreme weather events. The healthcare sector, with its mission to protect health, is thus in contradiction by contributing to a major health threat through its reliance on fossil fuels.
Environmental and health impacts of fossil fuel use The environmental and health impacts of fossil fuel use in hospitals are significant. According to the WHO, climate change is the greatest threat to global health in the 21st century. The main cause of climate change is the increasing concentration of GHGs, such as carbon dioxide, in the atmosphere. Human activities, including the burning of fossil fuels, deforestation, and industrial processes, have greatly increased these concentrations, leading to rapid and unprecedented warming of the planet. These gases trap heat from the sun and warm the Earth’s surface, resulting in rising sea levels, more frequent and severe weather
26 Health Estate Journal November 2025
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