Recycling in Ambulatory Gastrointestinal Endoscopy, A Single Center Experience.

Abstract

INTRODUCTION Gastrointestinal endoscopy depends on high utilization of resources and is associated with significant production of waste. Recycling is one strategy that could decrease the carbon footprint from endoscopic activities and reduce landfill waste. OBJECTIVE To assess the impact of recycling of endoscopic materials in a high-volume university outpatient ambulatory endoscopy center. METHODS 3063 patients (1253 M, 1810 F) underwent gastrointestinal procedures over a 6-month period from 1/15/2024 to 6/15/2024. Endoscopy equipment consisting of cinch pad, gauze, lubricant gel packaging, sponge, suction valves, biopsy valve, air water cleaning adapter, water jet connector, suction tubing, plastic bowl, dual end brush, air/water bottle cap, and irrigation tubing were recycled after use. Data was collected through analysis of company invoices. Greenhouse gas avoidance was determined utilizing United States Environmental Protection Agency Waste Reduction Model (WARM). The daily procedure volume and room turnover time were compared to a control group of 3060 patients in the preceding six months. RESULTS Total waste recycled equaled 1708.4 kg, or 0.56 kg per procedure. In contrast to landfilling, recycling was resulted in a net reduction of 4.42 metric tons of CO2 equivalent. Compared to controls, volume per day increased (28.9 vs. 24.3; p<0.05), turnover time per patient decreased (18.2 min vs. 19.9 min; p<0.05), and total regulated medical waste collected remained steady (3007.9 kg vs. 2976.1 kg) (p=0.11). CONCLUSION Recycling used endoscopy equipment is feasible, reduces the carbon footprint, and does not impede endoscopy unit efficiency.