Petre Maria-Alexandra, Malherbe Stephan
Department of Anesthesiology, Montreal Children's Hospital, McGill University, Montreal, QC, Canada.
Department of Anesthesiology, Pharmacology & Therapeutics, British Columbia Children's Hospital, University of British Columbia, Vancouver, BC, Canada.
Can J Anaesth. 2020 Aug;67(8):1044-1063. doi: 10.1007/s12630-020-01726-0. Epub 2020 Jun 8.
This continuing professional development module aims to inform anesthesiologists about the magnitude of healthcare-related waste and its contribution to global warming, as well as providing general strategies to improve environmental sustainability in daily anesthesia practice in a Canadian context.
Global warming is considered to be the biggest global health threat of the 21 century. Healthcare is not only adversely impacted by but also a significant contributor to global warming and environmental degradation. Healthcare provision produces 4.6% of the total national greenhouse gas emissions in Canada, while healthcare waste has increased unabated in recent years, largely because of increased use of disposable medical supplies. Operating rooms are highly energy-intensive and produce up to 33% of total hospital waste. Increasingly, attention in healthcare is being focused on environmental sustainability by exploring evidence-based approaches to more sustainable delivery of healthcare. Key to environmental sustainability research is the life-cycle assessment methodology, which measures the cradle-to-grave impact of products on various environmental outcomes and empowers purchasing departments to make environmentally conscious decisions. By using the "reduce, reuse, recycle" hierarchy of waste reduction, several easily implementable evidence-based strategies are proposed to reduce the environmental footprint of everyday anesthesia practice. These recommendations focus on informed decisions on volatile anesthetic use, reduced drug waste, limited use of single-use devices, and meticulous waste segregation and recycling strategies.
Anesthesiologists have a unique opportunity to be champions of environmental sustainability through evidence-based practices, while simultaneously reaping significant synergistic health, cost, and quality co-benefits.
本持续专业发展模块旨在让麻醉医生了解医疗相关废弃物的规模及其对全球变暖的影响,并提供在加拿大背景下改善日常麻醉实践中环境可持续性的一般策略。
全球变暖被认为是21世纪最大的全球健康威胁。医疗保健不仅受到全球变暖的不利影响,也是其主要促成因素之一,会导致环境退化。在加拿大,医疗保健产生的温室气体排放量占全国总量的4.6%,而近年来医疗废弃物持续增加,主要原因是一次性医疗用品的使用增多。手术室能源密集度高,产生的废弃物占医院废弃物总量的33%。通过探索基于证据的方法以实现更可持续的医疗保健服务,医疗保健领域对环境可持续性的关注日益增加。环境可持续性研究的关键是生命周期评估方法,该方法衡量产品从摇篮到坟墓对各种环境结果的影响,并使采购部门能够做出具有环境意识的决策。通过采用“减少、再利用、回收”的废弃物减少层级,提出了一些易于实施的基于证据的策略,以减少日常麻醉实践对环境的影响。这些建议侧重于对挥发性麻醉剂使用做出明智决策、减少药物浪费、限制一次性设备的使用,以及细致的废弃物分类和回收策略。
麻醉医生有独特的机会通过基于证据的实践成为环境可持续性的倡导者,同时获得显著的健康、成本和质量协同效益。