Gordon Ilyssa O, Sherman Jodi D, Leapman Michael, Overcash Michael, Thiel Cassandra L
Department of Pathology, Cleveland Clinic, Cleveland, OH, USA.
Department of Anesthesiology, Yale School of Medicine, and Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
Am J Clin Pathol. 2021 Sep 8;156(4):540-549. doi: 10.1093/ajcp/aqab021.
Given adverse health effects of climate change and contributions of the US health care sector to greenhouse gas (GHG) emissions, environmentally sustainable delivery of care is needed. We applied life cycle assessment to quantify GHGs associated with processing a gastrointestinal biopsy in order to identify emissions hotspots and guide mitigation strategies.
The biopsy process at a large academic pathology laboratory was grouped into steps. Each supply and reagent was catalogued and postuse treatment noted. Energy consumption was estimated for capital equipment. Two common scenarios were considered: 1 case with 1 specimen jar (scenario 1) and 1 case with 3 specimen jars (scenario 2).
Scenario 1 generated 0.29 kg of carbon dioxide equivalents (kg CO2e), whereas scenario 2 resulted in 0.79 kg CO2e-equivalent to 0.7 and 2.0 miles driven, respectively. The largest proportion of GHGs (36%) in either scenario came from the tissue processor step. The second largest contributor (19%) was case accessioning, mostly attributable to production of single-use disposable jars.
Applied to more than 20 million biopsies performed in the US annually, emissions from biopsy processing is equivalent to yearly GHG emissions from 1,200 passenger cars. Mitigation strategies may include modification of surveillance guidelines to include the number of specimen jars.
鉴于气候变化对健康的不利影响以及美国医疗保健部门对温室气体(GHG)排放的贡献,需要实现环境可持续的医疗服务。我们应用生命周期评估来量化与处理胃肠道活检相关的温室气体,以确定排放热点并指导缓解策略。
将一家大型学术病理实验室的活检过程分为多个步骤。对每种耗材和试剂进行编目,并记录使用后的处理情况。估算了固定资产设备的能源消耗。考虑了两种常见情况:1个病例使用1个标本瓶(情况1)和1个病例使用3个标本瓶(情况2)。
情况1产生了0.29千克二氧化碳当量(kg CO2e),而情况2产生了0.79千克CO2e,分别相当于行驶0.7英里和2.0英里的排放量。在这两种情况中,温室气体占比最大的部分(36%)来自组织处理步骤。第二大排放源(19%)是病例登记,主要归因于一次性标本瓶的生产。
在美国每年进行的2000多万例活检中,活检处理产生的排放相当于1200辆乘用车的年度温室气体排放量。缓解策略可能包括修改监测指南,将标本瓶数量纳入其中。