Wang Joyce, DasSarma Shiladitya
School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Institute of Marine and Environmental Technology, Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Int J Environ Res Public Health. 2024 Nov 22;21(12):1548. doi: 10.3390/ijerph21121548.
Considerable attention has recently been given to the contribution of the greenhouse gas (GHG) emissions of the healthcare sector to climate change. GHGs used in medical practice are regularly released into the atmosphere and contribute to elevations in global temperatures that produce detrimental effects on the environment and human health. Consequently, a comprehensive assessment of their global warming potential over 100 years (GWP) characteristics, and clinical uses, many of which have evaded scrutiny from policy makers due to their medical necessity, is needed. Of major interest are volatile anesthetics, analgesics, and inhalers, as well as fluorinated gases used as tamponades in retinal detachment surgery. In this review, we conducted a literature search from July to September 2024 on medical greenhouse gases and calculated estimates of these gases' GHG emissions in metric tons CO equivalent (MTCOe) and their relative GWP. Notably, the anesthetics desflurane and nitrous oxide contribute the most emissions out of the major medical GHGs, equivalent to driving 12 million gasoline-powered cars annually in the US. Retinal tamponade gases have markedly high GWP up to 23,500 times compared to CO and long atmospheric lifetimes up to 10,000 years, thus bearing the potential to contribute to climate change in the long term. This review provides the basis for discussions on examining the environmental impacts of medical gases with high GWP, determining whether alternatives may be available, and reducing emissions while maintaining or even improving patient care.
最近，医疗保健部门的温室气体（GHG）排放对气候变化的影响受到了广泛关注。医疗实践中使用的温室气体经常排放到大气中，导致全球气温升高，对环境和人类健康产生不利影响。因此，有必要对其100年全球变暖潜能值（GWP）特征、临床用途进行全面评估，其中许多由于其医疗必要性而未受到政策制定者的审查。主要关注的是挥发性麻醉剂、镇痛药和吸入器，以及视网膜脱离手术中用作填塞物的氟化气体。在本综述中，我们于2024年7月至9月对医疗温室气体进行了文献检索，并计算了这些气体以公吨二氧化碳当量（MTCOe）为单位的温室气体排放量及其相对全球变暖潜能值。值得注意的是，在主要的医疗温室气体中，麻醉剂地氟烷和一氧化二氮的排放量最大，相当于美国每年有1200万辆汽油驱动汽车的排放量。视网膜填塞气体的全球变暖潜能值显著高于二氧化碳，高达23500倍，大气寿命长达10000年，因此有可能在长期内对气候变化产生影响。本综述为讨论高全球变暖潜能值医疗气体的环境影响、确定是否有替代方案以及在维持甚至改善患者护理的同时减少排放提供了基础。
