26
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Environmental Impacts of Surgical Procedures: Life Cycle Assessment of Hysterectomy in the United States

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          The healthcare sector is a driver of economic growth in the U.S., with spending on healthcare in 2012 reaching $2.8 trillion, or 17% of the U.S. gross domestic product, but it is also a significant source of emissions that adversely impact environmental and public health. The current state of the healthcare industry offers significant opportunities for environmental efficiency improvements, potentially leading to reductions in costs, resource use, and waste without compromising patient care. However, limited research exists that can provide quantitative, sustainable solutions. The operating room is the most resource-intensive area of a hospital, and surgery is therefore an important focal point to understand healthcare-related emissions. Hybrid life cycle assessment (LCA) was used to quantify environmental emissions from four different surgical approaches (abdominal, vaginal, laparoscopic, and robotic) used in the second most common major procedure for women in the U.S., the hysterectomy. Data were collected from 62 cases of hysterectomy. Life cycle assessment results show that major sources of environmental emissions include the production of disposable materials and single-use surgical devices, energy used for heating, ventilation, and air conditioning, and anesthetic gases. By scientifically evaluating emissions, the healthcare industry can strategically optimize its transition to a more sustainable system.

          Related collections

          Most cited references11

          • Record: found
          • Abstract: found
          • Article: not found

          Robotically assisted vs laparoscopic hysterectomy among women with benign gynecologic disease.

          Although robotically assisted hysterectomy for benign gynecologic conditions has been reported, little is known about the incorporation of the procedure into practice, its complication profile, or its costs compared with other routes of hysterectomy. To analyze the uptake of robotically assisted hysterectomy, to determine the association between use of robotic surgery and rates of abdominal and laparoscopic hysterectomy, and to compare the in-house complications of robotically assisted hysterectomy vs abdominal and laparoscopic procedures. Cohort study of 264,758 women who underwent hysterectomy for benign gynecologic disorders at 441 hospitals across the United States from 2007 to 2010. Uptake of and factors associated with utilization of robotically assisted hysterectomy. Complications, transfusion, reoperation, length of stay, death, and cost for women who underwent robotic hysterectomy compared with both abdominal and laparoscopic procedures were analyzed. Use of robotically assisted hysterectomy increased from 0.5% in 2007 to 9.5% of all hysterectomies in 2010. During the same time period, laparoscopic hysterectomy rates increased from 24.3% to 30.5%. Three years after the first robotic procedure at hospitals where robotically assisted hysterectomy was performed, robotically assisted hysterectomy accounted for 22.4% of all hysterectomies. The rates of abdominal hysterectomy decreased both in hospitals where robotic-assisted hysterectomy was performed as well as in those where it was not performed. In a propensity score-matched analysis, the overall complication rates were similar for robotic-assisted and laparoscopic hysterectomy (5.5% vs 5.3%; relative risk [RR], 1.03; 95% CI, 0.86-1.24). Although patients who underwent a robotic-assisted hysterectomy were less likely to have a length of stay longer than 2 days (19.6% vs 24.9%; RR, 0.78, 95% CI, 0.67-0.92), transfusion requirements (1.4% vs 1.8%; RR, 0.80; 95% CI, 0.55-1.16) and the rate of discharge to a nursing facility (0.2% vs 0.3%; RR, 0.79; 95% CI, 0.35-1.76) were similar. Total costs associated with robotically assisted hysterectomy were $2189 (95% CI, $2030-$2349) more per case than for laparoscopic hysterectomy. Between 2007 and 2010, the use of robotically assisted hysterectomy for benign gynecologic disorders increased substantially. Robotically assisted and laparoscopic hysterectomy had similar morbidity profiles, but the use of robotic technology resulted in substantially more costs.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            People, planet and profits: the case for greening operating rooms.

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Inhalation anaesthetics and climate change.

              Although the increasing abundance of CO(2) in our atmosphere is the main driver of the observed climate change, it is the cumulative effect of all forcing agents that dictate the direction and magnitude of the change, and many smaller contributors are also at play. Isoflurane, desflurane, and sevoflurane are widely used inhalation anaesthetics. Emissions of these compounds contribute to radiative forcing of climate change. To quantitatively assess the impact of the anaesthetics on the forcing of climate, detailed information on their properties of heat (infrared, IR) absorption and atmospheric lifetimes are required. We have measured the IR spectra of these anaesthetics and conducted calculations of their contribution to radiative forcing of climate change recognizing the important fact that radiative forcing is strongly dependent on the wavelength of the absorption features. Radiative efficiencies of 0.453, 0.469, and 0.351 W m(-2) ppb(-1) and global warming potentials (GWPs) of 510, 1620, and 210 (100 yr time horizon) were established for isoflurane, desflurane, and sevoflurane, respectively. On the basis of the derived 100 yr GWPs, the average climate impact per anaesthetic procedure at the University of Michigan is the same as the emission of ∼22 kg CO(2). We estimate that the global emissions of inhalation anaesthetics have a climate impact which is comparable with that from the CO(2) emissions from one coal-fired power plant or 1 million passenger cars.
                Bookmark

                Author and article information

                Journal
                Environ Sci Technol
                Environ. Sci. Technol
                es
                esthag
                Environmental Science & Technology
                American Chemical Society
                0013-936X
                1520-5851
                17 December 2015
                17 December 2014
                03 February 2015
                : 49
                : 3
                : 1779-1786
                Affiliations
                []Department of Civil and Environmental Engineering, University of Pittsburgh , 153 Benedum Hall, 3700 O’Hara Street, Pittsburgh, Pennsylvania 15261, United States
                []Magee-Womens Hospital of UPMC, Department of Obstetrics and Gynecology, University of Pittsburgh School of Medicine , 300 Halket Street, Pittsburgh, Pennsylvania 15213, United States
                [§ ]Department of Civil and Environmental Engineering, Northeastern University , 360 Huntington Avenue, Boston, Massachusetts 02115, United States
                []Department of Anesthesiology, Yale University School of Medicine , 333 Cedar Street, TMP 3, New Haven, Connecticut 06520, United States
                []School of Sustainable Engineering and the Built Environment, Arizona State University P.O. Box 875306, Tempe, Arizona 85287, United States
                Author notes
                [* ]Cassandra L. Thiel, Ph.D. E-mail: clt31@ 123456pitt.edu . M: (608)387-1985. O: (412)624-9870. F: (412)624-0135.
                Article
                10.1021/es504719g
                4319686
                25517602
                e30243e3-ef49-44c1-bbeb-96586b254587
                Copyright © 2014 American Chemical Society

                This is an open access article published under an ACS AuthorChoice License, which permits copying and redistribution of the article or any adaptations for non-commercial purposes.

                History
                : 25 September 2014
                : 17 December 2014
                : 16 December 2014
                Funding
                National Institutes of Health, United States
                Categories
                Article
                Custom metadata
                es504719g
                es-2014-04719g

                General environmental science
                General environmental science

                Comments

                Comment on this article