Operating in a climate crisis: a state-of-the-science review of life cycle assessment within surgical and anesthetic care
Open accessAbstract
BACKGROUND: Both human health and the health systems we depend on are increasingly threatened by a range of environmental crises, including climate change. Paradoxically, health care provision is a significant driver of environmental pollution, with surgical and anesthetic services among the most resource-intensive components of the health system. OBJECTIVES: This analysis aimed to summarize the state of life cycle assessment (LCA) practice as applied to surgical and anesthetic care via review of extant literature assessing environmental impacts of related services, procedures, equipment, and pharmaceuticals. METHODS: A state-of-the-science review was undertaken following a registered protocol and a standardized, LCA-specific reporting framework. Three bibliographic databases (Scopus®, PubMed, and Embase®) and the gray literature were searched. Inclusion criteria were applied, eligible entries critically appraised, and key methodological data and results extracted. RESULTS: ). DISCUSSION: Despite the recent proliferation of surgical and anesthesiology-related LCAs, extant studies address a miniscule fraction of the numerous services, procedures, and products available today. Methodological heterogeneity, external validity, and a lack of background life cycle inventory data related to many essential surgical and anesthetic inputs are key limitations of the current evidence base. This review provides an indication of the spectrum of environmental impacts associated with surgical and anesthetic care at various scales. https://doi.org/10.1289/EHP8666.
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- Authors
- Drew, J., Christie, S. D., Tyedmers, P., Smith-Forrester, J., & Rainham, D.
- Affiliations
- Dalhousie University (CA)
- Department of Surgery (Division of Neurosurgery), Dalhousie University, Halifax, Nova Scotia, Canada
- Corresponding author
- Drew, Jonathan
- Venue
- Environmental Health Perspectives
- Publisher
- American Chemical Society (ACS)
- Published
- 2021-07
- Volume
- 129
- Issue
- 7
- Pages
- 76001-76001
- ISSN
- 0091-6765 (ISSN-L)
- 1552-9924
- PMC
- PMC8274692
- OpenAlex
- W3182909466
- Cited by
- 191
- References
- 79
- Citations by year
- 2026: 37 · 2025: 47 · 2024: 39 · 2023: 34 · 2022: 28 · 2021: 6
- FWCI
- 2.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- public-domain
- Locations
- Environmental Health Perspectives (publishedVersion, public-domain)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Environmental Science › Environmental Engineering › Environmental Impact and Sustainability
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Surgery
- Physical Sciences › Environmental Science › Ecology › Agriculture Sustainability and Environmental Impact
- Keywords
- life cycle assessment, surgical care, anesthesia care, climate change, anesthesia equipment, life cycle inventory data, methodological heterogeneity, health system sustainability
- MeSH terms
- Anesthetics, Animals, Environment, Environmental Pollution, Heating, Humans, Life Cycle Stages
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