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Maestri F, Ferrero A, Rothschild PR, Eymard P, Brézin AP, Monnet D. The carbon footprint and wastage of intravitreal injections. J Fr Ophtalmol 2024; 47:104079. [PMID: 38377875 DOI: 10.1016/j.jfo.2024.104079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/23/2023] [Accepted: 08/31/2023] [Indexed: 02/22/2024]
Abstract
PURPOSE The healthcare system emits greenhouse gas emissions and produces waste that in turn threatens the health of populations. The objective of our study was to measure the ecological threat related to intravitreal injections. METHODS Emissions were separated into scope 2 corresponding to Heating, Ventilation and Air Conditioning (HVAC) of the building, and scope 3 corresponding to travels (patients and staff), and life cycle assessment (LCA) of medical devices (MD) and pharmaceutics. Greenhouse gas (GHG) emissions and waste for a single injection were first measured through a waste audit, and secondly anticipated theoretically with a calculator. RESULTS The average GHG emissions and waste measured were 277kgCO2eq/IVI and 0.5kg/IVI, respectively. Pharmaceuticals were responsible for 97% of total emissions. Emissions unrelated to pharmaceuticals counted for 8.4kgCO2eq/IVI. GHG emissions and waste estimated with the calculator were 276kgCO2eq/IVI and 0.5kg/IVI, respectively, showing that the calculator was accurate. CONCLUSION Our study provides a puzzle piece to carbon footprint and waste assessment in the field of ophthalmology. It may help provide concrete data for future green vs. vision discussions.
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Affiliation(s)
- F Maestri
- Service d'ophtalmologie, hôpital Cochin, Paris, France.
| | - A Ferrero
- Service d'ophtalmologie, hôpital Cochin, Paris, France
| | | | - P Eymard
- Service d'ophtalmologie, hôpital Cochin, Paris, France
| | - A P Brézin
- Service d'ophtalmologie, hôpital Cochin, Paris, France
| | - D Monnet
- Service d'ophtalmologie, hôpital Cochin, Paris, France
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Piffoux M, Delpon G, Ducrot C, Alexis A, Allignet B, Dupraz C, Egnell M, Kernec M, Milewski C, Rivera S, Vitré J, Ali D, Supiot S. Insights on the carbon footprint of radiotherapy in France. Cancer Radiother 2023; 27:487-490. [PMID: 37558609 DOI: 10.1016/j.canrad.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/20/2023] [Accepted: 07/20/2023] [Indexed: 08/11/2023]
Abstract
The French healthcare system is responsible for 8% of the national footprint. Achieving a net zero emissions scenario will require a 4-5 fold decrease of carbon emissions in the coming years. The carbon footprint of radiation therapy has not been specifically studied to date. In this review we summarize the content of the carbon footprint dedicated session at the annual meeting of the French society of radiation oncology (SFRO). We discuss the French healthcare system carbon footprint and its major drivers and our work on the estimation of the carbon footprint of external beam radiation therapy in the French setting. We developed a dedicated methodology to estimate the carbon footprint related to radiation therapies, and describe the main drivers of emissions based on a single centre as an example, namely patient's rides, accelerators acquisition and maintenance and data storage. Based on the carbon footprint calculated in our centres, we propose mitigation strategies and an estimation of their respective potential. Our results may be extrapolated to other occidental settings by adapting emission factors (kilograms of carbon per item or euro) to other national settings. External beam radiation therapy has a major carbon footprint that may be mitigated in many ways that may impact how radiation therapy treatments are delivered, as well as the national organization of the radiotherapy sector. This needs to be taken into account when thinking about the future of radiotherapy.
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Affiliation(s)
- M Piffoux
- Département d'oncologie médicale, hospices civils de Lyon, Citohl, Lyon, France; Direction de la recherche clinique et de l'innovation, centre Léon-Bérard, Lyon, France.
| | - G Delpon
- Département de physique médicale, Institut de cancérologie de l'Ouest centre René-Gauducheau, Saint-Herblain, France; Laboratoire Subatech, UMR 6457 CNRS-IN2P3, IMT Atlantique, Nantes, France
| | - C Ducrot
- Département de chirurgie orthopédique, hôpital Femme-Mère-Enfant, hospices civils de Lyon, Bron, France; Laboratoire mort cellulaire et cancers de l'enfant, U1052, Inserm, U5286, CNRS, centre de recherche en cancérologie de Lyon, Lyon, France
| | - A Alexis
- Département de physique médicale, Institut de cancérologie de l'Ouest centre René-Gauducheau, Saint-Herblain, France
| | - B Allignet
- Département de radiothérapie, centre Léon-Bérard, Lyon, France; Insa-Lyon, université Claude-Bernard Lyon-1, laboratoire Creatis UMR 5220, U1294, Lyon, France; Université Jean-Monnet, Saint-Étienne, France
| | - C Dupraz
- Direction de la recherche clinique et de l'innovation, centre Léon-Bérard, Lyon, France
| | - M Egnell
- The Shift Project, Paris, France
| | - M Kernec
- The Shift Project, Paris, France
| | - C Milewski
- Institut Gustave-Roussy, Villejuif, France
| | - S Rivera
- Institut Gustave-Roussy, Villejuif, France
| | - J Vitré
- Institut Gustave-Roussy, Villejuif, France
| | - D Ali
- Centre de radiothérapie de Versailles, Versailles, France
| | - S Supiot
- Département de radiothérapie, Institut de cancérologie de l'Ouest centre René-Gauducheau, Saint-Herblain, France; Laboratoire US2B, CNRS UMR 6286, université de Nantes, Nantes, France
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Leraut J, Boissinot L, Hassani Y, Bonnet-Zamponi D, Le Gonidec P. [Reducing the environmental impact of inhalers dispensed in France. From diagnosis to sustainable action]. Ann Pharm Fr 2023; 81:123-137. [PMID: 35944697 DOI: 10.1016/j.pharma.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/04/2022] [Accepted: 08/01/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES While inhaled drugs are mainly used to treat chronic respiratory diseases, they are also responsible for greenhouse gas (GHG) emission. To highlight this issue, a dispensed analysis and a carbon footprint evaluation of inhalers in France have been conducted. METHODS A national qualitative and quantitative analysis of dispensed inhalers in community pharmacies (CP) and hospitals (H) was conducted in France for 2019. A data review from the literature led to the determination of the inhalers carbon footprint, expressed in carbon dioxide equivalent (CO2e) during the inhaler life cycle. RESULTS Close to 40 million inhalers were dispensed by community pharmacies and one million by hospitals in 2019. It concerned three types of inhalers: metered-dose inhalers (MDI) [CP: 49%; H: 45%], dry powder inhalers (DPI) [CP: 47%; H: 51%], and soft mist inhalers (SMI) [CP: 4%; H: 4%]. According to the literature, MDI have the highest carbon footprint, ranging from 11 to 28 kgCO2e versus less than 1 kgCO2e for DPI/SMI. In 2019, the national carbon footprint of salbutamol (MDI), the most dispensed inhaler, was estimated to be over 310 million kgCO2e (CP+H) corresponding to more than 310,000 round-trip Paris-New York. CONCLUSIONS This study shows the involvement of MDI in GHG emissions. Taking actions as part of a global and coordinated approach to limit their environmental impact is possible and thus is a priority.
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Affiliation(s)
- J Leraut
- OMEDIT Île-De-France, 3, avenue Victoria, 75001 Paris, France.
| | - L Boissinot
- OMEDIT Île-De-France, 3, avenue Victoria, 75001 Paris, France
| | - Y Hassani
- OMEDIT Île-De-France, 3, avenue Victoria, 75001 Paris, France
| | | | - P Le Gonidec
- OMEDIT Île-De-France, 3, avenue Victoria, 75001 Paris, France
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Filfilan A, Anract J, Chartier-Kastler E, Parra J, Vaessen C, de La Taille A, Roupret M, Pinar U. Positive environmental impact of remote teleconsultation in urology during the COVID-19 pandemic in a highly populated area. Prog Urol 2021; 31:1133-1138. [PMID: 34454847 PMCID: PMC8387203 DOI: 10.1016/j.purol.2021.08.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/24/2021] [Accepted: 08/07/2021] [Indexed: 11/19/2022]
Abstract
Introduction Greenhouse gas (GHG) emissions are a serious environmental issue. The healthcare sector is an important emitter of GHGs. Our aim was to assess the environmental cost of teleconsultations in urology compared to face-to-face consultations. Materials and methods Prospective study of all patients who had a remote teleconsultation over a 2-week period during COVID-19 pandemic. Main outcome was the reduction in CO2e emissions related to teleconsultation compared to face-to-face consultation and was calculated as: total teleconsultation CO2e emissions–total face-to-face consultation CO2e emissions. Secondary outcome measures were the reduction in travel distance and travel time related to teleconsultation. Results Eighty patients were included. Face-to-face consultations would have resulted in 6699 km (4162 miles) of travel (83.7 km (52 miles) per patient). Cars were the usual means of transport. CO2e avoided due to lack of travel was calculated at 1.1 tonnes. Teleconsultation was responsible for 1.1 kg CO2e while face-to-face consultation emitted 0.5 kg of CO2e. Overall, the total reduction in GHGs with teleconsultation was 1141 kg CO2e, representing a 99% decrease in emissions. Total savings on transport were 974 € and savings on travel time were 112 h (1.4 h/patient). Conclusions Teleconsultation reduces the environmental impact of face-to-face consultations. The use of teleconsultation in our urology departments resulted in the avoidance of more than 6000 km of travel, equivalent to a reduction of 1.1 tonnes of CO2e. Teleconsultation should be considered for specific indications as the healthcare system attempts to become greener. Level of evidence 3.
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Affiliation(s)
- A Filfilan
- Sorbonne University, GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitie-Salpetriere Hospital, 75013 Paris, France
| | - J Anract
- Sorbonne University, GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitie-Salpetriere Hospital, 75013 Paris, France
| | - E Chartier-Kastler
- Sorbonne University, GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitie-Salpetriere Hospital, 75013 Paris, France
| | - J Parra
- Sorbonne University, GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitie-Salpetriere Hospital, 75013 Paris, France
| | - C Vaessen
- Sorbonne University, GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitie-Salpetriere Hospital, 75013 Paris, France
| | - A de La Taille
- Henri Mondor hôpital, urology, hôpitaux universitaires Henri Mondor, AP-HP, 94010 Créteil, France
| | - M Roupret
- Sorbonne University, GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitie-Salpetriere Hospital, 75013 Paris, France.
| | - U Pinar
- Sorbonne University, GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitie-Salpetriere Hospital, 75013 Paris, France
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Guillon S, Nguyen Ba E, Oufkir N, Hequet D, Rouzier R. [Carbon footprint and cancer: Time for green oncology?]. Bull Cancer 2020; 107:612-613. [PMID: 32245606 DOI: 10.1016/j.bulcan.2020.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 02/13/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Sarah Guillon
- Institut Curie, 35 rue Dailly, 92210 Saint-Cloud, France
| | | | - Nina Oufkir
- Institut Curie, 35 rue Dailly, 92210 Saint-Cloud, France; UFR des Sciences de la santé Simone Veil (Université de Versailles SQY), Université Paris Saclay, Versailles France
| | - Delphine Hequet
- Institut Curie, 35 rue Dailly, 92210 Saint-Cloud, France; UFR des Sciences de la santé Simone Veil (Université de Versailles SQY), Université Paris Saclay, Versailles France
| | - Roman Rouzier
- Institut Curie, 35 rue Dailly, 92210 Saint-Cloud, France; UFR des Sciences de la santé Simone Veil (Université de Versailles SQY), Université Paris Saclay, Versailles France.
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