Arnoldo Saranya, Bailey Dana, Leung Felix, Bouhtiauy Ihssan, El Hassan Mohamed Abou, Oleschuk Curtis, Beriault Daniel R
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Department of Laboratory Medicine, Unity Health Toronto, Toronto, ON, Canada.
LifeLabs Medical Laboratory Services, Ontario, Canada.
Clin Biochem. 2025 Aug;138:110944. doi: 10.1016/j.clinbiochem.2025.110944. Epub 2025 May 2.
Choosing Wisely Canada has made significant contributions to diagnostic stewardship and appropriate test ordering. Given that laboratories play a crucial role in advancing healthcare efficiency and sustainability, it is imperative to continue advocating for Choosing Wisely laboratory initiatives to minimize unnecessary testing and mitigate the associated environmental impact. Herein, we recommend the focus on two environmental impacts associated with the overuse of diagnostic laboratory tests. Firstly, collaboration with healthcare providers is essential to raise public awareness about the waste generated by performing lab tests in the absence of a clear clinical indication. Not only does unnecessary testing come with clinical and financial costs, but it also contributes significantly to a substantial carbon footprint. Patients also have a role in reducing waste by understanding when tests are truly necessary and when they might be redundant or even harmful. Secondly, laboratories should partner with in vitro diagnostic device manufacturers to prioritize environmentally conscientious solutions. This includes minimizing the use of single-use consumables, toxic chemicals, and high-energy consumption processes. Laboratories should adopt a holistic, "environmental lens" approach, scrutinizing every stage of the laboratory total testing workflow- from sample collection and transportation, to testing, reporting, and disposal-to identify areas where waste reduction and process efficiencies can be achieved. The optimization of testing workflows to eliminate unnecessary steps can lead to both environmentally sound and cost-effective operations. In summary, laboratories are in a unique position to lead the way in both improving clinical care and driving eco-friendliness in healthcare. By aligning with Choosing Wisely initiatives and focusing on greener practices, laboratories can lead the way in improving both patient care and environmental sustainability.
