Park Su Bee, Cha Jae Myung
Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
Clin Endosc. 2023 May;56(3):263-267. doi: 10.5946/ce.2023.003. Epub 2023 Mar 31.
Climate change is a global emergency. Consequently, current global targets to combat the climate crisis include reaching net-zero carbon emissions by 2050 and keeping global temperature increases below 1.5 ˚C. In 2014, the healthcare carbon footprint was 5.5% of the total national footprint. Gastrointestinal endoscopy (GIE) has a large carbon footprint compared to other procedures performed in healthcare facilities. GIE was identified as the third largest generator of medical waste in healthcare facilities for the following reasons: (1) GIE is associated with high case volumes, (2) GIE patients and relatives travel frequently, (3) GIE involves the use of many nonrenewable wastes, (4) single-use devices are used during GIE, and (5) GIE is frequently reprocessed. Immediate actions to reduce the environmental impact of GIE include: (1) adhering to guidelines, (2) implementing audit strategies to determine the appropriateness of GIE, (3) avoiding unnecessary procedures, (4) using medication rationally, (4) digitalization, (5) telemedicine, (6) critical pathways, (7) outpatient procedures, (8) adequate waste management, and (9) minimizing single-use devices. In addition, sustainable infrastructure for endoscopy units, using renewable energy, and 3R (reduce, reuse, and recycle) programs are necessary to reduce the impact of GIE on the climate crisis. Consequently, healthcare providers need to work together to achieve a more sustainable future. Therefore, strategies must be implemented to achieve net-zero carbon emissions in the healthcare field, especially from GIE, by 2050.
气候变化是一场全球紧急情况。因此，当前应对气候危机的全球目标包括到2050年实现净零碳排放，并将全球气温升幅控制在1.5摄氏度以下。2014年，医疗保健领域的碳足迹占全国总足迹的5.5%。与医疗机构进行的其他手术相比，胃肠内镜检查（GIE）的碳足迹较大。GIE被确定为医疗机构中第三大医疗废物产生源，原因如下：（1）GIE病例数量多；（2）GIE患者及其亲属出行频繁；（3）GIE涉及使用许多不可再生废物；（4）GIE过程中使用一次性设备；（5）GIE经常进行再处理。减少GIE对环境影响的立即行动包括：（1）遵守指南；（2）实施审计策略以确定GIE的适当性；（3）避免不必要的手术；（4）合理用药；（4）数字化；（5）远程医疗；（6）关键路径；（7）门诊手术；（8）适当的废物管理；（9）尽量减少一次性设备的使用。此外，需要有可持续的内镜检查单元基础设施、使用可再生能源以及开展3R（减少、再利用和回收）计划，以减少GIE对气候危机的影响。因此，医疗保健提供者需要共同努力，以实现更可持续的未来。所以，必须实施相关策略，到2050年在医疗保健领域实现净零碳排放，尤其是来自GIE的碳排放。
