Environmental Impact of Flexible Single-Use and Reusable Video Laryngoscopes.

Objectives: The objective of this study was to evaluate and compare the environmental impact of single-use and reusable video laryngoscopes.

Methods: We performed life-cycle assessments of video laryngoscopes at a tertiary-care academic center: single-use Ambu aScope 4 RhinoLaryngo Slim (Ambu Inc., Columbia, MD), single-use Video Rhino-Laryngoscope (Karl Storz, Tuttlingen, Germany), and reusable Storz Video Rhinolaryngoscope 1101HD. We collected data regarding lifecycle, manual reprocessing, and waste disposal at our institution. The lifetime carbon footprint of each device was calculated and included emissions related to manufacturing, transportation, sterilization, repair, and disposal. We then assessed carbon footprint of each device per procedure.

Results: The total estimated carbon footprint per procedure for single-use Ambu and Storz laryngoscopes is 7.46 and 5.49 kg CO₂, respectively. The mass of solid waste of single-use laryngoscopes and packaging contribute to carbon emissions of 0.173 and 0.40 kg CO₂ for Ambu and Storz laryngoscopes, respectively. Reusable laryngoscopes are estimated to have a carbon footprint of 0.1137 kg CO₂ per procedure at our institution. The greatest contributions to carbon footprint during reusable laryngoscope manual reprocessing include personal protective equipment solid waste and electrical energy (0.0859 and 0.016 kg CO₂, respectively). The carbon footprint of single-use laryngoscopes is estimated to range from 1.5-fold (based on solid waste alone) up to 66-fold greater than traditional reusable laryngoscopes, although the use of water and chemicals for reprocessing must also be considered.

Discussion: While single-use laryngoscopes have benefits of added convenience, cost effectiveness, and ease of use, they have a significantly greater environmental impact than resusable laryngoscopes. Otolaryngologists should consider the environmental impact of single-use laryngoscopes with goals of improving carbon footprint reduction.