Eye care and the carbon foot print

Abstract

Climate change and its impact on the environment are rapidly becoming a crisis, resulting in extreme climate conditions and directly impacting health. The World Health Organization attributes 13.7 million deaths in 2016 to overall environmental factors. As health-care providers, we seem to be a significant contributor to carbon emissions. Health Care Without Harm, an organization promoting environmental health and justice, estimates that health-care accounts for an equivalent to 4.4% of global net carbon emissions. As a specialty with very high surgical volume, eye care would be contributing a significant portion of these carbon emissions. Thus, there is a need for us to explore ways of mitigating this. A descriptive case study method has been adopted to study environmentally sustainable practices with published or real-world data. Data from power consumption and energy audits were used in the analysis. The various approaches to reducing carbon emissions in eye care were studied using a broad framework of looking at what resources are deployed and how those resources are used. Whether it is resources or how they are put to use, there is a great scope for reducing carbon emissions through reducing use, re-use, and recycling. On the energy front just through the use of energy efficient electrical devices, and 8%–10% reduction in power consumption could be achieved immediately. Since green energy is less expensive than grid power, switching to it can generate another 15% in cost savings. It was feasible to switch to green energy for 75% of the power needs in the larger hospitals. Organic water recycling technology could recycle over 90% of the water and re-used it. Lean clinical protocols showed that the carbon emissions could be reduced to 5% of what it is in the west for procedures like phacoemulsification. While it is inevitable that eye care delivery will generate carbon emissions, it is well within our control to minimize it, per unit of care. This could be achieved essentially by minimizing waste or underutilization, enhancing efficiency, reducing consumption, and reducing patients’ efforts. These are the early days of trying to figure out, how the eye care sector can change its practices to minimize carbon emissions. A lot more evidence is required, signaling the need for research and publications in this space. As with any activity, for continuous improvement, we need benchmarks and robust monitoring systems. All of these are yet to evolve in clinical care.