The hidden cost of chronic pain: A narrative review of the environmental impact of outpatient spine and musculoskeletal care.
Journal
PM & R : the journal of injury, function, and rehabilitation
ISSN: 1934-1563
Titre abrégé: PM R
Pays: United States
ID NLM: 101491319
Informations de publication
Date de publication:
11 Jul 2024
11 Jul 2024
Historique:
revised:
26
03
2024
received:
29
12
2023
accepted:
02
05
2024
medline:
11
7
2024
pubmed:
11
7
2024
entrez:
11
7
2024
Statut:
aheadofprint
Résumé
Health care is a major driver of greenhouse gas emissions and is closely intertwined with industrial processes responsible for air, water, and soil pollution. Chronic pain - particularly as it relates to spine and musculoskeletal diagnoses - comprises a significant portion of health care utilization and affects millions of people worldwide. Despite the prevalence of chronic spine and musculoskeletal pain, there has been limited discussion of the environmental impacts of outpatient clinics and interventional processes as they relate to these conditions. This narrative review explores the environmental impact related to diagnostics, pharmacologics, and common nonoperative interventional procedures utilized in the management of patients with chronic musculoskeletal and spine pain. Topics explored include energy utilization, production and disposal of pharmaceuticals, and waste production from interventional procedures. This study aims to educate providers involved in spine and musculoskeletal disease management regarding the possible environmental consequences of their practices. The article also focuses on modifying approaches to patient care to those that are more sustainable as well as highlighting areas in need of further investigation.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 American Academy of Physical Medicine and Rehabilitation.
Références
Campbell‐Lendrum D, Neville T, Schweizer C, Neira M. Climate change and health: three grand challenges. Nat Med. 2023;29(7):1631‐1638. doi:10.1038/s41591‐023‐02438‐w
U.S. Centers for Disease Control. Preparing for the regional health impacts of climate change in the United States. 2020 https://www.cdc.gov/climateandhealth/
Taylor AL, Perret D, Morice K, et al. Climate change and physiatry: a call to proportional and prospective action. Am J Phys Med Rehabil. 2022;101(10):988‐993. doi:10.1097/PHM.0000000000002017
Brown LH, Buettner PG, Canyon DV. The energy burden and environmental impact of health services. Am J Public Health. 2012;102(12):e76‐e82. doi:10.2105/AJPH.2012.300776
Watts N, Amann M, Arnell N, et al. The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come. Lancet. 2018;392(10163):2479‐2514. doi:10.1016/S0140‐6736(18)32594‐7
Kwakye G, Brat GA, Makary MA. Green surgical practices for health care. Arch Surg. 2011;146(2):131‐136. doi:10.1001/ARCHSURG.2010.343
Eckelman MJ, Sherman J. Environmental impacts of the U.S. health care system and effects on public health. PLoS One. 2016;11(6). doi:10.1371/JOURNAL.PONE.0157014
Best MJ, McFarland EG, Anderson GF, Srikumaran U. The likely economic impact of fewer elective surgical procedures on US hospitals during the COVID‐19 pandemic. Surgery. 2020;168(5):962‐967. doi:10.1016/j.surg.2020.07.014
Bose SK, Dasani S, Roberts SE, et al. The cost of quarantine: projecting the financial impact of canceled elective surgery on the Nation's hospitals. Ann Surg. 2021;273:844‐849.
Manchikanti L, Singh V, Benyamin RM, Kaye AD, Pampati V, Hirsch JA. Reframing medicare physician payment policy for 2019: a look at proposed policy. Pain Physician. 2018;21(5):415‐432.
Haglin JM, Arthur JR, Deckey DG, Makovicka JL, Pollock JR, Spangehl MJ. Temporal analysis of medicare physician reimbursement and procedural volume for all hip and knee arthroplasty procedures billed to medicare part B from 2000 to 2019. J Arthroplasty. 2021;36(7s):S121‐s127. doi:10.1016/j.arth.2021.02.006
Hensher M, Zywert K. Can healthcare adapt to a world of tightening ecological constraints? Challenges on the road to a post‐growth future. BMJ. 2020;371:m4168. doi:10.1136/bmj.m4168
Kotcher J, Maibach E, Miller J, et al. Views of health professionals on climate change and health: a multinational survey study. Lancet Planetary Health. 2021;5(5):e316‐e323. doi:10.1016/S2542‐5196(21)00053‐X
Institute of Medicine Roundtable on Environmental Health Sciences. The National Academies Collection: Reports funded by National Institutes of Health. Green Healthcare Institutions: Health, Environment, and Economics: Workshop Summary. National Academies Press (US), National Academy of Sciences 2007.
McNamee C, Rakovac A, Cawley DT. The environmental impact of spine surgery and the path to sustainability. Spine. 2023;48(8):545‐551. doi:10.1097/BRS.0000000000004550
Phoon KM, Afzal I, Sochart DH, Asopa V, Gikas P, Kader D. Environmental sustainability in orthopaedic surgery: a scoping review. Bone & Joint Open. 2022;3(8):628‐640. doi:10.1302/2633‐1462.38.BJO‐2022‐0067.R1
Shoham MA, Baker NM, Peterson ME, Fox P. The environmental impact of surgery: a systematic review. Surgery. 2022;172(3):897‐905. doi:10.1016/J.SURG.2022.04.010
Kuvadia M, Cummis CE, Liguori G, Wu CL. ‘Green‐gional’ anesthesia: the non‐polluting benefits of regional anesthesia to decrease greenhouse gases and attenuate climate change. Reg Anesth Pain Med. 2020;45(9):744‐745. doi:10.1136/RAPM‐2020‐101452
McGain F, Sheridan N, Wickramarachchi K, Yates S, Chan B, McAlister S. Carbon footprint of general, regional, and combined anesthesia for total knee replacements. Anesthesiology. 2021;135(6):976‐991. doi:10.1097/ALN.0000000000003967
Petre MA, Bahrey L, Levine M, vanRensburg A, Crawford M, Matava CT. Anesthesia environmental sustainability programs—a survey of Canadian department chiefs and residency program directors. Can J Anesth. 2020;67(9):1190‐1200. doi:10.1007/S12630‐020‐01738‐W/TABLES/6
Boussuge‐Roze J, Duchateau J, Bessiere F, Sacher F, Jaïs P. Environmental sustainability in cardiology: reducing the carbon footprint of the catheterization laboratory. Nat Rev Cardiol. 2023;20(2):69‐70. doi:10.1038/s41569‐022‐00826‐2
Chua ALB, Amin R, Zhang J, Thiel CL, Gross JS. The environmental impact of interventional radiology: an evaluation of greenhouse gas emissions from an academic interventional radiology practice. J Vasc Interv Radiol. 2021;32(6):907‐915. doi:10.1016/J.JVIR.2021.03.531
Shum PL, Kok HK, Maingard J, et al. Sustainability in interventional radiology: are we doing enough to save the environment? CVIR Endovascular. 2022;5(1). doi:10.1186/S42155‐022‐00336‐9
George SZ, Lentz TA, Goertz CM. Back and neck pain: in support of routine delivery of non‐pharmacologic treatments as a way to improve individual and population health. Transl Res. 2021;234:129‐140. doi:10.1016/J.TRSL.2021.04.006
Vos T, Allen C, Arora M, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1545. doi:10.1016/S0140‐6736(16)31678‐6
Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2021;396(10267):2006‐2017. doi:10.1016/S0140‐6736(20)32340‐0
Fathy R, Nelson CA, Barbieri JS. Combating climate change in the clinic: cost‐effective strategies to decrease the carbon footprint of outpatient dermatologic practice. Int J Womens Dermatol. 2021;7(1):107‐111. doi:10.1016/j.ijwd.2020.05.015
U.S. Energy Information Admininstration. Commercial buildings energy consumption survey. 2018. 2021. https://www.eia.gov/cbecs
Tsagkaris C, Nikolakea M, Laskaratou ED, et al. Environmental sustainability in healthcare: time to make outpatient care in orthopaedics and rheumatology greener. Int J Health Plann Manage. 2023;38(3):547‐556. doi:10.1002/HPM.3617
McKenzie BJ, Haas R, Ferreira GE, Maher CG, Buchbinder R. The environmental impact of health care for musculoskeletal conditions: a scoping review. PLoS One. 2022;17(11):e0276685. doi:10.1371/JOURNAL.PONE.0276685
Evan Mills PD. Building commissioning: A golden opportunity for reducing energy costs and greenhouse gas emissions. 2009 https://eta‐publications.lbl.gov/sites/default/files/building_commissioning_‐_a_golden_opportunity_for_reducing_energy_costs_and_greenhouse‐gas_emissions.pdf
American Medical Association. Lower costs by going green! Accessed 10/22/2023, https://medsocietiesforclimatehealth.org/wp‐content/uploads/2016/10/AMA‐Office‐Envir‐Sustainability‐Tool‐Oct‐2017.pdf
Pollard AS, Taylor TJ, Fleming LE, Stahl‐Timmins W, Depledge MH, Osborne NJ. Mainstreaming carbon management in healthcare systems: a bottom‐up modeling approach. Environ Sci Technol. 2013;47(2):678‐686. doi:10.1021/es303776g
Carrico AR, Spoden M, Wallston KA, Vandenbergh MP. The environmental cost of misinformation: why the recommendation to use elevated temperatures for handwashing is problematic. Int J Consum Stud. 2013;37(4):433‐441.
U.S. Department of Energy. 15 ways to save on your water heating bill. Accessed 10/22/2023, https://www.energy.gov/energysaver/articles/15-ways-save-your-water-heating-bill
U.S. Department of Energy. LED Lighting | Department of Energy. Accessed 10/22/2023, https://www.energy.gov/energysaver/led-lighting
U.S. Department of Energy. Hospitals pulling the plug on energy‐wasting electric equipment and procedures non‐medical equipment. 2011 https://www1.eere.energy.gov/buildings/publications/pdfs/alliances/hea_plugloads.pdf
Bradley MP, Tung G, Green A. Overutilization of shoulder magnetic resonance imaging as a diagnostic screening tool in patients with chronic shoulder pain. J Shoulder Elbow Surg. 2005;14(3):233‐237. doi:10.1016/j.jse.2004.08.002
Sheridan GA, Bisseru A, Glynn AA. The utility of MRI scans for a painful knee in the elderly patient. Ir J Med Sci. 2021;190(1):363‐366. doi:10.1007/S11845‐020‐02261‐Z
Emery DJ, Shojania KG, Forster AJ, Mojaverian N, Feasby TE. Overuse of magnetic resonance imaging. JAMA Intern Med. 2013;173(9):823‐825. doi:10.1001/JAMAINTERNMED.2013.3804
Knott JJ, Varangu L, Waddington K, Easy T, Shi S. Medical imaging equipment study: assessing opportunities to reduce energy consumption in the health care sector. 2017 https://greenhealthcare.ca/wp‐content/uploads/2016/11/Medical‐Imaging‐Equipment‐Energy‐Use‐CCGHC‐2017.pdf
Bureau NJ, Ziegler D. Economics of musculoskeletal ultrasound. Curr Radiol Rep. 2016;4:1‐7.
McAlister S, McGain F, Petersen M, et al. The carbon footprint of hospital diagnostic imaging in Australia. Lancet Reg Health West Pac. 2022;24:100459. doi:10.1016/j.lanwpc.2022.100459
Purohit A, Smith J, Hibble A. Does telemedicine reduce the carbon footprint of healthcare? A systematic review. Future Healthc J. 2021;8(1):e85‐e91. doi:10.7861/fhj.2020‐0080
Tenforde AS, Hefner JE, Kodish‐Wachs JE, Iaccarino MA, Paganoni S. Telehealth in physical medicine and rehabilitation: a narrative review. PM R. 2017;9(5s):S51‐s58. doi:10.1016/j.pmrj.2017.02.013
Minx J, Baiocchi G, Wiedmann T, et al. International comparison of health care carbon footprints. Environ Res Lett. 2019;14(6):64004. doi:10.1088/1748‐9326/AB19E1
World Resources Institute. Corporate value chain (scope 3) accounting and reporting standard supplement to the GHG protocol corporate accounting and reporting standard GHG protocol team. 2011 https://ghgprotocol.org/sites/default/files/standards/Corporate‐Value‐Chain‐Accounting‐Reporing‐Standard_041613_2.pdf
Belkhir L, Elmeligi A. Carbon footprint of the global pharmaceutical industry and relative impact of its major players. J Clean Prod. 2019;214:185‐194. doi:10.1016/J.JCLEPRO.2018.11.204
Vetters R. How can collective action in healthcare help tackle the climate crisis? 2022 https://www.ey.com/en_ch/strategy/how-can-collective-action-in-healthcare-help-tackle-the-climate-crisis
U.S. Environmental Protection Agency. Greenhouse gas equivalencies calculator. Accessed 10/22/2023, https://www.epa.gov/energy/greenhouse-gas-equivalencies-calculator#results
Siegert MW, Saling P, Mielke P, Czechmann C, Emara Y, Finkbeiner M. Cradle‐to‐grave life cycle assessment of an ibuprofen analgesic. Sustain Chem Pharm. 2020;18:100329. doi:10.1016/J.SCP.2020.100329
McAlister S, Ou Y, Neff E, et al. The environmental footprint of morphine: a life cycle assessment from opium poppy farming to the packaged drug. BMJ Open. 2016;6(10):e013302. doi:10.1136/BMJOPEN‐2016‐013302
Liu X, Machado GC, Eyles JP, Ravi V, Hunter DJ. Dietary supplements for treating osteoarthritis: a systematic review and meta‐analysis. Br J Sports Med. 2018;52(3):167‐175. doi:10.1136/BJSPORTS‐2016‐097333
Jan‐Roblero J, Cruz‐Maya JA. Ibuprofen: toxicology and biodegradation of an emerging contaminant. Molecules. 2023;28(5):2097. doi:10.3390/MOLECULES28052097
Sathishkumar P, Meena RAA, Palanisami T, Ashokkumar V, Palvannan T, Gu FL. Occurrence, interactive effects and ecological risk of diclofenac in environmental compartments and biota ‐ a review. Sci Total Environ. 2020;698:134057. doi:10.1016/J.SCITOTENV.2019.134057
Cryer B, Barnett MA, Wagner J, Wilcox CM. Overuse and misperceptions of nonsteroidal anti‐inflammatory drugs in the United States. Am J Med Sci. 2016;352(5):472‐480. doi:10.1016/J.AMJMS.2016.08.028
Cavagna L, Caporali R, Trifirò G, Arcoraci V, Rossi S, Montecucco C. Overuse of prescription and OTC non‐steroidal anti‐inflammatory drugs in patients with rheumatoid arthritis and osteoarthritis. Int J Immunopathol Pharmacol. 2013;26(1):279‐281. doi:10.1177/039463201302600132
Logan J, Liu Y, Paulozzi L, Zhang K, Jones C. Opioid prescribing in emergency departments: the prevalence of potentially inappropriate prescribing and misuse. Med Care. 2013;51(8):646‐653. doi:10.1097/MLR.0b013e318293c2c0
Orive G, Lertxundi U, Brodin T, Manning P. Greening the pharmacy. Science. 2022;377(6603):259‐260. doi:10.1126/science.abp9554
Bielfeldt S, Urquhart D, Brandt M, Hennighausen N, Bazzanella R. Reduction of residual topical diclofenac in waste water by a wiping procedure before hand washing. Chemosphere. 2022;292:133350. doi:10.1016/J.CHEMOSPHERE.2021.133350
Cunha MF, Pellino G. Environmental effects of surgical procedures and strategies for sustainable surgery. Nat Rev Gastroenterol Hepatol. 2023;20(6):399‐410.
Nelson AM, Kelleher DC, Ip V, Narouze S. Environmental pain approach (EPA): sustainability in chronic pain practice. Pain Med. 2023;24(6):573‐575. doi:10.1093/PM/PNAC185
Taylor AL, Levin J, Chan J, et al. Improving environmental sustainability in outpatient clinics: lessons from a waste audit. J Clim Change Health. 2021;4:100070. doi:10.1016/J.JOCLIM.2021.100070
Grimmond TR, Bright A, Cadman J, et al. Before/after intervention study to determine impact on life‐cycle carbon footprint of converting from single‐use to reusable sharps containers in 40 UK NHS trusts. BMJ Open. 2021;11(9):e046200. doi:10.1136/BMJOPEN‐2020‐046200
Nyhsen CM, Humphreys H, Nicolau C, Mostbeck G, Claudon M. Infection prevention and ultrasound probe decontamination practices in Europe: a survey of the European Society of Radiology. Insights Imaging. 2016;7(6):841‐847. doi:10.1007/S13244‐016‐0528‐Z
Saroa R, Mitra S, Sinha S. Reusable ultrasound probe covers. Indian J Crit Care Med. 2014;18(7):479‐480. doi:10.4103/0972‐5229.136083
Deshmukh P, Sable P, Deshmukh P, Borkar A. Simple kitchen cling film, an affordable alternative as ultrasound probe cover for peripheral nerve blocks: a prospective cross‐sectional observational study. Indian J. Anaesth. 2022;66(12):869‐872. doi:10.4103/IJA.IJA_619_22
McGee G, Frantz B, Dreier A, Palmer P. Are sterile glove precautions necessary for joint injections or is a general aseptic process sufficient? A clin‐IQ. J Okla State Med Assoc. 2021;114(3):118‐119.
Creamer J, Davis K, Rice W. Sterile gloves: do they make a difference? Am J Surg. 2012;204(6):976‐980. doi:10.1016/J.AMJSURG.2012.06.003
GE HealthCare (United States). Recycling iodine: How hospitals are keeping contrast media in the circular economy. Accessed 10/22/2023, https://www.gehealthcare.com/insights/article/recycling‐iodine‐how‐hospitals‐are‐keeping‐contrast‐media‐in‐the‐circular‐economy
Palstam A, Andersson M, Lange E, Grenholm A. A call to include a perspective of sustainable development in physical therapy research. Phys Ther. 2021;101(3):1‐4. doi:10.1093/PTJ/PZAA228
AcuPrime. Which acupuncture guide tubes are most sustainable? Accessed 10/22/2023, https://acuprime.com/sustainable-guide-tubes/
Cherkin DC, Sherman KJ, Balderson BH, et al. Effect of mindfulness‐based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: a randomized clinical trial. JAMA. 2016;315(12):1240‐1249.
Elma Ö, Brain K, Dong HJ. The importance of nutrition as a lifestyle factor in chronic pain management: a narrative review. J Clin Med. 2022;11(19):5950. doi:10.3390/jcm11195950
Poore J, Nemecek T. Reducing food's environmental impacts through producers and consumers. Science. 2018;360(6392):987‐992. doi:10.1126/science.aaq0216
U.S. Department of Energy. Hospitals realize greatest savings through formal energy management program. 2011 https://www1.eere.energy.gov/buildings/publications/pdfs/alliances/hea_emp_fs.pdf
Practice Greenhealth. Engaged leadership. 2023. Accessed 10/28/2023 https://practicegreenhealth.org/topics/engaged-leadership
Perret D, Rosen C. A physician‐driven solution—the Association for Medical Ethics, the physician payment sunshine act, and ethical challenges in pain medicine. Pain Med. 2011;12(9):1361‐1375. doi:10.1111/j.1526‐4637.2011.01217.x
Taylor ML. The impact of the “business” of pain medicine on patient care. Pain Med. 2011;12(5):763‐772. doi:10.1111/j.1526‐4637.2011.01114.x
Medical Society Consortium on Climate and Health. Home Page. Accessed 10/28/2023, https://medsocietiesforclimatehealth.org/
Heye T, Knoerl R, Wehrle T, et al. The energy consumption of radiology: energy‐ and cost‐saving opportunities for CT and MRI operation. Radiology. 2020;295(3):593‐605. doi:10.1148/RADIOL.2020192084/ASSET/IMAGES/LARGE/RADIOL.2020192084.FIG7.JPEG