Decontamination
waste is recycled. There is significant room for improvement, therefore. The WHO is calling for action and states that the majority of healthcare waste should be recycled. But to support this, more data is required. “There are huge efforts in the fields of
gastroenterology and endoscopy in the past few years, so data will support our practice in the future,” Prof. Hayee commented. He went on to present figures for the current carbon footprint of endoscopy, which suggest that one endoscopy generates around 2kgCO2
the equivalent of driving five miles. This is based on the energy consumption alone, however, and does not include consumables or equipment. “When you consider how many procedures we perform, in the UK, that is a lot of ‘miles driven’,” he commented. “We saw how the world mobilised during the pandemic – but climate change poses a significant and existential threat, far greater than COVID-19. So, let’s make the effort to address this aspect of our practice too,” he asserted. The climate crisis has not gone away.
The COVID-19 pandemic has given us pause to change how we practice. But the 5.5% reduction in emissions globally is not enough. Global temperatures have risen 1.1 degree C above preindustrial levels. As temperatures have been driven up by high temperatures across the world, July 2023 is virtually certain to be the world’s warmest month on record, say scientists. UN Secretary, General Antonio Guterres, says the era of “global boiling” has arrived and that we urgently need to tackle climate change. Prof. Hayee pointed out that it is not just carbon emissions that we need to address – in 2017, the UN warned of a ‘planetary crisis’ being caused by ocean plastic. By 2019, ocean plastic was reported to be “visible from space”.
e –
Services can apply reductions in the following
areas: l Curb unnecessary procedures. l Move to paperless reports/electronic documentation.
l Favour cold snare polypectomy over diathermy.
l Reduce single use consumables. l Reduce nitrous oxide/general anaesthesia where possible.
l Use LED lights. l Procurement: move to bulk purchasing, low carbon alternatives, and alternatives to single use.
l Fill sharps bins full before disposal. l Avoid plastic bags/plastic cups. l Switch off unused lights/equipment. l Avoid overheating. l Cohort COVID+ patients to minimise cleaning/ PPE.
Reuse also has a contribution to make in the following areas: l Reuse the endoscope if not used for later procedure.
l Gastroscope for flexible sigmoidoscopy procedures for the same patient.
l Reuse cups/trays/endoscopes. l Use rechargeable batteries. l Distribute endoscopy solutions (e.g. lifting solutions/dye spray/acetic acid) between rooms.
l Washable sharps bin emptied into a central disposable collection point.
In terms of recycling, providers can: l Segregate waste disposal to individual recyclable components:
l plastic, paper l cardboard l glass l metals. l Increase availability of recycling bins. l Provide staff training on waste management. l Review waste recycling streams. l Use novel plastic recycling strategies, e.g. Sterimelt.
l Employ water reprocessing.
Prof. Hayee commented that suppliers should be held to account: “Our procurement teams are becoming more and more empowered to ask questions around the sustainability credentials of suppliers. If they can’t help us meet our Net Zero target, we simply won’t be doing business with them.” The CSC will continue to raise awareness
of how the decontamination sector can help the NHS reach its Net Zero goals and will be revisiting issues around sustainability at this
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