The carbon footprint of healthcare settings: A systematic review.
carbon footprint
environmental impact
greenhouse gases emissions
healthcare settings
life cycle assessment
Journal
Journal of advanced nursing
ISSN: 1365-2648
Titre abrégé: J Adv Nurs
Pays: England
ID NLM: 7609811
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
revised:
01
03
2023
received:
18
10
2022
accepted:
07
04
2023
medline:
18
7
2023
pubmed:
18
5
2023
entrez:
18
5
2023
Statut:
ppublish
Résumé
Healthcare systems are responsible for 4%-5% of the emissions of greenhouse gases worldwide. The Greenhouse Gas Protocol divides carbon emissions into three scopes: scope 1 or direct emissions secondary to energy use; scope 2 or indirect emissions secondary to purchased electricity; and scope 3 for the rest of indirect emissions. To describe the environmental impact of health services. A systematic review was conducted in the Medline, Web of Science, CINAHL, and Cochrane databases. Studies that focused their analysis on a functional healthcare unit and which included. This review was conducted from August to October 2022. The initial electronic search yielded a total of 4368 records. After the screening process according to the inclusion criteria, 13 studies were included in this review. The reviewed studies found that between 15% and 50% of the total emissions corresponded to scopes 1 and 2 emissions, whereas scope 3 emissions ranged between 50% and 75% of the total emissions. Disposables, equipment (medical and non-medical) and pharmaceuticals represented the higher percentage of emissions in scope 3. Most of the emissions corresponded to scope 3, which includes the indirect emission occurring as a consequence of the healthcare activity, as this scope includes a wider range of emission sources than the other scopes. Interventions should be carried out by the healthcare organizations responsible of Greenhouse Gas emissions, and also every single individual that integrates them should make changes. The use of evidence-based approaches to identify carbon hotspots and implement the most effective interventions in the healthcare setting could lead to a significant reduction of carbon emissions. This literature review highlights the impact that healthcare systems have on climate change and the importance of adopting and carrying out interventions to prevent its fast development. This review adhered to PRISMA guideline. PRISMA 2020 is a guideline designed for systematic reviews of studies that analyse the effects of heath interventions, and aim is to help authors improve the reporting of systematic review and meta-analyses. No Patient or Public Contribution.
Substances chimiques
Greenhouse Gases
0
Carbon
7440-44-0
Types de publication
Systematic Review
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2830-2844Informations de copyright
© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.
Références
Booth, A., Noyes, J., Flemming, K., Moore, G., Tunçalp, Ö., & Shakibazadeh, E. (2019). Formulating questions to explore complex interventions within qualitative evidence synthesis. BMJ Global Health, 4(Suppl 1), e001107. https://doi.org/10.1136/bmjgh-2018-001107
Bozoudis, V., & Sebos, I. (2021). The carbon footprint of transport activities of the 401 military general Hospital of Athens. Environmental Modeling and Assessment, 26(2), 155-162. https://doi.org/10.1007/s10666-020-09701-1
Bozoudis, V., Sebos, I., & Tsakanikas, A. (2022). Action plan for the mitigation of greenhouse gas emissions in the hospital-based health care of the Hellenic Army. Environmental Monitoring and Assessment, 194(3), 221. https://doi.org/10.1007/s10661-022-09871-3
Campion, N., Thiel, C. L., Focareta, J., & Bilec, M. M. (2016). Understanding green building design and healthcare outcomes: Evidence-based design analysis of an oncology unit. Journal of Architectural Engineering, 22(3), 04016009. https://doi.org/10.1061/(ASCE)AE.1943-5568.0000217
Chiarini, A., Opoku, A., & Vagnoni, E. (2017). Public healthcare practices and criteria for a sustainable procurement: A comparative study between UK and Italy. Journal of Cleaner Production, 162, 391-399. https://doi.org/10.1016/j.jclepro.2017.06.027
Chua, P. L., Dorotan, M. M., Sigua, J. A., Estanislao, R. D., Hashizume, M., & Salazar, M. A. (2019). Scoping review of climate change and Health Research in The Philippines: A complementary tool in research agenda-setting. International Journal of Environmental Research and Public Health, 16(14), 2624. https://doi.org/10.3390/ijerph16142624
Eckelman, M. J., & Sherman, J. (2016). Environmental impacts of the U.S. health care system and effects on public health. PloS One, 11(6), e0157014. https://doi.org/10.1371/journal.pone.0157014
Eckelman, M. J., Sherman, J. D., & MacNeill, A. J. (2018). Life cycle environmental emissions and health damages from the Canadian healthcare system: An economic-environmental-epidemiological analysis. PLoS Medicine, 15(7), e1002623. https://doi.org/10.1371/journal.pmed.1002623
Fournier, A., Laurent, A., Lheureux, F., Ribeiro-Marthoud, M. A., Ecarnot, F., Binquet, C., & Quenot, J. P. (2022). Impact of the COVID-19 pandemic on the mental health of professionals in 77 hospitals in France. PLoS One, 17(2), e0263666. https://doi.org/10.1371/journal.pone.0263666
Freund, T., Campbell, S. M., Geissler, S., Kunz, C. U., Mahler, C., Peters-Klimm, F., & Szecsenyi, J. (2013). Strategies for reducing potentially avoidable hospitalizations for ambulatory care-sensitive conditions. Annals of Family Medicine, 11(4), 363-370. https://doi.org/10.1370/afm.1498
García-Sanz-Calcedo, J., Al-Kassir, A., & Yusaf, T. (2018). Economic and environmental impact of energy saving in healthcare buildings. Applied Sciences, 8(3), 440. https://doi.org/10.3390/app8030440
Hallegatte, S., Bangalore, M., Bonzanigo, L., Fay, M., Kane, T., Narloch, U., Rozenberg, J., Treguer, D., & Vogt-Schilb, A. (2016). Shock waves: Managing the impacts of climate change on poverty. Climate Change and Development. World Bank. https://openknowledge.worldbank.org/handle/10986/22787
Hess, J., Eidson, M., Tlumak, J., Raab, K., & Luber, G. (2014). An evidence-based public health approach to climate change adaptation. Environmental Health Perspectives, 122(11), 1177-1186.
Hong, Z., Li, N., Li, D., Li, J., Li, B., Xiong, W., Lu, L., Li, W., & Zhou, D. (2020). Telemedicine during the COVID-19 pandemic: Experiences from Western China. Journal of Medical Internet Research, 22(5), e19577. https://doi.org/10.2196/19577
Intergovernmental Panel on Climate Change. (2018). Special Report on Global Warming of 1.5°C (SR15). https://www.ipcc.ch/sr15/
Karliner, J., Slotterback, S., Boyd, R., Ashby, B., Steele, K., & Wang, J. (2020). Health care's climate footprint: The health sector contribution and opportunities for action. European Journal of Public Health, 30(5), 311. https://doi.org/10.1093/eurpub/ckaa165.843
Keller, R. L., Muir, K., Roth, F., Jattke, M., & Stucki, M. (2021). From bandages to buildings: Identifying the environmental hotspots of hospitals. Journal of Cleaner Production, 319, 128479. https://doi.org/10.1016/j.jclepro.2021.128479
Lee, I. C., Chang, C. S., & Du, P. L. (2017). Do healthier lifestyles lead to less utilization of healthcare resources? BMC Health Services Research, 17(1), 243. https://doi.org/10.1186/s12913-017-2185-4
Lim, A. E., Perkins, A., & Agar, J. W. (2013). The carbon footprint of an Australian satellite haemodialysis unit. Australian Health Review: A Publication of the Australian Hospital Association, 37(3), 369-374. https://doi.org/10.1071/AH13022
Lin, J., Liu, Y., Meng, F., Cui, S., & Xu, L. (2013). Using hybrid method to evaluate carbon footprint of Xiamen City, China. Energy Policy, 58, 220-227.
Lindsay, G., Macmillan, A., & Woodward, A. (2011). Moving urban trips from cars to bicycles: Impact on health and emissions. Australian and New Zealand Journal of Public Health, 35(1), 54-60. https://doi.org/10.1111/j.1753-6405.2010.00621.x
MacNeill, A. J., Lillywhite, R., & Brown, C. J. (2017). The impact of surgery on global climate: A carbon footprinting study of operating theatres in three health systems. The Lancet. Planetary Health, 1(9), e381-e388. https://doi.org/10.1016/S2542-5196(17)30162-6
Malhotra, A., Maughan, D., Ansell, J., Lehman, R., Henderson, A., Gray, M., Stephenson, T., & Bailey, S. (2016). Choosing wisely in the UK: Reducing the harms of too much medicine. British Journal of Sports Medicine, 50(13), 826-828. https://doi.org/10.1136/bjsports-2016-h2308rep
Malik, A., Lenzen, M., McAlister, S., & McGain, F. (2018). The carbon footprint of Australian health care. The Lancet. Planetary Health, 2(1), e27-e35. https://doi.org/10.1016/S2542-5196(17)30180-8
Malik, A., Padget, M., Carter, S., Wakiyama, T., Maitland-Scott, I., Vyas, A., Boylan, S., Mulcahy, G., Li, M., Lenzen, M., Charlesworth, K. E., & Geschke, A. (2021). Environmental impacts of Australia's largest health system. Resources Conservation and Recycling, 169, 105556.
McAlister, S., McGain, F., Breth-Petersen, M., Story, D., Charlesworth, K., Ison, G., & Barratt, A. (2022). The carbon footprint of hospital diagnostic imaging in Australia. The Lancet Regional Health-Western Pacific, 24, 100459. https://doi.org/10.1016/j.lanwpc.2022.100459
Montiel-Santiago, F. J., Hermoso-Orzáez, M. J., & Terrados-Cepeda, J. (2020). Sustainability and energy efficiency: BIM 6D. Study of the BIM methodology applied to hospital buildings. Value of interior lighting and daylight in energy simulation. Sustainability, 12, 5731. https://doi.org/10.3390/su12145731
Mtioui, N., Zamd, M., Ait Taleb, A., Bouaalam, A., & Ramdani, B. (2021). Carbon footprint of a hemodialysis unit in Morocco. Therapeutic Apheresis and Dialysis, 25(5), 613-620. https://doi.org/10.1111/1744-9987.13607
Nansai, K., Fry, J., Malik, A., Takayanagi, W., & Kondo, N. (2020). Carbon footprint of Japanese health care services from 2011 to 2015. Resources Conservation and Recycling, 152, 104525.
National Health Service England. (2017). Sustainable development unit study. https://www.england.nhs.uk/greenernhs/wp-content/uploads/sites/51/2021/02/Sustainability-and-the-NHS-Staff-survey-2017.pdf
National Health Service England. (2020). Delivering a ‘Net Zero’ National Health Service. https://www.england.nhs.uk/greenernhs/wp-content/uploads/sites/51/2020/10/delivering-a-net-zero-national-health-service.pdf
National Health Service England. (2022). Reducing the environmental impact of equipment, medicines and resources. https://www.england.nhs.uk/ahp/greener-ahp-hub/specific-areas-for-consideration/reducing-the-environmental-impact-of-equipment-medicines-and-resources/
National Health Service England. Sustainable Development Unit. (2008). NHS England carbon emissions. Carbon Footprinting report. https://www.sd-commission.org.uk/data/files/publications/NHS_Carbon_Emissions_modelling1.pdf
National Health Service England. Sustainable Development Unit. (2018). Reducing the use of natural resources in health and social care 2018 report. https://networks.sustainablehealthcare.org.uk/sites/default/files/resources/20180912_Health_and_Social_Care_NRF_web.pdf
Nicolet, J., Mueller, Y., Paruta, P., Boucher, J., & Senn, N. (2022). What is the carbon footprint of primary care practices? A retrospective life-cycle analysis in Switzerland. Environmental Health: A Global Access Science Source, 21(1), 3. https://doi.org/10.1186/s12940-021-00814-y
Ouslander, J., Naharci, I., Engstrom, G., Shutes, J., Wolf, D., Alpert, G., Rojido, C., Tappen, R., & Newman, D. (2016). Root cause analyses of transfers of skilled nursing facility patients to acute hospitals: Lessons learned for reducing unnecessary hospitalizations. Journal of the American Medical Directors Association, 17(3), 256-262.
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ (Clinical Research Ed.), 372, n71. https://doi.org/10.1136/bmj.n71
Panagioti, M., Khan, K., Keers, R. N., Abuzour, A., Phipps, D., Kontopantelis, E., Bower, P., Campbell, S., Haneef, R., Avery, A. J., & Ashcroft, D. M. (2019). Prevalence, severity, and nature of preventable patient harm across medical care settings: Systematic review and meta-analysis. BMJ (Clinical Research Ed.), 366, l4185. https://doi.org/10.1136/bmj.l4185
Pichler, P., Jaccard, I., Weisz, U., & Weisz, H. (2019). International comparison of health care carbon footprints. Environmental Research Letters, 14(6), 064004.
Prasad, P. A., Joshi, D., Lighter, J., Agnis, J., Allen, R., Collins, M., Pena, F., Velletri, J., & Thiel, C. (2022). Environmental footprint of regular and intensive inpatient care in a large US hospital. International Journal of Life Cycle Assessment, 27, 38-49. https://doi.org/10.1007/s11367-021-01998-8
Purohit, A., Smith, J., & Hibble, A. (2021). Does telemedicine reduce the carbon footprint of healthcare? A systematic review. Future Healthcare Journal, 8(1), e85-e91. https://doi.org/10.7861/fhj.2020-0080
Pussegoda, K., Turner, L., Garritty, C., Mayhew, A., Skidmore, B., Stevens, A., Boutron, I., Sarkis-Onofre, R., Bjerre, L. M., Hróbjartsson, A., Altman, D. G., & Moher, D. (2017). Systematic review adherence to methodological or reporting quality. Systematic Reviews, 6(1), 131. https://doi.org/10.1186/s13643-017-0527-2
Rizan, C., Steinbach, I., Nicholson, R., Lillywhite, R., Reed, M., & Bhutta, M. (2020). The carbon footprint of surgical operations. Annals of Surgery, 272(6), 986-995.
Romanello, M., McGushin, A., Di Napoli, C., Drummond, P., Hughes, N., Jamart, L., Kennard, H., Lampard, P., Solano Rodriguez, B., Arnell, N., Ayeb-Karlsson, S., Belesova, K., Cai, W., Campbell-Lendrum, D., Capstick, S., Chambers, J., Chu, L., Ciampi, L., Dalin, C., … Hamilton, I. (2021). The 2021 report of the lancet countdown on health and climate change: Code red for a healthy future. Lancet (London, England), 398(10311), 1619-1662. https://doi.org/10.1016/S0140-6736(21)01787-6
Scarborough, P., Appleby, P. N., Mizdrak, A., Briggs, A. D., Travis, R. C., Bradbury, K. E., & Key, T. J. (2014). Dietary greenhouse gas emissions of meat-eaters, fish-eaters, vegetarians and vegans in the UK. Climatic Change, 125(2), 179-192. https://doi.org/10.1007/s10584-014-1169-1
Spruell, T., Webb, H., Steley, Z., Chan, J., & Robertson, A. (2021). Environmentally sustainable emergency medicine. Emergency Medicine Journal: EMJ, 38(4), 315-318. https://doi.org/10.1136/emermed-2020-210421
Tennison, I., Roschnik, S., Ashby, B., Boyd, R., Hamilton, I., Oreszczyn, T., Owen, A., Romanello, M., Ruyssevelt, P., Sherman, J. D., Smith, A., Steele, K., Watts, N., & Eckelman, M. J. (2021). Health care's response to climate change: A carbon footprint assessment of the NHS in England. The Lancet. Planetary Health, 5(2), e84-e92. https://doi.org/10.1016/S2542-5196(20)30271-0
The Paris Agreement. (2015). United Nations. https://www.un.org/en/climatechange/paris-agreement
Tukker, A., Goldbohm, R. A., de Koning, A., Verheijden, M., Kleijn, R., Wolf, O., Perez- Dominguez, I., & Rueda-Cantuche, J. M. (2011). Environmental impacts of changes to healthier diets in Europe. Ecology Economics, 70(10), 1776-1788.
UK Government Legislation. (2008). Climate Change Act. https://www.legislation.gov.uk/ukpga/2008/27/contents
Vollmer, M., Rhee, T., Rigby, M., Hofstetter, D., Hill, M., Schoenenberger, F., & Reimann, S. (2015). Modern inhalation anesthetics: Potent greenhouse gases in the global atmosphere. Geophysical Research Letters, 42(5), 1606-1611.
Watts, N., Amann, M., Arnell, N., Ayeb-Karlsson, S., Belesova, K., Berry, H., Bouley, T., Boykoff, M., Byass, P., Cai, W., Campbell-Lendrum, D., Chambers, J., Daly, M., Dasandi, N., Davies, M., Depoux, A., Dominguez-Salas, P., Drummond, P., Ebi, K. L., … Costello, A. (2018). The 2018 report of the lancet countdown on health and climate change: Shaping the health of nations for centuries to come. Lancet (London, England), 392(10163), 2479-2514. https://doi.org/10.1016/S0140-6736(18)32594-7
Woodcock, J., Edwards, P., Tonne, C., Armstrong, B. G., Ashiru, O., Banister, D., Beevers, S., Chalabi, Z., Chowdhury, Z., Cohen, A., Franco, O. H., Haines, A., Hickman, R., Lindsay, G., Mittal, I., Mohan, D., Tiwari, G., Woodward, A., & Roberts, I. (2009). Public health benefits of strategies to reduce greenhouse-gas emissions: Urban land transport. Lancet (London, England), 374(9705), 1930-1943. https://doi.org/10.1016/S0140-6736(09)61714-1
World Resources Institute. (2022). Greenhouse gas protocol. https://www.wri.org/initiatives/greenhouse-gas-protocol
Wu, R. (2019). The carbon footprint of the Chinese health-care system: An environmentally extended input-output and structural path analysis study. The Lancet: Planetary Health, 3(10), e413-e419. https://doi.org/10.1016/S2542-5196(19)30192-5
Zeng, X., Zhang, Y., Kwong, J. S., Zhang, C., Li, S., Sun, F., Niu, Y., & Du, L. (2015). The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: A systematic review. Journal of Evidence-Based Medicine, 8(1), 2-10. https://doi.org/10.1111/jebm.12141