Strategies for energy conservation and sustainability in medical laboratories.

Medical laboratories require a great amount of energy, ranging from three to six times more than a standard office building. Also, they consume massive amounts of water and gases and produce diverse waste products, some of which are toxic. Their energy requirements are complex and when estimating the total carbon footprint of a medical laboratory, we need to keep in mind the different contributors present. First, laboratory instrumentation varies for various laboratory tests, requiring different amounts of electricity, gas, water, and consumables. Furthermore, according to some estimates, laboratory infrastructure of heating, ventilation, and air-conditioning (HVAC) system may account for 40-60% of energy consumption, depending on its complexity and different requirements for different buildings. A lighting/shading system may consume up to 15% of the total energy. Also, the computers and their supporting systems needed for laboratory data processing use electrical power and contribute to the carbon footprint of medical laboratories. The systematic approach to mitigate the environmental impact of the healthcare sector in general, and medical laboratories in particular, is the voluntary adoption of an Environmental Management System (EMS) according to the International Standards ISO 14001 or the European EMAS (Eco-Management and Audit Scheme). Focusing on managing energy efficiency, the ISO 50001 Energy Management Systems - Requirements with guidance for use, can help medical laboratories develop and implement an energy-saving strategy by establishing achievable energy usage goals, defining action plans to achieve them, and quantifying improvements. To prevent and manage the risks of uncontrolled energy consumption in medical laboratories, it is important to bear in mind the energy-intensive laboratory features, thus facilitating the implementation of strategies for energy conservation and sustainability. Additionally, laboratory buildings have a substantial embodied carbon that significantly affects their functional environmental impact. In recent years, many initiatives, tools, and methods that address the environmental sustainability of health research have been developed. Many of them are applicable and are used in clinical laboratory settings even though they are not developed specifically for it. Recently, the European Federation of Clinical Chemistry and Laboratory Medicine generated educational material that aims to both raise awareness of medical laboratories carbon footprint, and to guide them on how to decrease it. This review aims to give an overview of the current efforts to improve the sustainability of medical laboratories in the sense of energy conservation. We will present the extent of the environmental impact of healthcare structures and medical laboratories, identify the major contributors to their carbon footprint, focus on energy consumption, and finally, offer strategies that could mitigate it.