Greenhouse gas: global healthcare inventory

This paper proposes a new data-gathering framework to improve the World Health Organization (WHO) estimate of the impact of greenhouse gases. The new framework will be undertaken by the International Federation of Hospital Engineers.

Healthcare constitutes a significant portion of human activity and of the global economy. It is, therefore, both a significant generator of greenhouse gases (GHGs) and a potential leader in reducing emissions. The WHO is currently finalising a book,

Health in the Green Economy, detailing actions the global healthcare sector should take to combat climate change while simultaneously producing health co-benefits. An Annex to this attempts to generate an estimate for GHG impact of the global health sector, using sketchy available data and large extrapolations. That work concludes with the observation that much more data is needed. The WHO’s initial estimates suggest the healthcare sector contributes 2.8% of total global GHG emissions. The Intergovernmental Panel on

Climate Change synthesises scientific opinion expressing both an evaluation of underlying scientific understanding and level of confidence in that science. The findings in its fifth assessment report are clear. Warming of the climate system is unequivocal. Greenhouse gases, including carbon dioxide (CO2

), methane (CH4 oxide (N2 ), nitrous O) and others,

trap heat within earth’s atmosphere, warming the planet. Human influence on the climate system is also clear, and it is extremely likely that human influence has been the dominant cause of the observed warming since the mid- 20th century. The atmosphere and ocean have warmed, the amounts of snow and ice have diminished, sea level has risen and GHG gas concentrations have increased. Unabated, this will impact climate systems and likely lead to various public health threats.1 Greenhouse gas emissions

occur from many sectors of the IFHE DIGEST 2017

economy. Sectors such as power generation, cement generation, steel, forestry (especially as it relates to forests as a depository/sink for carbon dioxide), and transportation are often studied and cited as industries with large GHG impacts. As opposed to looking at GHG at a national level, many have advocated taking a sectoral approach, working specifically within sectors, to reduce overall GHG impacts. These advocates believe that working within sectors may lead to more innovative solutions, regulations, and collaborations to reduce GHG emissions.

WHO’s estimate Given the various sources of healthcare sector GHG emissions and the disparity in likely emission levels between countries, it can be difficult to quantify world healthcare sector emissions. The methodology presented here

seeks to be continuously robust, inviting submissions of country-level data from readers, IFHE members,

Troy Savage Troy Savage is a Project

Manager with Mazzetti. He

works with organisations to define and implement

strategic initiatives to reduce energy use intensity and greenhouse gas emissions.

Walt Vernon

Walt Vernon is the CEO of Mazzetti. He is one of the

Principal Authors for the WHO Book, Health in the Green Economy, and created the

WHO analysis of healthcare’s global GHG production. He serves on the Executive

Committee of the IFHE, and the board of the Facility Guidelines Institute.

Identifying and implementing ways to reduce emissions across the sector is an important activity

and other sources as described below. In order to remain robust, national-

level data needs must be clearly reported. Additionally, available public data should be utilised. This article extends a classical model to both assist understanding of healthcare GHG impacts and to ease provision of data for maximum estimate accuracy. The healthcare sector contributes to

GHG emissions. GHG emissions here are measured in carbon dioxide equivalent (CO2

e). In simple terms CO2 e is a unit

that allows all emissions with global warming potential to be expressed in comparison to the global warming potential of CO2

. When considering

greenhouse gas emissions, consider direct emissions, indirect energy related emissions, and all other indirect energy emissions. These emission types are known as Scope 1, Scope 2 and Scope 3 emissions respectively.2 Scope 1 emissions are direct

emissions from sources that are owned or controlled by the reporting entity, in this case the healthcare sector.

Examples of scope 1 emissions in healthcare include fuel used in generators, incinerators, air-conditioning and refrigeration gas refills; fuel used by emergency and other vehicles, gas used for cooking, medical gas consumed by anaesthetists and others.3 Scope 2 emissions are from purchased

or acquired electricity, steam, heat, and cooling. Power and steam/chilled water


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