Lancet Planetary Health最新文献

{"title":"Indigenous Elders' voices on health-systems change informed by planetary health: a qualitative and relational systems mapping inquiry","authors":"Nicole Redvers ND ,&nbsp;Felix Lockhart ,&nbsp;John B Zoe ,&nbsp;Rassi Nashalik ,&nbsp;Denise McDonald ,&nbsp;Gladys Norwegian ,&nbsp;Jamie Hartmann-Boyce DPhil ,&nbsp;Sarah Tonkin-Crine PhD","doi":"10.1016/S2542-5196(24)00277-8","DOIUrl":"10.1016/S2542-5196(24)00277-8","url":null,"abstract":"<div><div>Indigenous Peoples and their knowledge systems are increasingly being looked to for solutions regarding climate change, including within clinical health-care settings. Indigenous Elders specifically are noted knowledge keepers within their communities and are often looked to with great respect for their Land-based knowledges as they pertain to planetary health approaches. We sought to explore the views of health-systems change informed by planetary health within the circumpolar north from the perspective of Indigenous Elders. We held a sharing circle, in which Elders identified four interconnected themes following a cyclical pattern that were also depicted with relational systems mapping, including the past and how we got here, where we are now, where we need to go in the future, and our reflections. Our findings showed that any concepts related to planetary health that are discussed within health systems cannot be disconnected from the context around them. Overall, health systems were stated to be currently devoid of any environmental context or consideration.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 12","pages":"Pages e1106-e1117"},"PeriodicalIF":24.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Somebody has to move first","authors":"The Lancet Planetary Health","doi":"10.1016/S2542-5196(24)00313-9","DOIUrl":"10.1016/S2542-5196(24)00313-9","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 12","pages":"Page e973"},"PeriodicalIF":24.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the gender, climate, and health gap: the road to COP29","authors":"Kim Robin van Daalen PhD ,&nbsp;Laura Jung MD ,&nbsp;Sara Dada MSc ,&nbsp;Razan Othman MBBS ,&nbsp;Alanna Barrios-Ruiz MD ,&nbsp;Grace Zurielle Malolos MD ,&nbsp;Kai-Ti Wu MSc ,&nbsp;Ana Garza-Salas MD ,&nbsp;Salma El-Gamal MSc ,&nbsp;Tarek Ezzine BMSc ,&nbsp;Parnian Khorsand MPH ,&nbsp;Arthur Wyns MSc ,&nbsp;Blanca Paniello-Castillo MMSc ,&nbsp;Sophie Gepp MD ,&nbsp;Maisoon Chowdhury MPH ,&nbsp;Ander Santamarta Zamorano MPH ,&nbsp;Jess Beagley MSc ,&nbsp;Clare Oliver-Williams PhD ,&nbsp;Ramit Debnath PhD ,&nbsp;Ronita Bardhan PhD ,&nbsp;Prof Rachel Lowe PhD","doi":"10.1016/S2542-5196(24)00270-5","DOIUrl":"10.1016/S2542-5196(24)00270-5","url":null,"abstract":"<div><div>Focusing specifically on the gender–climate–health nexus, this Personal View builds on existing feminist works and analyses to discuss why intersectional approaches to climate policy and inclusive representation in climate decision making are crucial for achieving just and equitable solutions to address the impacts of climate change on human health and societies. This Personal View highlights how women, girls, and gender-diverse people often face disproportionate climate-related health impacts, particularly those who experience compounding and overlapping vulnerabilities due to current and former systems of oppression. We summarise the insufficient meaningful inclusion of gender, health, and their intersection in international climate governance. Despite the tendency to conflate gender equality with number-based representation, climate governance under the UNFCCC (1995–2023) remains dominated by men, with several countries projected to take over a decade to achieve gender parity in their Party delegations. Advancing gender-responsiveness in climate policy and implementation and promoting equitable participation in climate governance will not only improve the inclusivity and effectiveness of national strategies, but will also build more resilient, equitable, and healthier societies.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 12","pages":"Pages e1088-e1105"},"PeriodicalIF":24.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No silver bullets, no shortcuts: confronting the commercial determinants of the climate crisis","authors":"Benjamin Wood ,&nbsp;Penelope Milsom ,&nbsp;Sharon Friel","doi":"10.1016/S2542-5196(24)00278-X","DOIUrl":"10.1016/S2542-5196(24)00278-X","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 12","pages":"Pages e977-e978"},"PeriodicalIF":24.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intersections between climate change and antimicrobial resistance: a systematic scoping review","authors":"Bianca van Bavel PhD ,&nbsp;Prof Lea Berrang-Ford PhD ,&nbsp;Kelly Moon MSc ,&nbsp;Fredrick Gudda PhD ,&nbsp;Alexander J Thornton MSc ,&nbsp;Rufus F S Robinson MSc ,&nbsp;Prof Rebecca King PhD","doi":"10.1016/S2542-5196(24)00273-0","DOIUrl":"10.1016/S2542-5196(24)00273-0","url":null,"abstract":"<div><div>Climate change and antimicrobial resistance (AMR) present crucial challenges for the health and wellbeing of people, animals, plants, and ecosystems worldwide, yet the two are largely treated as separate and unrelated challenges. The aim of this systematic scoping Review is to understand the nature of the growing evidence base linking AMR and climate change and to identify knowledge gaps and areas for further research. We conducted a systematic search of the peer-reviewed literature in Scopus, Web of Science, and PubMed on 27 June, 2022. Our search strategy identified and screened 1687 unique results. Data were extracted and analysed from 574 records meeting our inclusion criteria. 222 (39%) of these reviewed articles discussed harmful synergies in which both climate change and AMR exist independently and can interact synergistically, resulting in negative outcomes. Just over a quarter (n=163; 28%) of the literature contained general or broad references to AMR and climate change, whereas a fifth (n=111; 19%) of articles referred to climate change influencing the emergence and evolution of AMR. 12% of articles (n=70) presented positive synergies between approaches aimed at addressing climate change and interventions targeting the management and control of AMR. The remaining literature focused on the shared drivers of AMR and climate change, the trade-offs between climate actions that have unanticipated negative outcomes for AMR (or vice versa), and, finally, the pathways through which AMR can negatively influence climate change. Our findings indicate multiple intersections through which climate change and AMR can and do connect. Research in this area is still nascent, disciplinarily isolated, and only beginning to converge, with few documents primarily focused on the equal intersection of both topics. Greater empirical and evidence-based attention is needed to investigate knowledge gaps related to specific climate change hazards and antimicrobial resistant fungi, helminths, protists, and viruses.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 12","pages":"Pages e1118-e1128"},"PeriodicalIF":24.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate and health education in public health schools worldwide during 2023–24: a survey","authors":"Cecilia Sorensen MD ,&nbsp;Danielly Magalhães PhD ,&nbsp;Nicola Hamacher MPH ,&nbsp;James K Sullivan MD ,&nbsp;Hannah N W Weinstein BA ,&nbsp;Ana-Catarina Pinho-Gomes DPhil ,&nbsp;Dorothy Biberman MPH ,&nbsp;Holly Donaldson MPH ,&nbsp;Ingrid Gómez-Duarte PhD ,&nbsp;John Middleton FFPH ,&nbsp;Laura Magaña PhD ,&nbsp;Manuel Urbina MPH ,&nbsp;Prof Margaret Kaseje PhD ,&nbsp;Nora Cascante-Flores PhD ,&nbsp;Prof Rajendra Surenthirakumaran MD ,&nbsp;Prof Rebecca Ivers PhD ,&nbsp;Rocío Sáenz MPH ,&nbsp;Tara Tai-Wen Chen MPH ,&nbsp;Wendy Lopez BHS ,&nbsp;Marina Romanello PhD ,&nbsp;Ying Zhang PhD","doi":"10.1016/S2542-5196(24)00284-5","DOIUrl":"10.1016/S2542-5196(24)00284-5","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Public health professionals are crucial in implementing health-promoting climate change adaptation and mitigation measures, yet climate education is inconsistently integrated into public health curricula worldwide. We aimed to assess the proportion of institutions that provided public health degrees with climate and health education, the annual number of students trained in climate and health, and the extent to which students had climate and health knowledge during 2023–24.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;From Nov 1, 2023, to March 15, 2024, our online survey quantified climate and health education in public health schools that provide degrees across all WHO regions. The survey was available in English, Spanish, and Portuguese and distributed to Global Consortium on Climate and Health Education member institutions and organisations and the Global Network for Academic Public Health; institutions in 138 countries were invited to participate. We collected data on optional and mandatory training, enrolment in versus actual education on climate topics, degree programmes offering climate education, year of curriculum implementation, and the extent of training across eight competency domains. Instructions stated that the survey should be completed by school staff who designed, taught, or were familiar with climate or planetary health content and curricula within their institution. Two follow-up reminder emails were sent to institutions that had not completed the survey on Jan 13, 2024, and Feb 15, 2024. We also measured the presence of climate education among randomly selected non-responding institutions through internet searches for evidence of a class or a concentration from June 1 to July 25, 2024.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The survey was sent to 1251 public health institutions across 138 countries; we received responses from 279 (22%) of 1251 institutions in 81 (59%) of 138 countries. Most institutions that we invited were in the WHO region of the Americas (n=776), the African region (n=177), and the European region (n=155). 196 (70%) of 279 responding institutions and 62 (77%) of 81 responding countries reported providing climate and health education during 2023–24. The number of responding institutions providing climate and health education was 53 (80%) of 66 in the European region, 21 (72%) of 29 in the Western Pacific region, five (71%) of seven in the South-East Asia region, 97 (68%) of 143 in the region of the Americas, 15 (63%) of 24 in the African region, and five (50%) of ten in the Eastern Mediterranean region. 298 degree-level public health programmes were identified during 2023–24, of which 171 (57%) reported that climate and health education was part of the required curriculum. Master's degree programmes provided the most climate and health education (118 [40%] of 298 degree-level programmes identified). A search of 135 additional non-responding institutions indicated that 36 (27%) likely of","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 12","pages":"Pages e1010-e1019"},"PeriodicalIF":24.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dengue virus importation risks in Africa: a modelling study","authors":"Jenicca Poongavanan MSc ,&nbsp;José Lourenço PhD ,&nbsp;Joseph L-H Tsui MSc ,&nbsp;Vittoria Colizza PhD ,&nbsp;Yajna Ramphal BSc ,&nbsp;Cheryl Baxter PhD ,&nbsp;Prof Moritz U G Kraemer PhD ,&nbsp;Marcel Dunaiski PhD ,&nbsp;Prof Tulio de Oliveira PhD ,&nbsp;Houriiyah Tegally PhD","doi":"10.1016/S2542-5196(24)00272-9","DOIUrl":"10.1016/S2542-5196(24)00272-9","url":null,"abstract":"<div><h3>Background</h3><div>Dengue is a significant global public health concern that poses a threat in Africa. Particularly, African countries are at risk of viral introductions through air travel connectivity with areas of South America and Asia in which explosive dengue outbreaks frequently occur. Limited reporting and diagnostic capacity hinder a comprehensive assessment of continent-wide transmission dynamics and deployment of surveillance strategies in Africa. In this study, we aimed to identify African airports at high risk of receiving passengers with dengue from Asia, Latin America, and other African countries with high dengue incidence.</div></div><div><h3>Methods</h3><div>For this modelling study, air travel flow data were obtained from the International Air Transport Association database for 2019. Data comprised monthly passenger volumes from 14 high-incidence countries outside of Africa and 18 countries within the African continent that reported dengue outbreaks in the past 10 years to 54 African countries, encompassing all 197 commercial airports in both the source and destination regions. The risk of dengue introduction into Africa from countries of high incidence in Asia, Latin America, and within Africa was estimated based on origin–destination air travel flows and epidemic activity at origin. We produced a novel proxy for local dengue epidemic activity using a composite index of theoretical climate-driven transmission suitability and population density, which we used, in addition to travel information in a risk flow model, to estimate importation risk.</div></div><div><h3>Findings</h3><div>Countries in eastern Africa had a high estimated risk of dengue importation from Asia and other east African countries, whereas for west African countries, the risk of importation was higher from within the region than from countries outside of Africa. Some countries with high risk of importation had low local transmission suitability, which is likely to hamper the risk that dengue importations would lead to local transmission and establishment of a dengue outbreak. Mauritius, Uganda, Côte d'Ivoire, Senegal, and Kenya were identified as countries susceptible to dengue introductions during periods of persistent transmission suitability.</div></div><div><h3>Interpretation</h3><div>Our study improves data-driven allocation of surveillance resources, in regions of Africa that are at high risk of dengue introduction and establishment, including from regional circulation. Improvements in resource allocation will be crucial in detecting and managing imported cases and could improve local responses to dengue outbreaks.</div></div><div><h3>Funding</h3><div>Rockefeller Foundation, National Institute of Health, EDCTP3 and Horizon Europe Research and Innovation, World Bank Group, Medical Research Foundation, Wellcome Trust, Google, Oxford Martin School Pandemic Genomics programme, and John Fell Fund.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 12","pages":"Pages e1043-e1054"},"PeriodicalIF":24.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health outcomes, environmental impacts, and diet costs of adherence to the EAT-Lancet Diet in China in 1997–2015: a health and nutrition survey","authors":"Hongyi Cai PhD ,&nbsp;Elise F Talsma PhD ,&nbsp;Zhiyao Chang MSc ,&nbsp;Xin Wen PhD ,&nbsp;Prof Shenggen Fan PhD ,&nbsp;Prof Pieter van't Veer PhD ,&nbsp;Sander Biesbroek PhD","doi":"10.1016/S2542-5196(24)00285-7","DOIUrl":"10.1016/S2542-5196(24)00285-7","url":null,"abstract":"<div><h3>Background</h3><div>In 2019, the EAT-<em>Lancet</em> Commission proposed a global reference dietary pattern. Although research on the EAT-<em>Lancet</em> reference diet and its associations with mortality, cardiovascular disease, type 2 diabetes, dietary environmental impacts, and cost of diets is increasing, studies done in low-income and middle-income countries remain scarce. This study aimed to assess the health outcomes, environmental impacts, and dietary costs of adherence to the EAT-<em>Lancet</em> reference diet in China.</div></div><div><h3>Methods</h3><div>In this health and nutrition survey study, 16 029 participants from the China Health and Nutrition Survey cohort (1997–2015) were included at baseline. All-cause mortality was reported by family members and risk of cardiovascular disease and type 2 diabetes was self-reported. 3-day 24 h recall was used to assess adherence to the EAT-<em>Lancet</em> reference diet (Eat-<em>Lancet</em> Diet Index [ELDI]), diet-related environmental impacts (greenhouse-gas emissions [GHGE]), total water use (TWU), land use, and dietary costs in each survey round. Hazard ratios (HRs) for the ELDI-score were obtained by Cox models with time-varying covariates, adjusted for potential confounders. Multilevel mixed-effects linear regression was used to assess the association of environmental impacts and dietary costs to the ELDI score.</div></div><div><h3>Findings</h3><div>During a median follow-up of 9·86 years, 803 new cases of incident type 2 diabetes, 563 new cases of cardiovascular disease, and 908 cases of all-cause mortality were recorded. At baseline, the ELDI score ranged from 9·4 points to 110·8 points on a scale of 0 to 140, with a mean of 55·3 points (SD 11·8). With each SD increase in the ELDI score, there was an 8% decreased risk of mortality (95% CI 2·2–14·1), a 16·1% decreased risk of cardiovascular disease (9·2–20·3), and a 25·3% decreased risk of type 2 diabetes (19·5– 28·4). Each SD increase in the index was associated with a decrease of 2·2% (95% CI –2·6 to –1·8) in GHGE, 2·3% (–2·6 to –2·0) in land use, no association with TWU, but an increase in diet costs of 3·3% (2·8 to 3·8).</div></div><div><h3>Interpretation</h3><div>High adherence to the ELDI was associated with a lower risk of mortality, cardiovascular disease, and type 2 diabetes. However, the association with diet-related GHGE and land use was modest, and adherence was also linked to higher diet costs. The study advocates for the integration of sustainable indicators into future Chinese dietary guidelines. Additionally, policy measures such as agricultural subsidies on fruit and vegetable and carbon taxes on red meat are recommended to increase affordability, reduce environmental impact, and enhance the overall sustainability of dietary practices in China.</div></div><div><h3>Funding</h3><div>The China Scholarship Council and the National Natural Science Foundation of China.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 12","pages":"Pages e1030-e1042"},"PeriodicalIF":24.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Planet-friendly school meals: opportunities to improve children's health and leverage change in food systems.","authors":"Silvia Pastorino, Ulrika Backlund, Raffaella Bellanca, Danny Hunter, Minna Kaljonen, Samrat Singh, Melissa Vargas, Donal Bundy","doi":"10.1016/S2542-5196(24)00302-4","DOIUrl":"https://doi.org/10.1016/S2542-5196(24)00302-4","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":" ","pages":""},"PeriodicalIF":24.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of alternative dosing strategies of pembrolizumab and nivolumab on health-care emissions in the Netherlands: a carbon footprint analysis","authors":"Ruben Malmberg PharmD ,&nbsp;Jurrien H Loosveld MD ,&nbsp;Hans-Peter Schilte BBA ,&nbsp;Prof Alex Burdorf PhD ,&nbsp;Roelof W F van Leeuwen PharmD","doi":"10.1016/S2542-5196(24)00245-6","DOIUrl":"10.1016/S2542-5196(24)00245-6","url":null,"abstract":"<div><h3>Background</h3><div>Hospitals contribute substantially to greenhouse gas emissions and face a moral obligation to prioritise emission reduction. Drugs constitute an important component of the greenhouse gas emissions of hospitals. Alternative dosing strategies (ADS) have been implemented to improve the cost-effectiveness of pembrolizumab and nivolumab. However, the impact of these ADS on greenhouse gas emissions remains unknown. Therefore, we aimed to analyse the effect of ADS implementation on the carbon emissions of treatment with pembrolizumab and nivolumab.</div></div><div><h3>Methods</h3><div>We used a process-based lifecycle assessment to quantify the environmental impact of pembrolizumab and nivolumab, focused on equivalent carbon dioxide emissions (CO₂e). Lifecycle inventory and impact data from Erasmus University Medical Center (Rotterdam, Netherlands) were used to calculate the CO₂e for pembrolizumab and nivolumab, their dosing intervals, and the impact of ADS on CO₂e. The functional unit of the study was the administration of a single dose of pembrolizumab or nivolumab.</div></div><div><h3>Findings</h3><div>In 2022, the annual carbon emissions related to pembrolizumab and nivolumab treatment in the Erasmus University Medical Center were 445 tons of CO₂e, averaging 94 kg of CO₂e per dose. Pharmaceutical production was the main driver of treatment-related carbon emissions (mean 92·9% of total emissions). Applying ADS resulted in 21–26% and 9–11% CO₂e reductions for pembrolizumab and nivolumab, respectively.</div></div><div><h3>Interpretation</h3><div>This study shows the environmental impact of pembrolizumab and nivolumab treatment and calls for further implementation of ADS for pembrolizumab, nivolumab, and other anti-PD-(L)1 monoclonal antibodies, and more sustainable pharmaceutical production processes. Our findings create environmental awareness and contribute to the promotion and understanding of health-care practices with lower carbon emissions.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 11","pages":"Pages e915-e923"},"PeriodicalIF":24.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}