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常规使用的内镜器械的生命周期评估和简单干预以减少我们的环境影响。

Life cycle assessment of routinely used endoscopic instruments and simple intervention to reduce our environmental impact.

机构信息

Department of Gastroenterology, La Fe Health Research Institute - IIS La Fe, Valencia, Spain.

Center for Biomaterials and Tissue Engineering (CBIT), Universitat Politècnica de València, Valencia, Spain.

出版信息

Gut. 2023 Sep;72(9):1692-1697. doi: 10.1136/gutjnl-2023-329544. Epub 2023 Apr 26.


DOI:10.1136/gutjnl-2023-329544
PMID:37185655
Abstract

OBJECTIVES: GI endoscopy units represent the third largest producers of medical waste. We aimed to determine endoscopic instrument composition and life cycle assessment (LCA) and to assess a sustainability proposal based on a mark on the instruments that identifies parts can be safely recycled or ''. DESIGN: Material composition analysis and LCA of forceps, snares and clips from four different manufacturers (A-D) were performed with four different methods. Carbon footprint from production, transportation and end of life of these instruments was calculated. In 30 consecutive procedures, we marked the contact point with the working channel. 5 cm away from that point was considered as . One-week prospective study was conducted with 184 procedures evaluating 143 instruments (75 forceps, 49 snares and 19 haemoclips) to assess the efficacy of this recyclable mark. RESULTS: Composition from different manufacturers varied widely. Most common materials were high global warming potential (GWP) waste (polyethylene, polypropylene and acrylonitrile) and low GWP waste (stainless steel). Significant differences were found for the forceps (0.31-0.47 kg of CO equivalent (CO-eq)) and haemoclips (0.41-0.57 kg CO-eq) between the manufacturers. was established 131.26 cm for gastroscope and 195.32 cm for colonoscope. One-week activity produced 67.74 kg CO-eq. Applying our sustainability intervention, we could reduce up to 27.44% (18.26 kg CO-eq). This allows the recycling of 61.7% of the instrument total weight (4.69 kg). CONCLUSION: Knowledge of carbon footprint is crucial to select the most sustainable alternatives because there are large variations between brands. A mark to identify recyclable parts could reduce our environmental impact significantly.

摘要

目的:胃肠内镜检查单位是医疗废物的第三大产生者。我们旨在确定内镜器械的组成和生命周期评估(LCA),并基于器械上的标记评估可持续性建议,该标记可识别可安全回收的部分或“”。

设计:对来自四个不同制造商(A-D)的钳子、套圈和夹的材料组成分析和 LCA 进行了四项不同的方法。计算了这些器械从生产、运输到使用寿命结束的碳足迹。在 30 次连续的手术中,我们在与工作通道接触的点标记。距离该点 5 厘米处被认为是。进行了一项为期一周的前瞻性研究,共有 184 例手术评估了 143 个器械(75 个钳子、49 个套圈和 19 个止血夹),以评估这种可回收标记的效果。

结果:不同制造商的组成差异很大。最常见的材料是高全球变暖潜能值(GWP)废物(聚乙烯、聚丙烯和丙烯腈)和低 GWP 废物(不锈钢)。在钳子(0.31-0.47kg CO 当量(CO-eq))和止血夹(0.41-0.57kg CO-eq)之间发现了显著的差异。胃肠镜的为 131.26cm,结肠镜的为 195.32cm。一周的活动产生了 67.74kg CO-eq。应用我们的可持续性干预措施,我们可以减少多达 27.44%(18.26kg CO-eq)。这允许回收器械总重量的 61.7%(4.69kg)。

结论:了解碳足迹对于选择最可持续的替代品至关重要,因为品牌之间存在很大差异。一个标记可识别可回收部分可以显著减少我们的环境影响。

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引用本文的文献

[1]
Environmental footprint of a colonoscopy procedure: Life cycle assessment.

Endosc Int Open. 2025-5-12

[2]
Is the green mark really recyclable?

Gut. 2025-6-6

[3]
Green endoscopy, one step toward a sustainable future: Literature review.

Endosc Int Open. 2024-8-23

[4]
Audit of hemostatic clip use after colorectal polyp resection in an academic endoscopy unit.

Endosc Int Open. 2024-4-23

[5]
Healthcare in the era of climate change and the need for environmental sustainability.

Singapore Med J. 2024-4-1

[6]
Materials Science Toolkit for Carbon Footprint Assessment: A Case Study for Endoscopic Accessories of Common Use.

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[7]
Reducing scope 3 carbon emissions in gastrointestinal endoscopy: results of the prospective study of the 'Green Endoscopy Project Würzburg'.

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