Esophagus to Small Intestine

Gut. 2024;73(3):442–7

Henniger D, Lux T, Windsheimer M, Brand M, Weich A, Kudlich T, Schöttker K, Hann A, Meining A

Reducing scope 3 carbon emissions in gastrointestinal endoscopy: Results of the prospective study of the ‘Green Endoscopy Project Würzburg’

Objective: Carbon emissions generated by gastrointestinal endoscopy have been recognized as a critical issue. Scope 3 emissions are mainly caused by the manufacturing, packaging and transportation of purchased goods. However, to the authors’ knowledge, there are no prospective data on the efficacy of measurements aimed to reduce scope 3 emissions.
Design: The study was performed in a medium-sized academic endoscopy unit. Manufacturers of endoscopic consumables were requested to answer a questionnaire on fabrication, origin, packaging and transport. Based on these data, alternative products were purchased whenever possible. In addition, staff was instructed on how to avoid waste. Thereafter, the carbon footprint of each item purchased was calculated from February to May 2023 (intervention period), and scope 3 emissions were compared with the same period of the previous year (control period).
Results: 26 of 40 companies answered the questionnaire. 229 of 322 products were classified as unfavorable. A switch to alternative items was possible for 47 of 229 items (20.5%). 1666 endoscopies were performed during the intervention period compared with 1751 examinations during the control period (-4.1%). The number of instruments used decreased by 10.0% (3111 vs. 3457). Using fewer and alternative products resulted in 11.5% less carbon emissions (7.09 vs. 8.01 tons of carbon equivalent = tCO2e). Separation of waste led to a reduction of 20.1% (26.55 vs. 33.24 tCO2e). In total, carbon emissions could be reduced by 18.4%.

Conclusion: Use of fewer instruments per procedure, recycling packaging material and switching to alternative products can reduce carbon emissions without impairing the endoscopic workflow.

Prof. Dr. A. Meining, Gastroenterologie, Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany, E-Mail:

DOI: 10.1136/gutjnl-2023-331024

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