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Environmental impacts of surgical procedures: life cycle assessment of hysterectomy in the United States.

ABSTRACT: The healthcare sector is a driver of economic growth in the U.S., with spending on healthcare in 2012 reaching $2.8 trillion, or 17% of the U.S. gross domestic product, but it is also a significant source of emissions that adversely impact environmental and public health. The current state of the healthcare industry offers significant opportunities for environmental efficiency improvements, potentially leading to reductions in costs, resource use, and waste without compromising patient care. However, limited research exists that can provide quantitative, sustainable solutions. The operating room is the most resource-intensive area of a hospital, and surgery is therefore an important focal point to understand healthcare-related emissions. Hybrid life cycle assessment (LCA) was used to quantify environmental emissions from four different surgical approaches (abdominal, vaginal, laparoscopic, and robotic) used in the second most common major procedure for women in the U.S., the hysterectomy. Data were collected from 62 cases of hysterectomy. Life cycle assessment results show that major sources of environmental emissions include the production of disposable materials and single-use surgical devices, energy used for heating, ventilation, and air conditioning, and anesthetic gases. By scientifically evaluating emissions, the healthcare industry can strategically optimize its transition to a more sustainable system.

SUBMITTER: Thiel CL

PROVIDER: S-EPMC4319686 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

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Environmental impacts of surgical procedures: life cycle assessment of hysterectomy in the United States.

Thiel Cassandra L CL Eckelman Matthew M Guido Richard R Huddleston Matthew M Landis Amy E AE Sherman Jodi J Shrake Scott O SO Copley-Woods Noe N Bilec Melissa M MM

Environmental science & technology 20150114 3

The healthcare sector is a driver of economic growth in the U.S., with spending on healthcare in 2012 reaching $2.8 trillion, or 17% of the U.S. gross domestic product, but it is also a significant source of emissions that adversely impact environmental and public health. The current state of the healthcare industry offers significant opportunities for environmental efficiency improvements, potentially leading to reductions in costs, resource use, and waste without compromising patient care. How ...[more]

PMID: 25517602

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Project description:BackgroundMicroalgae are touted as an attractive alternative to traditional forms of biomass for biofuel production, due to high productivity, ability to be cultivated on marginal lands, and potential to utilize carbon dioxide (CO2) from industrial flue gas. This work examines the fossil energy return on investment (EROIfossil), greenhouse gas (GHG) emissions, and direct Water Demands (WD) of producing dried algal biomass through the cultivation of microalgae in Open Raceway Ponds (ORP) for 21 geographic locations in the contiguous United States (U.S.). For each location, comprehensive life cycle assessment (LCA) is performed for multiple microalgal biomass production pathways, consisting of a combination of cultivation and harvesting options.ResultsResults indicate that the EROIfossil for microalgae biomass vary from 0.38 to 1.08 with life cycle GHG emissions of -46.2 to 48.9 (g CO2 eq/MJ-biomass) and direct WDs of 20.8 to 38.8 (Liters/MJ-biomass) over the range of scenarios analyzed. Further anaylsis reveals that the EROIfossil for production pathways is relatively location invariant, and that algae's life cycle energy balance and GHG impacts are highly dependent on cultivation and harvesting parameters. Contrarily, algae's direct water demands were found to be highly sensitive to geographic location, and thus may be a constraining factor in sustainable algal-derived biofuel production. Additionally, scenarios with promising EROIfossil and GHG emissions profiles are plagued with high technological uncertainty.ConclusionsGiven the high variability in microalgae's energy and environmental performance, careful evaluation of the algae-to-fuel supply chain is necessary to ensure the long-term sustainability of emerging algal biofuel systems. Alternative production scenarios and technologies may have the potential to reduce the critical demands of biomass production, and should be considered to make algae a viable and more efficient biofuel alternative.

Project description:IntroductionIndividuals living with sickle cell disease (SCD) commonly report impaired health-related quality of life (HRQoL). However, impacts of SCD on HRQoL and the unmet needs of SCD treatment/management are under-researched. This study characterized the impact of SCD on HRQoL and identified the unmet needs of individuals with SCD.MethodsAdults with SCD (aged ≥ 18 years) and caregivers of adolescents (aged 12‒17) with SCD in the United States (US) and United Kingdom (UK) participated in one-on-one virtual semi-structured interviews and focus group discussions (hereafter referred to as 'interviews'). Interviews were transcribed and thematically analyzed.ResultsNineteen individuals participated in the study (across five interviews and three focus group discussions), including 18 adults with SCD (United States, n = 11; United Kingdom, n = 7) and one caregiver of an adolescent with SCD (United States). Most participants were female (n = 15). Participants reported negative impacts of SCD on their HRQoL, including the burden of structuring their lives around SCD, due to unpredictable symptoms. They reported negative impacts to psychological health (e.g., depression/low mood and anxiety) and physical health (e.g., chronic pain and fatigue) that affected their social and family life, work, and education, leading to feelings of isolation. Participants expressed concerns about the future, feelings of resentment, and the need for high resilience when facing the barriers/impacts associated with SCD. Many participants reported negative interactions with healthcare professionals, leading to trauma, anxiety, and routine care avoidance. Most participants reported perceived prejudice during routine SCD treatment/management, including being treated as drug-seekers.ConclusionIndividuals with SCD experience negative HRQoL impacts, including impacts to daily activities, social and family life, work and education, psychological health, and prejudice/stigma. Our findings highlight significant unmet needs of individuals living with SCD, including alternative treatment options to reduce vaso-occlusive crisis (VOC) frequency and treat fatigue.

Dataset Information

Environmental impacts of surgical procedures: life cycle assessment of hysterectomy in the United States.

Publications

Environmental impacts of surgical procedures: life cycle assessment of hysterectomy in the United States.

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