Skip to main content
Erschienen in: Intensive Care Medicine 5/2024

28.02.2024 | Systematic Review

The carbon footprint of critical care: a systematic review

verfasst von: Melany Gaetani, Elizabeth Uleryk, Camilla Halgren, Christina Maratta

Erschienen in: Intensive Care Medicine | Ausgabe 5/2024

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The provision of healthcare is a substantial global contributor to greenhouse gas (GHG) emissions. Several medical specialties and national health systems have begun evaluating their carbon emission contributions. The aim of this review is to summarise and describe the carbon footprint resulting from the provision of adult, paediatric and neonatal critical care.

Methods

A systematic search of Embase, Cochrane and Web of Science was performed in January 2023. Studies reporting any assessment of the carbon footprint of critical care were included. No language restrictions were applied. GHG emissions from life cycle assessments (LCA) were reported, in addition to waste, electricity and water use. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed.

Results

In total, 13 studies assessing and describing the environmental impact of 36 adult or paediatric intensive care units (ICUs) were included. Two studies described full LCAs, seven reported waste only, two provided audits of unused medical supplies, one reported electricity use, and one study described a Material Flow Analysis. The estimated carbon emissions from critical care range between 88 kg CO2e/patient/day and 178 kg CO2e/patient/day. The two predominant sources of carbon emissions in critical care originate from electricity and gas use, as well as consumables. Waste production ranged from 1.1 to 13.7 kg/patient/day in the 6 studies where mean waste could be calculated.

Conclusion

There is a significant carbon footprint that results from intensive care provision. Consumables and waste constitute important, measurable, and modifiable components of anthropogenic emissions. There remains uncertainty due to a lack of literature, several unstudied areas of carbon emissions from critical care units, and within measured areas, measurement and reporting of carbon emissions are inconsistent.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Who WHO (2021) Climate change and health. WHO, World Health Organization Who WHO (2021) Climate change and health. WHO, World Health Organization
3.
Zurück zum Zitat Atwoli L, Baqui AH, Benfield T, Bosurgi R, Godlee F, Hancocks S, Horton R, Laybourn-Langton L, Monteiro CA, Norman I, Patrick K, Praities N, Olde Rikkert MGM, Rubin EJ, Sahni P, Smith R, Talley N, Turale S, Vázquez D (2021) Call for emergency action to limit global temperature increases, restore biodiversity, and protect health. N Engl J Med 385:1134–1137CrossRefPubMed Atwoli L, Baqui AH, Benfield T, Bosurgi R, Godlee F, Hancocks S, Horton R, Laybourn-Langton L, Monteiro CA, Norman I, Patrick K, Praities N, Olde Rikkert MGM, Rubin EJ, Sahni P, Smith R, Talley N, Turale S, Vázquez D (2021) Call for emergency action to limit global temperature increases, restore biodiversity, and protect health. N Engl J Med 385:1134–1137CrossRefPubMed
4.
Zurück zum Zitat Rocque RJ, Beaudoin C, Ndjaboue R, Cameron L, Poirier-Bergeron L, Poulin-Rheault R-A, Fallon C, Tricco AC, Witteman HO (2021) Health effects of climate change: an overview of systematic reviews. BMJ Open 11:e046333CrossRefPubMedPubMedCentral Rocque RJ, Beaudoin C, Ndjaboue R, Cameron L, Poirier-Bergeron L, Poulin-Rheault R-A, Fallon C, Tricco AC, Witteman HO (2021) Health effects of climate change: an overview of systematic reviews. BMJ Open 11:e046333CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Romanello M, McGushin A, Di Napoli C, Drummond P, Hughes N, Jamart L, Kennard H, Lampard P, Rodriguez BS, Arnell N (2021) The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future. The Lancet 398:1619–1662CrossRef Romanello M, McGushin A, Di Napoli C, Drummond P, Hughes N, Jamart L, Kennard H, Lampard P, Rodriguez BS, Arnell N (2021) The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future. The Lancet 398:1619–1662CrossRef
6.
Zurück zum Zitat Health CCA, (2014) Quantitative risk assessment of the effects of climate change on selected causes of death, 2030s and 2050s. World Health Organization: 1–128 Health CCA, (2014) Quantitative risk assessment of the effects of climate change on selected causes of death, 2030s and 2050s. World Health Organization: 1–128
8.
Zurück zum Zitat Rodríguez-Jiménez L, Romero-Martín M, Spruell T, Steley Z, Gómez-Salgado J (2023) The carbon footprint of healthcare settings: a systematic review. J Adv Nurs 79:2830–2844CrossRefPubMed Rodríguez-Jiménez L, Romero-Martín M, Spruell T, Steley Z, Gómez-Salgado J (2023) The carbon footprint of healthcare settings: a systematic review. J Adv Nurs 79:2830–2844CrossRefPubMed
13.
Zurück zum Zitat McGain F, Burnham JP, Lau R, Aye L, Kollef MH, McAlister S (2018) The carbon footprint of treating patients with septic shock in the intensive care unit. Crit care Resusc 20:304PubMed McGain F, Burnham JP, Lau R, Aye L, Kollef MH, McAlister S (2018) The carbon footprint of treating patients with septic shock in the intensive care unit. Crit care Resusc 20:304PubMed
14.
Zurück zum Zitat Prasad PA, Joshi D, Lighter J, Agins 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. Int J Life Cycle Assess 1–12(27):38CrossRef Prasad PA, Joshi D, Lighter J, Agins 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. Int J Life Cycle Assess 1–12(27):38CrossRef
15.
Zurück zum Zitat McGain F, Muret J, Lawson C, Sherman JD (2020) Environmental sustainability in anaesthesia and critical care. Br J Anaesth 125:680–692CrossRefPubMed McGain F, Muret J, Lawson C, Sherman JD (2020) Environmental sustainability in anaesthesia and critical care. Br J Anaesth 125:680–692CrossRefPubMed
16.
Zurück zum Zitat Arzoumanidis I, D’Eusanio M, Raggi A, Petti L (2020) Functional unit definition criteria in life cycle assessment and social life cycle assessment: a discussion. In: Traverso M, Petti L, Zamagni A (eds) Book Functional unit definition criteria in life cycle assessment and social life cycle assessment: a discussion. Springer International Publishing, Cham, pp 1–10 Arzoumanidis I, D’Eusanio M, Raggi A, Petti L (2020) Functional unit definition criteria in life cycle assessment and social life cycle assessment: a discussion. In: Traverso M, Petti L, Zamagni A (eds) Book Functional unit definition criteria in life cycle assessment and social life cycle assessment: a discussion. Springer International Publishing, Cham, pp 1–10
17.
Zurück zum Zitat Brunner PH, Rechberger H (2016) Handbook of material flow analysis: for environmental, resource, and waste engineers. CRC PressCrossRef Brunner PH, Rechberger H (2016) Handbook of material flow analysis: for environmental, resource, and waste engineers. CRC PressCrossRef
18.
Zurück zum Zitat Allesch A, Brunner PH (2015) Material flow analysis as a decision support tool for waste management: a literature review. J Ind Ecol 19:753–764CrossRef Allesch A, Brunner PH (2015) Material flow analysis as a decision support tool for waste management: a literature review. J Ind Ecol 19:753–764CrossRef
19.
Zurück zum Zitat Hunfeld N, Diehl JC, Timmermann M, van Exter P, Bouwens J, Browne-Wilkinson S, de Planque N, Gommers D (2023) Circular material flow in the intensive care unit—environmental effects and identification of hotspots. Intensive Care Med 49:65–74CrossRefPubMed Hunfeld N, Diehl JC, Timmermann M, van Exter P, Bouwens J, Browne-Wilkinson S, de Planque N, Gommers D (2023) Circular material flow in the intensive care unit—environmental effects and identification of hotspots. Intensive Care Med 49:65–74CrossRefPubMed
21.
Zurück zum Zitat Ghersin ZJ, Flaherty MR, Yager P, Cummings BM (2020) Going green: decreasing medical waste in a paediatric intensive care unit in the United States. The New Bioethics 26:98–110CrossRefPubMed Ghersin ZJ, Flaherty MR, Yager P, Cummings BM (2020) Going green: decreasing medical waste in a paediatric intensive care unit in the United States. The New Bioethics 26:98–110CrossRefPubMed
22.
Zurück zum Zitat Vogel L (2019) Canada’s health system is among the least green. Can Med Assoc J 191:E1342CrossRef Vogel L (2019) Canada’s health system is among the least green. Can Med Assoc J 191:E1342CrossRef
23.
Zurück zum Zitat Bein T, Karagiannidis C, Quintel M (2020) Climate change, global warming, and intensive care. Intensive Care Med 46:485–487CrossRefPubMed Bein T, Karagiannidis C, Quintel M (2020) Climate change, global warming, and intensive care. Intensive Care Med 46:485–487CrossRefPubMed
24.
26.
Zurück zum Zitat McAlister S, Ou Y, Neff E, Hapgood K, Story D, Mealey P, McGain F (2016) The environmental footprint of morphine: a life cycle assessment from opium poppy farming to the packaged drug. BMJ Open 6:e013302CrossRefPubMedPubMedCentral McAlister S, Ou Y, Neff E, Hapgood K, Story D, Mealey P, McGain F (2016) The environmental footprint of morphine: a life cycle assessment from opium poppy farming to the packaged drug. BMJ Open 6:e013302CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Reporting standards for Systematic Evidence Syntheses in environmental research (2017). RepOrting standards for Systematic Evidence Syntheses in environmental research Systematic Review Reporting Standards. ROSES. https://www.roses-reporting.com/ Reporting standards for Systematic Evidence Syntheses in environmental research (2017). RepOrting standards for Systematic Evidence Syntheses in environmental research Systematic Review Reporting Standards. ROSES. https://​www.​roses-reporting.​com/​
29.
Zurück zum Zitat Sampath B, Jensen M, Lenoci-Edwards J, Little K, Singh H, Sherman J, (2022) Reducing healthcare carbon emissions: a primer on measures and actions for healthcare organizations to mitigate climate change. Agency for Healthcare Research and Quality Sampath B, Jensen M, Lenoci-Edwards J, Little K, Singh H, Sherman J, (2022) Reducing healthcare carbon emissions: a primer on measures and actions for healthcare organizations to mitigate climate change. Agency for Healthcare Research and Quality
30.
Zurück zum Zitat Pollard A, Paddle J, Taylor T, Tillyard A (2014) The carbon footprint of acute care: how energy intensive is critical care? Public Health 128:771–776CrossRefPubMed Pollard A, Paddle J, Taylor T, Tillyard A (2014) The carbon footprint of acute care: how energy intensive is critical care? Public Health 128:771–776CrossRefPubMed
31.
Zurück zum Zitat Parvatker AG, Tunceroglu H, Sherman JD, Coish P, Anastas P, Zimmerman JB, Eckelman MJ (2019) Cradle-to-gate greenhouse gas emissions for twenty anesthetic active pharmaceutical ingredients based on process scale-up and process design calculations. ACS Sustain Chem Eng 7:6580–6591CrossRef Parvatker AG, Tunceroglu H, Sherman JD, Coish P, Anastas P, Zimmerman JB, Eckelman MJ (2019) Cradle-to-gate greenhouse gas emissions for twenty anesthetic active pharmaceutical ingredients based on process scale-up and process design calculations. ACS Sustain Chem Eng 7:6580–6591CrossRef
32.
Zurück zum Zitat McGain F, Hendel S, Story D (2009) An audit of potentially recyclable waste from anaesthetic practice. Anaesth Intensive Care 37:820–823CrossRefPubMed McGain F, Hendel S, Story D (2009) An audit of potentially recyclable waste from anaesthetic practice. Anaesth Intensive Care 37:820–823CrossRefPubMed
33.
Zurück zum Zitat Johnston PF, Jumbo-Cueva P, Kurup V, Govindan A, Rao S, Sifri ZC (2019) The RECOVER initiative: supply recovery and donation beyond the operating room. Int J Acad Med 5:62CrossRef Johnston PF, Jumbo-Cueva P, Kurup V, Govindan A, Rao S, Sifri ZC (2019) The RECOVER initiative: supply recovery and donation beyond the operating room. Int J Acad Med 5:62CrossRef
34.
Zurück zum Zitat Corbin L, Hoff H, Smith A, Owens C, Weisinger K, Philipsborn R (2022) A 24-hour waste audit of the neuro ICU during the COVID-19 pandemic and opportunities for diversion. J Clim Change Health 8:100154CrossRef Corbin L, Hoff H, Smith A, Owens C, Weisinger K, Philipsborn R (2022) A 24-hour waste audit of the neuro ICU during the COVID-19 pandemic and opportunities for diversion. J Clim Change Health 8:100154CrossRef
35.
Zurück zum Zitat Furukawa PdO, Cunha ICKO, Pedreira MdLG, Marck PB (2016) Environmental sustainability in medication processes performed in hospital nursing care. Acta Paul de Enferm 29:316–324CrossRef Furukawa PdO, Cunha ICKO, Pedreira MdLG, Marck PB (2016) Environmental sustainability in medication processes performed in hospital nursing care. Acta Paul de Enferm 29:316–324CrossRef
36.
Zurück zum Zitat Hames K (2013) Healthcare waste disposal: an analysis of the effect of education on improving waste disposal. Healthc Infect 18:110–114CrossRef Hames K (2013) Healthcare waste disposal: an analysis of the effect of education on improving waste disposal. Healthc Infect 18:110–114CrossRef
37.
Zurück zum Zitat Kubicki MA, McGain F, O’Shea CJ, Bates S (2015) Auditing an intensive care unit recycling program. Crit Care Resusc 17:135–140PubMed Kubicki MA, McGain F, O’Shea CJ, Bates S (2015) Auditing an intensive care unit recycling program. Crit Care Resusc 17:135–140PubMed
38.
Zurück zum Zitat Shen MY, Chang CC, Li MY, Lin JH (2017) Decreasing the output of biomedical waste in the intensive care unit. Hu Li Za Zhi 64:81–90PubMed Shen MY, Chang CC, Li MY, Lin JH (2017) Decreasing the output of biomedical waste in the intensive care unit. Hu Li Za Zhi 64:81–90PubMed
39.
40.
Zurück zum Zitat McGain F, Story D, Hendel S (2009) An audit of intensive care unit recyclable waste. Anaesthesia 64:1299–1302CrossRefPubMed McGain F, Story D, Hendel S (2009) An audit of intensive care unit recyclable waste. Anaesthesia 64:1299–1302CrossRefPubMed
44.
Zurück zum Zitat Khanna AK, Labeau SO, McCartney K, Blot SI, Deschepper M (2022) International variation in length of stay in intensive care units and the impact of patient-to-nurse ratios. Intensive Crit Care Nurs 72:103265CrossRefPubMed Khanna AK, Labeau SO, McCartney K, Blot SI, Deschepper M (2022) International variation in length of stay in intensive care units and the impact of patient-to-nurse ratios. Intensive Crit Care Nurs 72:103265CrossRefPubMed
45.
Zurück zum Zitat Eckelman MJ, Sherman JD, MacNeill AJ (2018) Life cycle environmental emissions and health damages from the Canadian healthcare system: an economic-environmental-epidemiological analysis. PLoS Med 15:e1002623CrossRefPubMedPubMedCentral Eckelman MJ, Sherman JD, MacNeill AJ (2018) Life cycle environmental emissions and health damages from the Canadian healthcare system: an economic-environmental-epidemiological analysis. PLoS Med 15:e1002623CrossRefPubMedPubMedCentral
46.
Zurück zum Zitat Rizan C, Steinbach I, Nicholson R, Lillywhite R, Reed M, Bhutta MF (2020) The carbon footprint of surgical operations: a systematic review. Ann Surg 272:986–995CrossRefPubMed Rizan C, Steinbach I, Nicholson R, Lillywhite R, Reed M, Bhutta MF (2020) The carbon footprint of surgical operations: a systematic review. Ann Surg 272:986–995CrossRefPubMed
47.
Zurück zum Zitat Alec Y, Iman B (2021) Environmental sustainability in canadian critical care: a nationwide survey study on medical waste management. Healthc Q 23:39–45CrossRef Alec Y, Iman B (2021) Environmental sustainability in canadian critical care: a nationwide survey study on medical waste management. Healthc Q 23:39–45CrossRef
49.
Zurück zum Zitat Rizan C, Bhutta MF, Reed M, Lillywhite R (2021) The carbon footprint of waste streams in a UK hospital. J Clean Prod 286:125446CrossRef Rizan C, Bhutta MF, Reed M, Lillywhite R (2021) The carbon footprint of waste streams in a UK hospital. J Clean Prod 286:125446CrossRef
51.
Zurück zum Zitat Oakes AH, Radomski TR (2021) Reducing low-value care and improving health care value. JAMA 325:1715–1716CrossRefPubMed Oakes AH, Radomski TR (2021) Reducing low-value care and improving health care value. JAMA 325:1715–1716CrossRefPubMed
52.
Zurück zum Zitat Kampman JM, Sperna Weiland NH (2023) Anaesthesia and environment: impact of a green anaesthesia on economics. Curr Opin Anaesthesiol 36:188–195CrossRefPubMedPubMedCentral Kampman JM, Sperna Weiland NH (2023) Anaesthesia and environment: impact of a green anaesthesia on economics. Curr Opin Anaesthesiol 36:188–195CrossRefPubMedPubMedCentral
53.
Zurück zum Zitat McAlister S, Barratt AL, Bell KJ, McGain F (2020) The carbon footprint of pathology testing. Med J Aust 212:377–382CrossRefPubMed McAlister S, Barratt AL, Bell KJ, McGain F (2020) The carbon footprint of pathology testing. Med J Aust 212:377–382CrossRefPubMed
54.
Zurück zum Zitat 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. Lancet Reg Health-West Pacif 24:100459CrossRef 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. Lancet Reg Health-West Pacif 24:100459CrossRef
Metadaten
Titel
The carbon footprint of critical care: a systematic review
verfasst von
Melany Gaetani
Elizabeth Uleryk
Camilla Halgren
Christina Maratta
Publikationsdatum
28.02.2024
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 5/2024
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-023-07307-1

Weitere Artikel der Ausgabe 5/2024

Intensive Care Medicine 5/2024 Zur Ausgabe

Blutdrucksenkung schon im Rettungswagen bei akutem Schlaganfall?

31.05.2024 Apoplex Nachrichten

Der optimale Ansatz für die Blutdruckkontrolle bei Patientinnen und Patienten mit akutem Schlaganfall ist noch nicht gefunden. Ob sich eine frühzeitige Therapie der Hypertonie noch während des Transports in die Klinik lohnt, hat jetzt eine Studie aus China untersucht.

Ähnliche Überlebensraten nach Reanimation während des Transports bzw. vor Ort

29.05.2024 Reanimation im Kindesalter Nachrichten

Laut einer Studie aus den USA und Kanada scheint es bei der Reanimation von Kindern außerhalb einer Klinik keinen Unterschied für das Überleben zu machen, ob die Wiederbelebungsmaßnahmen während des Transports in die Klinik stattfinden oder vor Ort ausgeführt werden. Jedoch gibt es dabei einige Einschränkungen und eine wichtige Ausnahme.

Nicht Creutzfeldt Jakob, sondern Abführtee-Vergiftung

29.05.2024 Hyponatriämie Nachrichten

Eine ältere Frau trinkt regelmäßig Sennesblättertee gegen ihre Verstopfung. Der scheint plötzlich gut zu wirken. Auf Durchfall und Erbrechen folgt allerdings eine Hyponatriämie. Nach deren Korrektur kommt es plötzlich zu progredienten Kognitions- und Verhaltensstörungen.

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.