Krista Verlis, Jessica F Davies, Forbes McGain, Hayden Burch, Alexandra L Barratt, Luise Kazda
{"title":"2002-2022年澳大利亚与麻醉气体相关的温室气体排放：回顾性描述性分析","authors":"Krista Verlis, Jessica F Davies, Forbes McGain, Hayden Burch, Alexandra L Barratt, Luise Kazda","doi":"10.5694/mja2.70046","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To assess changes in greenhouse gas emission rates associated with the use of anaesthetic gases (desflurane, sevoflurane, and isoflurane) in Australian health care during 2002-2022, overall and by state or territory and hospital type.</p><p><strong>Study design: </strong>Retrospective descriptive analysis of IQVIA anaesthetic gases purchasing data.</p><p><strong>Setting: </strong>All Australian public and private hospitals, 1 January 2002 - 31 December 2022.</p><p><strong>Main outcome measures: </strong>Absolute carbon dioxide equivalent (CO<sub>2</sub>e) emissions and CO<sub>2</sub>e emissions rate per 100 000 population by gas and year, overall and by state/territory and hospital type (public or private).</p><p><strong>Results: </strong>The overall emissions rate increased from 74 t CO<sub>2</sub>e per 100 000 population in 2002 to 328 t CO<sub>2</sub>e per 100 000 population in 2012, most rapidly during 2002-2004 (annual percentage change [APC], 51%; 95% confidence interval [CI], 38-62%). The rate then declined to 83 t CO<sub>2</sub>e per 100 000 population in 2022, most rapidly during 2017-2022 (APC, -21%; 95% CI, -23% to -20%). Patterns of emissions rate change were similar for all states and territories. More units of sevoflurane than of desflurane or isoflurane were purchased each year throughout 2002-2022, but desflurane provided the largest proportion of total emissions from anaesthetic gases during 2002-2022: 33% in 2002, 88% in 2013, and 68% in 2022. Mean emission rates per 100 000 population during 2002-2022 were highest for South Australia/Northern Territory (276 t CO<sub>2</sub>e per year) and lowest for Victoria/Tasmania (196 t CO<sub>2</sub>e per year). The desflurane emissions rate was consistently higher for private than public hospitals; it declined for public hospitals during 2009-2018 (APC, -8%; 95% CI, -10% to -5%) and 2018-2022 (APC, -43%; 95% CI, -48% to -37%), but for private hospitals only during 2017-2022 (APC, -20%; 95% CI, -24% to -17%).</p><p><strong>Conclusions: </strong>In Australia, the CO<sub>2</sub>e emissions rate for anaesthetic gases increased during 2002-2008 but declined during 2017-2022, at first primarily in public hospitals. Continuing to reduce the use of anaesthetic gases, particularly desflurane, will advance the decarbonisation of clinical practice in Australian health care.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":" ","pages":""},"PeriodicalIF":8.5000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Greenhouse gas emissions associated with anaesthetic gases in Australia, 2002-2022: a retrospective descriptive analysis.\",\"authors\":\"Krista Verlis, Jessica F Davies, Forbes McGain, Hayden Burch, Alexandra L Barratt, Luise Kazda\",\"doi\":\"10.5694/mja2.70046\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To assess changes in greenhouse gas emission rates associated with the use of anaesthetic gases (desflurane, sevoflurane, and isoflurane) in Australian health care during 2002-2022, overall and by state or territory and hospital type.</p><p><strong>Study design: </strong>Retrospective descriptive analysis of IQVIA anaesthetic gases purchasing data.</p><p><strong>Setting: </strong>All Australian public and private hospitals, 1 January 2002 - 31 December 2022.</p><p><strong>Main outcome measures: </strong>Absolute carbon dioxide equivalent (CO<sub>2</sub>e) emissions and CO<sub>2</sub>e emissions rate per 100 000 population by gas and year, overall and by state/territory and hospital type (public or private).</p><p><strong>Results: </strong>The overall emissions rate increased from 74 t CO<sub>2</sub>e per 100 000 population in 2002 to 328 t CO<sub>2</sub>e per 100 000 population in 2012, most rapidly during 2002-2004 (annual percentage change [APC], 51%; 95% confidence interval [CI], 38-62%). The rate then declined to 83 t CO<sub>2</sub>e per 100 000 population in 2022, most rapidly during 2017-2022 (APC, -21%; 95% CI, -23% to -20%). Patterns of emissions rate change were similar for all states and territories. More units of sevoflurane than of desflurane or isoflurane were purchased each year throughout 2002-2022, but desflurane provided the largest proportion of total emissions from anaesthetic gases during 2002-2022: 33% in 2002, 88% in 2013, and 68% in 2022. Mean emission rates per 100 000 population during 2002-2022 were highest for South Australia/Northern Territory (276 t CO<sub>2</sub>e per year) and lowest for Victoria/Tasmania (196 t CO<sub>2</sub>e per year). The desflurane emissions rate was consistently higher for private than public hospitals; it declined for public hospitals during 2009-2018 (APC, -8%; 95% CI, -10% to -5%) and 2018-2022 (APC, -43%; 95% CI, -48% to -37%), but for private hospitals only during 2017-2022 (APC, -20%; 95% CI, -24% to -17%).</p><p><strong>Conclusions: </strong>In Australia, the CO<sub>2</sub>e emissions rate for anaesthetic gases increased during 2002-2008 but declined during 2017-2022, at first primarily in public hospitals. Continuing to reduce the use of anaesthetic gases, particularly desflurane, will advance the decarbonisation of clinical practice in Australian health care.</p>\",\"PeriodicalId\":18214,\"journal\":{\"name\":\"Medical Journal of Australia\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":8.5000,\"publicationDate\":\"2025-09-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medical Journal of Australia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5694/mja2.70046\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Journal of Australia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5694/mja2.70046","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Greenhouse gas emissions associated with anaesthetic gases in Australia, 2002-2022: a retrospective descriptive analysis.
Objectives: To assess changes in greenhouse gas emission rates associated with the use of anaesthetic gases (desflurane, sevoflurane, and isoflurane) in Australian health care during 2002-2022, overall and by state or territory and hospital type.
Study design: Retrospective descriptive analysis of IQVIA anaesthetic gases purchasing data.
Setting: All Australian public and private hospitals, 1 January 2002 - 31 December 2022.
Main outcome measures: Absolute carbon dioxide equivalent (CO2e) emissions and CO2e emissions rate per 100 000 population by gas and year, overall and by state/territory and hospital type (public or private).
Results: The overall emissions rate increased from 74 t CO2e per 100 000 population in 2002 to 328 t CO2e per 100 000 population in 2012, most rapidly during 2002-2004 (annual percentage change [APC], 51%; 95% confidence interval [CI], 38-62%). The rate then declined to 83 t CO2e per 100 000 population in 2022, most rapidly during 2017-2022 (APC, -21%; 95% CI, -23% to -20%). Patterns of emissions rate change were similar for all states and territories. More units of sevoflurane than of desflurane or isoflurane were purchased each year throughout 2002-2022, but desflurane provided the largest proportion of total emissions from anaesthetic gases during 2002-2022: 33% in 2002, 88% in 2013, and 68% in 2022. Mean emission rates per 100 000 population during 2002-2022 were highest for South Australia/Northern Territory (276 t CO2e per year) and lowest for Victoria/Tasmania (196 t CO2e per year). The desflurane emissions rate was consistently higher for private than public hospitals; it declined for public hospitals during 2009-2018 (APC, -8%; 95% CI, -10% to -5%) and 2018-2022 (APC, -43%; 95% CI, -48% to -37%), but for private hospitals only during 2017-2022 (APC, -20%; 95% CI, -24% to -17%).
Conclusions: In Australia, the CO2e emissions rate for anaesthetic gases increased during 2002-2008 but declined during 2017-2022, at first primarily in public hospitals. Continuing to reduce the use of anaesthetic gases, particularly desflurane, will advance the decarbonisation of clinical practice in Australian health care.
期刊介绍：
The Medical Journal of Australia (MJA) stands as Australia's foremost general medical journal, leading the dissemination of high-quality research and commentary to shape health policy and influence medical practices within the country. Under the leadership of Professor Virginia Barbour, the expert editorial team at MJA is dedicated to providing authors with a constructive and collaborative peer-review and publication process. Established in 1914, the MJA has evolved into a modern journal that upholds its founding values, maintaining a commitment to supporting the medical profession by delivering high-quality and pertinent information essential to medical practice.
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