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CC BY 4.0 · Endoscopy
DOI: 10.1055/a-2739-4080
DOI: 10.1055/a-2739-4080
Systematic review
Environmental footprint of gastrointestinal endoscopy services: a systematic review
Authors
Funded internally by Erasmus University Medical Center Convergence Sustainable Health Program.
Abstract
Background
Gastrointestinal (GI) endoscopy is a significant contributor to health care-related climate change due to high procedure volumes, intensive decontamination processes, and reliance on single-use products. This systematic review aimed to synthesize the current evidence on the environmental impact of GI endoscopy.
Methods
MEDLINE, Embase, and Web of Science were systematically searched up to May 2025 for studies assessing the environmental impact of GI endoscopy. Two reviewers independently performed study selection, data extraction, and quality assessment. The PRISMA guidelines were followed.
Results
28 studies were included. Most studies assessed carbon emissions; only four studies (14%) examined environmental impacts beyond greenhouse gas emissions. The largest contributors to emissions were patient travel, energy use, and procedure-related products, whereas waste had limited impact. Overall, scope 3 emissions accounted for the majority of total emissions, though reporting across different emission scopes was inconsistent. In line with heterogeneity in methodology, per-procedure emissions ranged from 5.4 to 73.2 kg carbon dioxide equivalent. Overall, 21 studies (75%) were judged to have a high risk of bias.
Conclusion
Current evidence on the environmental impact of GI endoscopy services is fragmented, methodologically inconsistent, and often limited in coverage. Emissions were dominated by patient travel, energy use, and procedure-related products. Broader and more standardized environmental assessments are needed to guide the transition to low-carbon, sustainable GI endoscopy.
Publication History
Received: 02 August 2025
Accepted after revision: 29 October 2025
Accepted Manuscript online:
05 November 2025
Article published online:
19 December 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
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