Maida Marcello, Vitello Alessandro, Shahini Endrit, Vassallo Roberto, Sinagra Emanuele, Pallio Socrate, Melita Giuseppinella, Ramai Daryl, Spadaccini Marco, Hassan Cesare, Facciorusso Antonio
Department of Medicine and Surgery, University of Enna 'Kore', Enna, Italy.
Gastroenterology Unit, Umberto I Hospital, Enna, Italy.
Endosc Int Open. 2024 Aug 23;12(8):E968-E980. doi: 10.1055/a-2303-8621. eCollection 2024 Aug.
Rapid climate change or climate crisis is one of the most serious emergencies of the 21st century, accounting for highly impactful and irreversible changes worldwide. Climate crisis can also affect the epidemiology and disease burden of gastrointestinal diseases because they have a connection with environmental factors and nutrition. Gastrointestinal endoscopy is a highly intensive procedure with a significant contribution to greenhouse gas (GHG) emissions. Moreover, endoscopy is the third highest generator of waste in healthcare facilities with significant contributions to carbon footprint. The main sources of direct carbon emission in endoscopy are use of high-powered consumption devices (e.g. computers, anesthesia machines, wash machines for reprocessing, scope processors, and lighting) and waste production derived mainly from use of disposable devices. Indirect sources of emissions are those derived from heating and cooling of facilities, processing of histological samples, and transportation of patients and materials. Consequently, sustainable endoscopy and climate change have been the focus of discussions between endoscopy providers and professional societies with the aim of taking action to reduce environmental impact. The term "green endoscopy" refers to the practice of gastroenterology that aims to raise awareness, assess, and reduce endoscopy´s environmental impact. Nevertheless, while awareness has been growing, guidance about practical interventions to reduce the carbon footprint of gastrointestinal endoscopy are lacking. This review aims to summarize current data regarding the impact of endoscopy on GHG emissions and possible strategies to mitigate this phenomenon. Further, we aim to promote the evolution of a more sustainable "green endoscopy".
快速的气候变化或气候危机是21世纪最严重的紧急情况之一，在全球范围内造成了极具影响力且不可逆转的变化。气候危机还会影响胃肠道疾病的流行病学和疾病负担，因为它们与环境因素和营养有关。胃肠内镜检查是一项高强度的操作，对温室气体（GHG）排放有重大影响。此外，内镜检查是医疗机构中第三大废物产生源，对碳足迹有重大贡献。内镜检查中直接碳排放的主要来源是使用高功率消耗设备（如计算机、麻醉机、再处理用清洗机、内镜处理器和照明设备）以及主要由一次性设备使用产生的废物。间接排放源包括设施的加热和冷却、组织学样本的处理以及患者和物资的运输。因此，可持续的内镜检查和气候变化一直是内镜检查提供者和专业协会讨论的焦点，目的是采取行动减少环境影响。“绿色内镜检查”一词指的是胃肠病学的一种实践，旨在提高认识、评估并减少内镜检查对环境的影响。然而，尽管人们的认识在不断提高，但关于减少胃肠内镜检查碳足迹的实际干预措施的指导却很缺乏。本综述旨在总结当前关于内镜检查对温室气体排放影响的数据以及减轻这一现象的可能策略。此外，我们旨在推动更具可持续性的“绿色内镜检查”的发展。
