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New analysis highlights carbon footprint of single-use surgical items
A new analysis of the carbon footprint of products used in the five most common surgical operations carried out in the NHS in England shows that 68% of carbon contributions come from single-use items, such as single-use gowns, patient drapes and instrument table drapes. Published by the Journal of the Royal Society of Medicine, the analysis highlights significant carbon contributors were the production of single use items and their waste disposal, together with processes for decontaminating reusable products. Researchers from Brighton and Sussex Medical
School and the University of Warwick carried out the study, which is the first to systematically evaluate the carbon footprint of products used in common operations. The analysis was based on direct observation of operating rooms across three sites of University Hospitals Sussex NHS Foundation Trust. Applying the carbon dioxide equivalent (CO2e), the standard unit for measuring carbon footprints, to each of the operations, the researchers showed that the operation with the highest product carbon footprint was knee replacement (85.5kg CO2e). This was followed by gall bladder removal (20.3kg CO2e), carpal tunnel decompression surgery (12.0kg CO2e), hernia repair (11.7kg CO2e) and tonsillectomy (7.5kg CO2e). Across the five operations, the researchers found that relatively few products (23%) were responsible for more than 80% of the product carbon footprint. This indicates that strategies for reducing greenhouse gas emissions associated with surgical operations should focus on the few products with highest emissions, typically large single-use (often plastic) items. Lead researcher, Dr. Chantelle Rizan, clinical
lecturer in sustainable healthcare at Brighton and Sussex Medical School, said: “Mitigating the carbon
footprint of products used in resource-intensive areas such as surgical operating rooms will be important in achieving Net Zero carbon healthcare. Strategies should include eliminating or finding low carbon alternatives for products with the biggest contribution.” Strategies to eliminate products, write the
researchers, include avoiding non-sterile gloves, where they could be replaced with hand-washing, not opening gauze swab packs unless required and asking suppliers to remove rarely used items from single-use pre-prepared packs. The researchers also suggest that a number of single-use high carbon products have reusable alternatives. For example, single-use gowns, patient drapes and instrument table drapes were high carbon contributors in the study, yet the researchers note there is no evidence that reusable surgical textiles, which hold significant reductions in carbon
footprint, are clinically inferior. Dr. Rizan concludes: “Eliminating single-use
items or switching to reusables where feasible, alongside optimising associated decontamination processes and waste segregation and recycling, could reduce product carbon footprint by one third. This model was based on reusable alternatives already on the market, and this figure may be surpassed where industry rises to the challenge of sustainable surgical product innovation.”
Reference 1 Rizan C, Lillywhite R, Reed M, Bhutta MF. The carbon footprint of products used in five common surgical operations: identifying contributing products and processes. J R Soc Med. 2023 Apr 13:1410768231166135. doi: 10.1177/01410768231166135. Epub ahead of print. PMID: 37054734.
Long COVID in women: research highlights link to inflammation
Women who have mild inflammation in the acute stages of COVID-19 infection may be more likely to experience a particular set of Long COVID symptoms, according to new research. The study, carried out by clinical researchers at the University of York, Hull York Medical school (HYMS) and the Hull University Teaching Hospital NHS Trust, found that women who survived severe COVID in the first wave of infection in 2019 were more likely to experience the muscle ache, low mood and anxiety that characterises Long COVID if their blood showed signs of inflammation while
they battled the disease. The research examined the cases of 144 COVID survivors, to explore possible pathways for further research into potential drivers of persisting symptoms in Long COVID. A significant number of the survivors were experiencing lingering symptoms, including fatigue (54.2%), breathlessness (52.8%), and sleep disturbance (37.5%) three months post-recovery. The researchers looked at blood samples taken
from the patients at the peak of their COVID-19 infection. They found that for many of the patients with lingering symptoms, and particularly the
women, the samples showed elevated biomarkers indicating inflammation activity in the body, including Interleukin-6, C-reactive protein, troponin-T, and ferritin. Scientists have been working to unravel the complexities of Long COVID since the first reports of the condition began to emerge shortly after the initial wave of the pandemic in early 2020. This observation sheds new light on the long-term effects of the virus by suggesting a potential link between inflammation and persistent symptoms in women, the researchers say.
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