Gastroenterology and Climate Change — How Can We Do Our Part?
A joint strategic plan developed by the AGA, ACG, ASGE, and AASLD draws important attention to the significant interplay across climate change, healthcare, and digestive health, and the responsibility of the gastroenterology community to help mitigate climate change and its effects.1 Unfortunately, the effects of climate change are neither equitable nor wholly predictable and disproportionately affect disadvantaged populations.2
While healthcare contributes significantly to climate change, the practice of gastroenterology represents an especially prominent contributor. In particular, gastrointestinal endoscopy represents the third-highest generator of waste within healthcare,3 with over 22 million endoscopic procedures performed annually in the US.4 Endoscopy generates waste in multifaceted ways, which include personal protective equipment and single-use consumables, equipment and device reprocessing, medical waste disposal, and operational resource utilization (energy, water, cleaning), among others.5,6
This multi-society climate change plan eloquently presents strategic goals and objectives for our professional societies to help mitigate climate change and decrease the environmental impacts of gastroenterology across clinical care, education, research, industry, advocacy, and collaboration. While our societies may lead these efforts, early-career and trainee gastroenterologists will disproportionately and more profoundly experience the deleterious effects of climate change across their careers and lifetimes.
What are examples of some actions that young (and all) gastroenterology providers may consider “at work” to help mitigate climate change and decrease carbon footprints on an individual level?5-9
- Optimize telehealth instead of in-person clinic visits when appropriate.
- Minimize unnecessary endoscopic procedures based on guidelines and evidence.
- Consider noninvasive evaluation and/or screening modalities when reasonable.
- Perform single-session bidirectional endoscopy with the same endoscope if possible.
- Minimize the numbers of different endoscopic accessories and specimen containers used.
- Consider electronic (paperless) consents, documentation, reports, and pathology letters.
- Segregate waste appropriately and recycle whenever possible; educate others.
- Advocate for sustainable endoscopy practices to leadership and administration.
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Additional Info
- Pohl H, de Latour R, Reuben A, et al. GI Multisociety Strategic Plan on Environmental Sustainability. Am J Gastroenterol. 2022 Oct 18. doi: 10.1002/hep.32810. Online ahead of print.
- Leddin D, Omary MB, Veitch A, et al. Uniting the Global Gastroenterology Community to Meet the Challenge of Climate Change and Non-Recyclable Waste. Gastroenterology. 2021;161(5):1354-1360.
- Vaccari M, Tudor T, Perteghella A. Costs associated with the management of waste from healthcare facilities: An analysis at national and site level. Waste Manag Res. 2018;36(1):39-47.
- Peery AF, Crockett SD, Murphy CC, et al. Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2021. Gastroenterology. 2022;162(2):621-644.
- Rodríguez de Santiago E, Dinis-Ribeiro M, Pohl H, et al. Reducing the environmental footprint of gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement. Endoscopy 2022;54(8):797-826.
- Siau K, Hayee B, Gayam S. Endoscopy’s Current Carbon Footprint. Techniques and Innovations in Gastrointestinal Endoscopy. 2021;23(4):344-352.
- Haddock R, Gopfert A, van Hove M, et al. The Case for Sustainable Endoscopy as a Professional Priority. Techniques and Innovations in Gastrointestinal Endoscopy. 2021;23(4):337-343.
- Baddeley R, Aabakken L, Veitch A, et al. Green Endoscopy: Counting the Carbon Cost of Our Practice. Gastroenterology. 2022;162(6):1556-1560.
- Williams JA, Kao JY, Omary MB. How Can Individuals and the GI Community Reduce Climate Change? Gastroenterology. 2020;158(1):14-17.
Disclosure statements are available on the authors' profiles: