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1ISG-019 Do all surgical specialties have an identical carbon footprint within an ambulatory unit?
  1. O Jouhet,
  2. M Quentin,
  3. B Rui,
  4. T Damien
  1. Hospital Cochin- APHP, Central Sterile Services Department CSSD- Pharmacy Department, Paris, France


Background and Importance Operating theatres produce 30% of the healthcare system’s greenhouse gas (GHGs) emissions. As part of its sustainable development strategy, our hospital has decided to assess the greenhouse gases emitted by an Ambulatory Surgery Unit (ASU). Opened in April 2018, the ASU has five operating theatres where eight surgical specialties can operate 22 patients a day.

Aim and Objectives The aim is to assess the carbon footprint of surgical specialties in order to identify the most GHG emitting sources.

Material and Methods Thanks to the hospital’s Sustainable Development Commission (SDC), the carbon footprint of the surgical specialties was assessed by two community service students, one extern and one pharmacy resident. The GHG emissions generated in 2022 by water, electricity and energy consumption, equipment, drugs, gas, single-use medical devices (SUMDs) and re-sterilisable medical devices (RSMDs) procurement, Regulated Medical Waste (RMW) and Municipal Solid Waste (MSW), patient and staff movements were estimated based on ADEME factors. Emissions associated with the acquisition of Sterile Medical Devices, known as ‘specific emissions’, vary according to surgical specialty. The remaining emissions sources are called ‘common emissions’.

Results In 2022, the ASU emitted 634 tonnes of eCO2. Common emissions reached 292 t eCO2: equipment (9%), energy (9%), travel (7%), RSMD (6%), drugs (4%), waste (1%) and gas (1%). Specific emissions account for 54% (342 tonnes eCO2). Orthopaedic surgery emits 166 t eCO2 per year, including 59 t eCO2 from common emissions. Orthopaedic, urological, dermatological, gynaecological, gastrointestinal and plastic surgery account for 171, 117, 84, 93, 93 and 85 kg eCO2 per patient respectively.

Conclusion and Relevance This study highlights the most GHG emitting positions (SMD procurement) and specialties (Orthopaedic surgery) in the ASU. Several actions have been taken towards sustainable development. Environmentally, the air-conditioning output is reduced when the operating theatre is closed, waste is distributed in paper or plastic garbage bins, and sevoflurane is the only gas administered. Economically, hospital stays are shorter than those for conventional surgery. Socially, the unit offers patients a peaceful environment. These findings were presented to the SDC. Suggestions were made to refine RSMD compositions with input from surgeons and replace SMD with RSMD whenever possible.

Conflict of Interest No conflict of interest.

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