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DOI: 10.1055/a-2570-6599
Environmental footprint of a colonoscopy procedure: Life cycle assessment
Authors
Gefördert durch: Appropriate Care in cooperation with insurance company VGZ
Gefördert durch: ZonMw 80-86800-98-112

Abstract
Background and study aims
Gastroenterology is a specialty that has evolved rapidly over time, especially in terms of advancements in endoscopic procedures. However, these advancements also present challenges, given the substantial resource demands associated with endoscopy procedures. Numerous actions could be taken to develop a resilient healthcare system that consumes as few resources as possible, but recommendations are needed to prioritize which processes could be improved. We aimed to evaluate the environmental footprint of a colonoscopy procedure, and to identify the main contributing impact process categories.
Methods
A single-center observational study was conducted at a Dutch university hospital. No clinical patient data were collected, but the colonoscopy procedure was studied. Data were collected during 13 colonoscopies. Life cycle assessment (LCA) was used to calculate environmental impact.
Results
Damage to human health from one colonoscopy was 11.3·10–5 disability-adjusted life-years, equivalent to 1 hour. A single colonoscopy resulted in emission of 56.4 kg of CO2-equivalent (CO2eq), equal to driving a car for 255 km or 55 days of emissions for an average European household. Transportation of patients and staff (76.5%) and disposables (13.5%) were the greatest contributors to damage to human health.
Conclusions
Among the 13 colonoscopies studied, the environmental impact was mainly attributable to transportation of patients and staff, and disposables. Therefore, raising awareness about the impact of transportation by car, and reducing resource consumption, particularly of disposable products, should be prioritized. Implementing alternatives to colonoscopy, such as intestinal ultrasound, could reduce the environmental footprint of the healthcare system.
* Shared last authorship.
Publikationsverlauf
Eingereicht: 06. Februar 2025
Angenommen nach Revision: 27. März 2025
Accepted Manuscript online:
31. März 2025
Artikel online veröffentlicht:
12. Mai 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
Paulina Lämmer, Dorien Oomkens, Tim Stobernack, Marjolijn Duijvestein. Environmental footprint of a colonoscopy procedure: Life cycle assessment. Endosc Int Open 2025; 13: a25706599.
DOI: 10.1055/a-2570-6599
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References
- 1
Lenzen M,
Malik A,
Li M.
et al.
The environmental footprint of health care: a global assessment. Lancet Planet Health
2020; 4: e271-e279
Reference Ris Wihthout Link
- 2
Vaccari M,
Tudor T,
Perteghella A.
Costs associated with the management of waste from healthcare facilities: An analysis
at national and site level. Waste Manag Res 2018; 36: 39-47
Reference Ris Wihthout Link
- 3
Rodriguez de Santiago E,
Dinis-Ribeiro M,
Pohl H.
et al.
Reducing the environmental footprint of gastrointestinal endoscopy: European Society
of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and
Endoscopy Nurses and Associates (ESGENA) Position Statement. Endoscopy 2022; 54: 797-826
Reference Ris Wihthout Link
- 4
Henniger D,
Windsheimer M,
Beck H.
et al.
Assessment of the yearly carbon emission of a gastrointestinal endoscopy unit. Gut
2023; 72: 1816-1818
Reference Ris Wihthout Link
- 5
Duijvestein M,
Sidhu R,
Zimmermann K.
et al.
The United European Gastroenterology green paper-climate change and gastroenterology.
United European Gastroenterol J 2024; 12: 1292-1305
Reference Ris Wihthout Link
- 6
McGain F,
Burnham JP,
Lau R.
et al.
The carbon footprint of treating patients with septic shock in the intensive care
unit. Crit Care Resusc 2018; 20: 304-312
Reference Ris Wihthout Link
- 7
Siegert M-W,
Lehmann A,
Emara Y.
et al.
Harmonized rules for future LCAs on pharmaceutical products and processes. In J Life
Cycle Assessment 2018; 24: 1040-1057
Reference Ris Wihthout Link
- 8
Thiel CL,
Eckelman M,
Guido R.
et al.
Environmental impacts of surgical procedures: life cycle assessment of hysterectomy
in the United States. Environ Sci Technol 2015; 49: 1779-1786
Reference Ris Wihthout Link
- 9
Duffy J,
Slutzman JE,
Thiel CL.
et al.
Sustainable purchasing practices: A comparison of single-use and reusable pulse oximeters
in the Emergency Department. West J Emerg Med 2023; 24: 1034-1042
Reference Ris Wihthout Link
- 10
Huijbregts MAJ,
Steinmann ZJN,
Elshout PMF.
et al.
ReCiPe2016: a harmonised life cycle impact assessment method at midpoint and endpoint
level. Int J Life Cycle Assessment 2016; 22: 138-147
Reference Ris Wihthout Link
- 11
Devleesschauwer B,
Havelaar AH,
Maertens de Noordhout C.
et al.
Calculating disability-adjusted life years to quantify burden of disease. Int J Public
Health 2014; 59: 565-569
Reference Ris Wihthout Link
- 12
Peery AF,
Crockett SD,
Murphy CC.
et al.
Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United
States: Update 2018. Gastroenterology 2019; 156: 254-272 e11
Reference Ris Wihthout Link
- 13
Lopez-Munoz P,
Martin-Cabezuelo R,
Lorenzo-Zuniga V.
et al.
Life cycle assessment of routinely used endoscopic instruments and simple intervention
to reduce our environmental impact. Gut 2023; 72: 1692-1697
Reference Ris Wihthout Link
- 14
Lacroute J,
Marcantoni J,
Petitot S.
et al.
The carbon footprint of ambulatory gastrointestinal endoscopy. Endoscopy 2023; 55:
918-926
Reference Ris Wihthout Link
- 15
Pioche M,
Pohl H,
Cunha Neves JA.
et al.
Environmental impact of single-use versus reusable gastroscopes. Gut 2024; 73: 1816-1822
Reference Ris Wihthout Link
- 16
Henniger D,
Windsheimer M,
Beck H.
et al.
Assessment of the yearly carbon emission of a gastrointestinal endoscopy unit. Gut
2023; 72: 1816-1818
Reference Ris Wihthout Link
- 17
Nordberg LB,
Pohl H,
Haavardsholm EA.
et al.
Carbon-footprint analyses in RCTs - Toward sustainable clinical practice. N Engl J
Med 2024; 390: 2234-2236
Reference Ris Wihthout Link
- 18
de Jong D,
Volkers A,
de Ridder E.
et al.
Steps toward a greener endoscopy unit. Clin Gastroenterol Hepatol 2023; 21: 2723-6
e2
Reference Ris Wihthout Link
- 19
Chavannes M,
Dolinger MT,
Cohen-Mekelburg S.
et al.
AGA Clinical Practice Update on the Role of Intestinal Ultrasound in Inflammatory
Bowel Disease: Commentary. Clin Gastroenterol Hepatol 2024; 22: 1790-5 e1
Reference Ris Wihthout Link
- 20
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
Reference Ris Wihthout Link