LCIs in the health sector: The Case for Better Emissions Data

Despite being responsible for more than $3 trillion in expenditures and 9-10% of the US’s total greenhouse gas emissions (GHGs), the healthcare sector has been largely overlooked in society’s drive towards environmental... [ view full abstract ]

Despite being responsible for more than $3 trillion in expenditures and 9-10% of the US’s total greenhouse gas emissions (GHGs), the healthcare sector has been largely overlooked in society’s drive towards environmental sustainability. The global and public health challenges emerging from climate change demand that the medical sector take a leadership role in mitigating impacts as soon as possible, but available life cycle inventory (LCI) data on healthcare products and processes limits the ability to start quantifying and addressing this issue.

This presentation will cover the existing literature on environmental emissions associated with medical practice to demonstrate the relate impact of the sector. We will then highlight published and ongoing LCA case studies with clinicians and hospital partners, where data availability leads to less-than-optimal emissions estimates. Case studies will focus on two main areas: pharmaceuticals and medical products.

Data on pharmaceutical impacts is particularly lacking in existing LCI databases, and may pose a significant opportunity to improve the footprint of healthcare. It was only within the last few years that researchers characterized the heat-trapping potential of common anesthetic gases, finding that some (desflurane) are up to 2500x more potent than CO₂ on a 100-year time scale. Our previous study in gynecology includes the impacts of common anesthetics in the context of a surgical procedure, finding that anesthetic selection can triple GHG emissions from an abdominal hysterectomy. Another study has analyzed, in detail, the emissions from intravenous morphine production, while the coauthors here have worked to assess the life cycle inventory of the top 20 drugs used in anesthesia in the US. The United Kingdom estimates that 20% of their National Health Service’s carbon footprint comes from drug production and use, and yet LCA databases still lack information on drug manufacturing and end-of-life emissions.

Another area of healthcare LCAs where more data are needed is medical devices and instruments.  More literature exists in this realm, but varies from granular procedural level hybrid LCAs to studies of individual reusable and disposable products. We will briefly present the limitations of studies of cataract surgery in India and reusable versus disposable laryngoscopes and blood pressure cuffs, and we will highlight the opportunities to expand existing LCI databases to include more medical products.