Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts.
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
Ann Surg. 2021 Jun 1;273(6):1108-1114. doi: 10.1097/SLA.0000000000004755.
We review the existing research on environmentally sustainable surgical practices to enable SAO to advocate for improved environmental sustainability in operating rooms across the country.
Climate change refers to the impact of greenhouse gases emitted as a byproduct of human activities, trapped within our atmosphere and resulting in hotter and more variable climate patterns.1 As of 2013, the US healthcare industry was responsible for 9.8% of the country's emissions2; if it were itself a nation, US healthcare would rank 13th globally in emissions.3 As one of the most energy-intensive and wasteful areas of the hospital, ORs drive this trend. ORs are 3 to 6 times more energy intensive than clinical wards.4 Further, ORs and labor/delivery suites produce 50%-70% of waste across the hospital.5,6 Due to the adverse health impacts of climate change, the Lancet Climate Change Commission (2009) declared climate change "the biggest global health threat of the 21st century" and predicted it would exacerbate existing health disparities for minority groups, children and low socioeconomic patients.7.
METHODS/RESULTS: We provide a comprehensive narrative review of published efforts to improve environmental sustainability in the OR while simultaneously achieving cost-savings, and highlight resources for clinicians interested in pursuing this work.
Climate change adversely impacts patient health, and disproportionately impacts the most vulnerable patients. SAO contribute to the problem through their resource-intensive work in the OR and are uniquely positioned to lead efforts to improve the environmental sustainability of the OR.
我们回顾了现有的环境可持续性外科实践研究,以使 SAO 能够倡导在全国手术室中提高环境可持续性。
气候变化是指人类活动产生的温室气体排放被捕获在大气层内,导致气候模式变得更热且更不稳定。截至 2013 年,美国医疗保健行业的排放量占全国的 9.8%;如果它本身是一个国家,美国的医疗保健行业在排放量方面将排在全球第 13 位。作为医院中能源密集度和浪费最严重的领域之一,手术室推动了这一趋势。手术室的能源密集度比临床病房高 3 到 6 倍。此外,手术室和产房/分娩室产生的废物占医院废物的 50%-70%。由于气候变化对健康的不利影响,柳叶刀气候变化委员会(2009 年)宣布气候变化是“21 世纪最大的全球健康威胁”,并预测它将加剧少数群体、儿童和低社会经济患者现有的健康差距。
方法/结果:我们全面叙述了在手术室中提高环境可持续性同时实现成本节约的已发表努力,并为有兴趣从事这项工作的临床医生提供了资源。
气候变化对患者健康产生不利影响,对最脆弱的患者的影响尤为严重。SAO 通过在手术室中的资源密集型工作加剧了这个问题,并且处于改善手术室环境可持续性的独特地位。