Two-thirds of NHS operations’ carbon footprint from single-use items – study

Single-use surgical items make up two-thirds of the carbon footprint of the five most common NHS operations, a new study has found.

By observing operations across three sites at University Hospitals Sussex NHS Foundation Trust, the researchers saw that 68% of the carbon contributions came from single-use, often plastic items such as gowns and drapes for patients and instrument tables.

Knee replacements were found to have the highest footprint, with 85.5kg CO2e, followed by gall bladder removal with 20.3kg CO2e, carpal tunnel decompression surgery with 12kg CO2e, hernia repair with 11.7kg CO2e and tonsillectomy with 7.5kg CO2e.

Carbon dioxide equivalent (CO2e) is the standard unit for measuring carbon footprints and is used to compare the emissions of various greenhouse gases by converting them into carbon dioxide with the same global warming potential.

The researchers, from Brighton and Sussex Medical School and the University of Warwick, said only 23% of items were responsible for more than 80% of the surgeries’ carbon footprint, so the focus should be on finding alternatives for these carbon-heavy items.

Lead researcher Dr Chantelle Rizan of Brighton and Sussex Medical School said immediate changes such as swapping single-use items for reusable ones where possible and better decontamination and waste processing could reduce the carbon footprint of operations by a third.

She added: “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.”

The study, published in the Journal of the Royal Society of Medicine, is the first of its kind to analyse the carbon footprint of surgical items used in common operations.

Healthcare professionals should avoid non-sterile gloves where they can be replaced with hand-washing, not open gauze swab packs unless required and ask suppliers to remove rarely used items from single-use pre-prepared packs, the researchers wrote.

They said there was no evidence to suggest that reusable surgical textiles are clinically inferior to significantly higher carbon-contributing items like single-use gowns and drapes.

Dr Rizan said: “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.”

NHS England has said it wants to reduce its carbon footprint to net zero by 2040 on the emissions it controls directly, such as energy use, facilities, waste and water.

It also wants to reduce its carbon footprint to net zero on emissions it influences indirectly by 2045, such as construction, catering, shipping, IT and patient and staff travel.