Abstract
Background
Endoscopy is a major producer of hospital waste. Liquid waste collected during endoscopic
procedures represents a third of endoscopy waste and is often managed as regulated
medical waste (RMW), costing more and emitting more greenhouse gases (GHGs) than regular
landfill waste. We assessed the carbon footprint and financial impact of alternative
processing methods to RMW.
Methods
After 1 month of prospectively weighing endoscopic liquid waste, costs (€) and GHG
emissions (kgCO2e) were calculated using the Carebone tool to compare the following
processing methods to standard RMW: (a) solidification – aspiration canister contents
are made less prone to leakage by including a jellifying additive and can be disposed
of in landfill waste bags instead of RMW; (b) urban sewer disposal (USD) – fluids
are eliminated into sewers by using a dedicated system instead of aspiration canisters.
Costs and GHG emissions were modelled according to the different scenarios.
Results
Mean procedure-related waste was 1.56 kg per patient, one-third of which was liquid
waste. Compared with RMW (assuming 0.5 L of waste per endoscopic procedure), a center
treating 4000 patients / year would save 923 € and avoid 1440 kgCO2e in GHG emissions
with solidification, while USD would cost 105 898 € more and avoid only 96.5 kgCO2e.
Different caseload and volume assumptions are discussed.
Conclusions
Endoscopic procedure-related liquid waste represents a third of the waste emitted
per patient in an endoscopy unit. Solidification allows fluids to be safely reallocated
to landfill waste and may reduce processing costs and environmental impact. USD appears
to be neither environmentally nor economically beneficial for endoscopy units.
