ESGE and ESGENA Issue Position Statement on the Environmental Footprint of Endoscopy

Endoscopists interested in reducing their carbon and plastic footprints will find this set of recommendations from the European Society of Gastrointestinal Endoscopy and the European Society of Gastroenterology and Endoscopy Nurses and Associates informative. 

Among the interesting cited facts:

• GI endoscopy ranks second behind radiology in hospital unit generation of hazardous waste.
• Per-procedure carbon dioxide consumption is 20 times greater with single-use versus reusable duodenoscopes.
• One gram of medication has a carbon footprint ranging from 10 to 1000 grams, compared to 1 gram of oil, which has a carbon footprint of 3 grams. 
• Currently registered randomized controlled medical trials generate emissions nearly equal to the total annual carbon footprint of Switzerland, and much of the trial emissions are travel-related.
• Facility heating and cooling accounts for 40% of GI endoscopy carbon emissions.

Some of the more interesting of the 39 recommendations include:

• The most effective step to reduce GI endoscopy-related emissions is to limit unnecessary procedures. 
• Endoscopy units should embed “reduce, reuse, and recycle” programs.
• Endoscopy units should establish local protocols and environmental education programs.
• Routine use of single-use endoscopes is not recommended, except for highly selected patients.
• Virtual training and online education have lower environmental impacts than in-person education. 
• GI endoscopy companies should assess, disclose, and audit the environmental impact of their value chains. 
• GI endoscopy should become a net-zero greenhouse gas emissions practice by 2050.