Browsing by Author "Pohl, Heiko"
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- Environmental impact of single-use versus reusable gastroscopesPublication . Pioche, Mathieu; Pohl, Heiko; Neves, João A. Cunha; Laporte, Arthur; Mochet, Mikael; Rivory, Jérôme; Grau, Raphaelle; Jacques, Jérémie; Grinberg, Daniel; Boube, Mathilde; Baddeley, Robin; Cottinet, Pierre-Jean; Schaefer, Marion; Rodríguez de Santiago, Enrique; Berger, ArthurIntroduction The environmental impact of endoscopy is a topic of growing interest. This study aimed to compare the carbon footprint of performing an esogastroduodenoscopy (EGD) with a reusable (RU) or with a single-use (SU) disposable gastroscope.Methods SU (Ambu aScope Gastro) and RU gastroscopes (Olympus, H190) were evaluated using life cycle assessment methodology (ISO 14040) including the manufacture, distribution, usage, reprocessing and disposal of the endoscope. Data were obtained from Edouard Herriot Hospital (Lyon, France) from April 2023 to February 2024. Primary outcome was the carbon footprint (measured in Kg CO2 equivalent) for both gastroscopes per examination. Secondary outcomes included other environmental impacts. A sensitivity analysis was performed to examine the impact of varying scenarios.Results Carbon footprint of SU and RU gastroscopes were 10.9 kg CO2 eq and 4.7 kg CO2 eq, respectively. The difference in carbon footprint equals one conventional car drive of 28 km or 6 days of CO2 emission of an average European household. Based on environmentally-extended input-output life cycle assessment, the estimated per-use carbon footprint of the endoscope stack and washer was 0.18 kg CO2 eq in SU strategy versus 0.56 kg CO2 eq in RU strategy. According to secondary outcomes, fossil eq depletion was 130 MJ (SU) and 60.9 MJ (RU) and water depletion for 6.2 m3 (SU) and 9.5 m3 (RU), respectively.Conclusion For one examination, SU gastroscope have a 2.5 times higher carbon footprint than RU ones. These data will help with the logistics and planning of an endoscopic service in relation to other economic and environmental factors.
- The environmental impact of small-bowel capsule endoscopyPublication . Pioche, Mathieu; Neves, João A. Cunha; Pohl, Heiko; Lê, Minh-Quyen; Grau, Raphaelle; Dray, Xavier; Yzet, Clara; Mochet, Mikael; Jacques, Jérémie; Wallenhorst, Timothée; Rivory, Jérôme; Siret, Nadège; Peillet, Anne-Laure; Chevaux, Jean-Baptiste; Mion, François; Chaput, Ulriikka; Jacob, Philippe; Grinberg, Daniel; Saurin, Jean-Christophe; Baddeley, Robin; Rodriguez de Santiago, Enrique; Cottinet, Pierre-JeanIntroduction The environmental impact of endoscopy, including small-bowel capsule endoscopy (SBCE), is a topic of growing attention and concern. This study aimed to evaluate the greenhouse gas (GHG) emissions (kgCO(2)) generated by an SBCE procedure. Methods Life cycle assessment methodology (ISO 14040) was used to evaluate three brands of SBCE device and included emissions generated by patient travel, bowel preparation, capsule examination, and video recording. A survey of 87 physicians and 120 patients was conducted to obtain data on travel, activities undertaken during the procedure, and awareness of environmental impacts. Results The capsule itself (4 g) accounted for < 6 % of the total product weight. Packaging (43-119 g) accounted for 9 %-97 % of total weight, and included deactivation magnets (5 g [4 %-6 %]) and paper instructions (11-50 g [up to 40 %]). A full SBCE procedure generated approximately 20 kgCO(2), with 0.04 kgCO(2) (0.2 %) attributable to the capsule itself and 18 kgCO(2) (94.7 %) generated by patient travel. Capsule retrieval using a dedicated device would add 0.98 kgCO(2) to the carbon footprint. Capsule deconstruction revealed materials (e. g. neodymium) that are prohibited from environmental disposal; 76 % of patients were not aware of the illegal nature of capsule disposal via wastewater, and 63 % would have been willing to retrieve it. The carbon impact of data storage and capsule reading was negligible. Conclusion The carbon footprint of SBCE is mainly determined by patient travel. The capsule device itself has a relatively low carbon footprint. Given that disposal of capsule components via wastewater is illegal, retrieval of the capsule is necessary but would likely be associated with an increase in device-related emissions.
- Perspectives and awareness of endoscopy healthcare professionals on sustainable practices in gastrointestinal endoscopy: results of the LEAFGREEN surveyPublication . Neves, João A. Cunha; Santiago, Enrique Rodriguez de; Pohl, Heiko; Lorenzo-Zúñiga, Vicente; Cunha, Miguel F.; Voiosu, Andrei M.; Römmele, Christoph; Penman, Douglas G.; Albéniz, Eduardo; Siau, Keith; Donnelly, Leigh; Elli, Luca; Pioche, Mathieu; Beilenhoff, Ulrike; Arvanitakis, Marianna; Weusten, Bas L.A.M.; Bisschops, Raf.; Hassan, Cesare; Messmann, Helmut; Gralnek, Ian M.; Ribeiro, Mário DinisBackground Gastrointestinal (GI) endoscopy is one of healthcare's main contributors to climate change. We aimed to assess healthcare professionals' attitudes and the perceived barriers to implementation of sustainable GI endoscopy. Methods The LEAFGREEN web-based survey was a cross-sectional study conducted by the European Society of Gastrointestinal Endoscopy (ESGE) Green Endoscopy Working Group. The questionnaire comprised 39 questions divided into five sections (respondent demographics; climate change and sustainability beliefs; waste and resource management; single-use endoscopes and accessories; education and research). The survey was available via email to all active members of the ESGE and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) in March 2023. Results 407 respondents participated in the survey (11% response rate). Most participants (86%) agreed climate change is real and anthropogenic, but one-third did not consider GI endoscopy to be a significant contributor to climate change. Improvement in the appropriateness of endoscopic procedures (41%) and reduction in single-use accessories (34%) were considered the most important strategies to reduce the environmental impact of GI endoscopy. Respondents deemed lack of institutional support and knowledge from staff to be the main barriers to sustainable endoscopy. Strategies to reduce unnecessary GI endoscopic procedures and comparative studies of single-use versus reusable accessories were identified as research priorities. Conclusions In this survey, ESGE and ESGENA members acknowledge climate change as a major threat to humanity. Further improvement in sustainability beliefs and professional attitudes, reduction in inappropriate GI endoscopy, and rational use of single-use accessories and endoscopes are critically required.