The Carbon Footprint of Hospital Services and Care Pathways: A State-of-the-Science Review.

IF 10.1 1区 环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES
Lisanne H J A Kouwenberg,Eva S Cohen,Wouter J K Hehenkamp,Lynn E Snijder,Jasper M Kampman,Burcu Küçükkeles,Arno Kourula,Marijn H C Meijers,Eline S Smit,Nicolaas H Sperna Weiland,Dionne S Kringos
{"title":"The Carbon Footprint of Hospital Services and Care Pathways: A State-of-the-Science Review.","authors":"Lisanne H J A Kouwenberg,Eva S Cohen,Wouter J K Hehenkamp,Lynn E Snijder,Jasper M Kampman,Burcu Küçükkeles,Arno Kourula,Marijn H C Meijers,Eline S Smit,Nicolaas H Sperna Weiland,Dionne S Kringos","doi":"10.1289/ehp14754","DOIUrl":null,"url":null,"abstract":"BACKGROUND\r\nClimate change is the 21st century's biggest global health threat, endangering health care systems worldwide. Health care systems, and hospital care in particular, are also major contributors to greenhouse gas emissions.\r\n\r\nOBJECTIVES\r\nThis study used a systematic search and screening process to review the carbon footprint of hospital services and care pathways, exploring key contributing factors and outlining the rationale for chosen services and care pathways in the studies.\r\n\r\nMETHODS\r\nThis state-of-the-science review searched the MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), GreenFILE (EBSCOhost), Web of Science, Scopus, and the HealthcareLCA databases for literature published between 1 January 2000 and 1 January 2024. Gray literature was considered up to 1 January 2024. Inclusion criteria comprised original research reporting on the carbon footprint of hospital services or care pathways. Quality of evidence was assessed according to the guidelines for critical review of product life cycle assessment (LCA). PROSPERO registration number: CRD42023398527.\r\n\r\nRESULTS\r\nOf 5,415 records, 76 studies were included, encompassing 151 hospital services and care pathways across multiple medical specialties. Reported carbon footprints varied widely, from 0.01kg carbon dioxide (CO2) equivalents (kgCO2e) for an hour of intravenously administered anesthesia to 10,200 kgCO2e for a year of hemodialysis treatment. Travel, facilities, and consumables were key contributors to carbon footprints, whereas waste disposal had a smaller contribution. Relative importance of carbon hotspots differed per service, pathway, medical specialty, and setting. Studies employed diverse methodologies, including different LCA techniques, functional units, and system boundaries. A quarter of the studies lacked sufficient quality.\r\n\r\nDISCUSSION\r\nHospital services and care pathways have a large climate impact. Quantifying the carbon footprint and identifying hotspots enables targeted and prioritized mitigation efforts. Even for similar services, the carbon footprint varies considerably between settings, underscoring the necessity of localized studies. The emerging field of health care sustainability research faces substantial methodological heterogeneity, compromising the validity and reproducibility of study results. This review informs future carbon footprint studies by highlighting understudied areas in hospital care and providing guidance for selecting specific services and pathways. https://doi.org/10.1289/EHP14754.","PeriodicalId":11862,"journal":{"name":"Environmental Health Perspectives","volume":"62 1","pages":"126002"},"PeriodicalIF":10.1000,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Environmental Health Perspectives","FirstCategoryId":"93","ListUrlMain":"https://doi.org/10.1289/ehp14754","RegionNum":1,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENVIRONMENTAL SCIENCES","Score":null,"Total":0}
引用次数: 0

Abstract

BACKGROUND Climate change is the 21st century's biggest global health threat, endangering health care systems worldwide. Health care systems, and hospital care in particular, are also major contributors to greenhouse gas emissions. OBJECTIVES This study used a systematic search and screening process to review the carbon footprint of hospital services and care pathways, exploring key contributing factors and outlining the rationale for chosen services and care pathways in the studies. METHODS This state-of-the-science review searched the MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), GreenFILE (EBSCOhost), Web of Science, Scopus, and the HealthcareLCA databases for literature published between 1 January 2000 and 1 January 2024. Gray literature was considered up to 1 January 2024. Inclusion criteria comprised original research reporting on the carbon footprint of hospital services or care pathways. Quality of evidence was assessed according to the guidelines for critical review of product life cycle assessment (LCA). PROSPERO registration number: CRD42023398527. RESULTS Of 5,415 records, 76 studies were included, encompassing 151 hospital services and care pathways across multiple medical specialties. Reported carbon footprints varied widely, from 0.01kg carbon dioxide (CO2) equivalents (kgCO2e) for an hour of intravenously administered anesthesia to 10,200 kgCO2e for a year of hemodialysis treatment. Travel, facilities, and consumables were key contributors to carbon footprints, whereas waste disposal had a smaller contribution. Relative importance of carbon hotspots differed per service, pathway, medical specialty, and setting. Studies employed diverse methodologies, including different LCA techniques, functional units, and system boundaries. A quarter of the studies lacked sufficient quality. DISCUSSION Hospital services and care pathways have a large climate impact. Quantifying the carbon footprint and identifying hotspots enables targeted and prioritized mitigation efforts. Even for similar services, the carbon footprint varies considerably between settings, underscoring the necessity of localized studies. The emerging field of health care sustainability research faces substantial methodological heterogeneity, compromising the validity and reproducibility of study results. This review informs future carbon footprint studies by highlighting understudied areas in hospital care and providing guidance for selecting specific services and pathways. https://doi.org/10.1289/EHP14754.
医院服务和护理途径的碳足迹:一项最新的科学评论。
气候变化是21世纪最大的全球健康威胁,危及世界各地的卫生保健系统。卫生保健系统,特别是医院护理,也是温室气体排放的主要来源。目的:本研究采用系统的搜索和筛选过程来回顾医院服务和护理途径的碳足迹,探索关键的影响因素,并概述研究中所选择的服务和护理途径的基本原理。方法本科学综述检索MEDLINE (Ovid)、Embase (Ovid)、CINAHL (EBSCOhost)、GreenFILE (EBSCOhost)、Web of Science、Scopus和HealthcareLCA数据库,检索2000年1月1日至2024年1月1日之间发表的文献。灰色文献被认为截止到2024年1月1日。纳入标准包括关于医院服务或护理途径的碳足迹的原始研究报告。根据产品生命周期评估(LCA)关键审查指南评估证据质量。普洛斯彼罗注册号:CRD42023398527。结果在5415项记录中,包括76项研究,涵盖151项医院服务和多个医学专业的护理途径。报告的碳足迹差异很大,从一小时静脉麻醉的0.01kg二氧化碳当量(kgCO2e)到一年血液透析治疗的10,200 kgCO2e。旅行、设施和消耗品是碳足迹的主要贡献者,而废物处理的贡献较小。碳热点的相对重要性因服务、途径、医学专业和环境而异。研究采用了多种方法,包括不同的LCA技术、功能单元和系统边界。四分之一的研究缺乏足够的质量。医院服务和护理途径对气候有很大的影响。量化碳足迹和确定热点地区有助于开展有针对性和优先的缓解工作。即使是类似的服务,不同环境下的碳足迹也有很大差异,这强调了本地化研究的必要性。卫生保健可持续性研究的新兴领域面临着大量的方法异质性,损害了研究结果的有效性和可重复性。本综述通过强调医院护理中研究不足的领域,并为选择特定服务和途径提供指导,为未来的碳足迹研究提供信息。https://doi.org/10.1289/EHP14754。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Environmental Health Perspectives
Environmental Health Perspectives 环境科学-公共卫生、环境卫生与职业卫生
CiteScore
14.40
自引率
2.90%
发文量
388
审稿时长
6 months
期刊介绍: Environmental Health Perspectives (EHP) is a monthly peer-reviewed journal supported by the National Institute of Environmental Health Sciences, part of the National Institutes of Health under the U.S. Department of Health and Human Services. Its mission is to facilitate discussions on the connections between the environment and human health by publishing top-notch research and news. EHP ranks third in Public, Environmental, and Occupational Health, fourth in Toxicology, and fifth in Environmental Sciences.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信