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Ribeiro T, Morais R, Monteiro C, Carvalho A, Barros S, Fernando A, Pioche M, de Santiago ER, Macedo G. Estimating the environmental impact of endoscopic activity at a tertiary center: a pilot study. Eur J Gastroenterol Hepatol 2024; 36:39-44. [PMID: 37942729 DOI: 10.1097/meg.0000000000002667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
INTRODUCTION The growing number of endoscopic procedures, frequently requiring single-use disposable instruments, is responsible for the production of a large amount of waste. To this date, the reality of waste production at large European Gastroenterology centers is unknown. This study aimed to estimate the amount of waste due to endoscopic practice at a tertiary center in Portugal. METHODS We performed a prospective study to calculate the mass (in kg) of residues generated during a period of 5 working days of endoscopic practice. We included residues produced at endoscopy suites, pre and postprocedure areas and during endoscope reprocessing. Residues were categorized as non-dangerous (groups I/II), of biologic risk (group III) and specific hazardous hospital residues (group IV). The production of residues separated for recycling/valorization (paper/card and plastic) was also quantified. The volume of water used for reprocessing an endoscope was also assessed. RESULTS During the analyzed period, 241 endoscopic procedures were performed. A total of 443.2 kg of waste (22.6 kg from groups I/II, 266.9 kg from group III and 3.9 kg from group IV) were produced, most from group III (75%). For each endoscopic procedure, 1.8 kg of waste was generated. Of the total waste mass, 17.8% was separated for recycling/valorization. A volume of 55L of water was required for reprocessing one endoscope. CONCLUSION Each endoscopic procedure generated a significant amount of waste and water consumption during reprocessing. These real-life analyses are a pivotal step before implementing effective measures to improve resource utilization and more sustainable practices.
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Affiliation(s)
- Tiago Ribeiro
- Department of Gastroenterology, Centro Hospitalar Universitário de São João
- WGO Gastroenterology and Hepatology Training Center
| | - Rui Morais
- Department of Gastroenterology, Centro Hospitalar Universitário de São João
- WGO Gastroenterology and Hepatology Training Center
- Faculty of Medicine of the University of Porto
| | - Cristiana Monteiro
- Department of Gastroenterology, Centro Hospitalar Universitário de São João
- WGO Gastroenterology and Hepatology Training Center
| | - Ana Carvalho
- Department of Gastroenterology, Centro Hospitalar Universitário de São João
- WGO Gastroenterology and Hepatology Training Center
| | - Sónia Barros
- Department of Gastroenterology, Centro Hospitalar Universitário de São João
- WGO Gastroenterology and Hepatology Training Center
| | - André Fernando
- Department of Facilities Operations, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Mathieu Pioche
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Lyon, France
| | - Enrique Rodríguez de Santiago
- Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
| | - Guilherme Macedo
- Department of Gastroenterology, Centro Hospitalar Universitário de São João
- WGO Gastroenterology and Hepatology Training Center
- Faculty of Medicine of the University of Porto
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Ang TL. Asian Pacific perspectives on the practice of green endoscopy. J Gastroenterol Hepatol 2024; 39:5-6. [PMID: 37940201 DOI: 10.1111/jgh.16405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/10/2023]
Affiliation(s)
- Tiing Leong Ang
- Department of Gastroenterology and Hepatology, Changi General Hospital, SingHealth, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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Mulki R, Qayed E, Yang D, Chua TY, Singh A, Yu JX, Bartel MJ, Tadros MS, Villa EC, Lightdale JR. The 2022 top 10 list of endoscopy topics in medical publishing: an annual review by the American Society for Gastrointestinal Endoscopy Editorial Board. Gastrointest Endosc 2023; 98:1009-1016. [PMID: 37977661 DOI: 10.1016/j.gie.2023.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/09/2023] [Accepted: 08/29/2023] [Indexed: 11/19/2023]
Abstract
Using a systematic literature search of original articles published during 2022 in Gastrointestinal Endoscopy and other high-impact medical and gastroenterology journals, the 10-member Editorial Board of the American Society for Gastrointestinal Endoscopy composed a list of the 10 most significant topic areas in GI endoscopy during the study year. Each Editorial Board member was directed to consider 3 criteria in generating candidate lists-significance, novelty, and global impact on clinical practice-and subject matter consensus was facilitated by the Chair through electronic voting. The 10 identified areas collectively represent advances in the following endoscopic spheres: artificial intelligence, endoscopic submucosal dissection, Barrett's esophagus, interventional EUS, endoscopic resection techniques, pancreaticobiliary endoscopy, management of acute pancreatitis, endoscopic environmental sustainability, the NordICC trial, and spiral enteroscopy. Each board member was assigned a consensus topic area around which to summarize relevant important articles, thereby generating this précis of the "top 10" endoscopic advances of 2022.
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Affiliation(s)
- Ramzi Mulki
- Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Emad Qayed
- Division of Digestive Diseases, Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Dennis Yang
- Center of Interventional Endoscopy (CIE) Advent Health, Orlando, Florida, USA
| | - Tiffany Y Chua
- Division of Digestive Diseases, Harbor-University of California Los Angeles, Torrance, California, USA
| | - Ajaypal Singh
- Division of Digestive Diseases and Nutrition, Rush University Medical Center, Chicago, Illinois, USA
| | - Jessica X Yu
- Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, Oregon, USA
| | | | | | - Edward C Villa
- NorthShore University Health System, Chicago, Illinois, USA
| | - Jenifer R Lightdale
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA
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Walldorf J, Mezger NCS, Weber L, Knothe A, Klose M, Moritz S, Kantelhardt EJ, Feller S, Schlitt A, Greinert R, Michl P. [Climate Crisis: What Gastrointestinal Complications of this Medical Emergency Should We Be Aware Of?]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2023; 61:1608-1617. [PMID: 37044125 DOI: 10.1055/a-2058-8883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
INTRODUCTION The climate crisis has serious consequences for many areas of life. This applies in particular to human health - also in Europe. While cardiovascular, pneumological and dermatological diseases related to the climate crisis are often discussed, the crisis' significant gastroenterological consequences for health must also be considered. METHODS A literature search (Pubmed, Cochrane Library) was used to identify papers with relevance particularly to the field of gastroenterology in (Central) Europe. Findings were supplemented and discussed by an interdisciplinary team. RESULTS The climate crisis impacts the frequency and severity of gastrointestinal diseases in Europe due to more frequent and severe heat waves, flooding and air pollution. While patients with intestinal diseases are particularly vulnerable to acute weather events, the main long-term consequences of climate change are gastrointestinal cancer and liver disease. In addition to gastroenteritis, other infectious diseases such as vector-borne diseases and parasites are important in the context of global warming, heat waves and floods. DISCUSSION Adaptation strategies must be consistently developed and implemented for vulnerable groups. Patients at risk should be informed about measures that can be implemented individually, such as avoiding heat, ensuring appropriate hydration and following hygiene instructions. Recommendations for physical activity and a healthy and sustainable diet are essential for the prevention of liver diseases and carcinomas. Measures for prevention and the promotion of resilience can be supported by the physicians at various levels. In addition to efforts fostering sustainability in the immediate working environment, a system-oriented commitment to climate protection is important.
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Affiliation(s)
- Jens Walldorf
- Klinik für Innere Medizin I, University Hospital Halle, Halle, Germany
| | - Nikolaus Christian Simon Mezger
- Arbeitsgruppe Global and Planetary Health, Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Lena Weber
- Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Anja Knothe
- Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Michelle Klose
- Klinik für Innere Medizin I, University Hospital Halle, Halle, Germany
| | - Stefan Moritz
- Klinische Infektiologie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Eva Johanna Kantelhardt
- Arbeitsgruppe Global and Planetary Health, Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Germany
| | - Stephan Feller
- Institut für Molekulare Medizin, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Axel Schlitt
- Paracelsus-Harz-Klinik Bad Suderode, Bad Suderode, Germany
| | - Robin Greinert
- Klinik für Innere Medizin I, University Hospital Halle, Halle, Germany
| | - Patrick Michl
- Klinik für Innere Medizin I, University Hospital Halle, Halle, Germany
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Shaukat A, Shah B, Fritz CD, Omary MB. Gastroenterology climate action opportunities via education, empowerment of trainees and research. Gut 2023; 72:2219-2221. [PMID: 37977582 DOI: 10.1136/gutjnl-2023-331093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Aasma Shaukat
- Division of Gastroenterology and Hepatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Brijen Shah
- Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Cassandra Dl Fritz
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - M Bishr Omary
- Department of Medicine, Rutgers Biomedical and Health Sciences, Rutgers University, Piscataway, New Jersey, USA
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6
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Omary MB, Leddin D, Metz G, Veitch AM, El-Omar EM, Macedo G, Perman ML. World Gastroenterology Organisation - Gut commentary series on digestive health and climate change. Gut 2023; 72:2193-2196. [PMID: 37977581 DOI: 10.1136/gutjnl-2023-331193] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 11/19/2023]
Affiliation(s)
- M Bishr Omary
- Rutgers Biomedical and Health Sciences, Rutgers University, Piscataway, New Jersey, USA
| | | | - Geoffrey Metz
- The University of Melbourne and Monash University, Melbourne, Victoria, Australia
| | | | - Emad M El-Omar
- UNSW Microbiome Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Guilherme Macedo
- Gastroenterology, Centro Hospitalar de São João, Porto, Portugal
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7
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Baddeley R, Watts N, Donnelly L. NHS efforts in England to mitigate the climate crisis: uniting nurses and gastroenterologists. Gut 2023; 72:2214-2215. [PMID: 37977579 DOI: 10.1136/gutjnl-2023-331275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/07/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Robin Baddeley
- Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute, London, UK
- King's Health Partners Institute for Therapeutic Endoscopy, King's College Hospital, London, UK
| | - Nick Watts
- Centre for Sustainable Medicine, National University of Singapore, Singapore
| | - Leigh Donnelly
- Department of Gastroenterology, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
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Tavabie O, Clough J, King J, Nicholas V, Kumar A. Challenges of developing a green gastroenterology evidence base and how trainee research networks can fill the gaps. Frontline Gastroenterol 2023:flgastro-2023-102497. [DOI: 10.1136/flgastro-2023-102497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2023] Open
Abstract
Trainee research networks are a collaborative effort to enable high-quality multicentre audits or research that is more widely accessible to trainees. Such networks lead, design and deliver research at a far higher scale than could be achieved locally and are carried out solely by trainees. There is an increasing focus on delivering research that is not only environmentally sustainable but also focuses on areas that can reduce the carbon footprint of service provision in gastroenterology and hepatology. In this manuscript, we performed a scoping review to understand the current evidence base of the impact of gastroenterology and hepatology services on the environment as well as exploring any association between pollution and climate change with gastrointestinal and liver disease. We further discuss the barriers that researchers face in delivering environmentally sustainable research, the limitation in clinical guidelines related to practicing environmentally sustainable gastroenterology and hepatology and how the trainee research networks are ideally placed to initiate change by developing, disseminating and implementing best practice in ‘green Gastroenterology’.
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Pohl H, de Latour R, Reuben A, Ahuja NK, Gayam S, Kohli R, Agrawal D, Omary MB. GI Multisociety Strategic Plan on Environmental Sustainability. Gastroenterology 2022; 163:1695-1701.e2. [PMID: 36270827 DOI: 10.1053/j.gastro.2022.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Heiko Pohl
- Veterans Affairs Medical Center, White River Junction, Vermont; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Rabia de Latour
- Bellevue Hospital, NYU Grossman School of Medicine, New York, New York
| | - Adrian Reuben
- Medical University of South Carolina, Charleston, South Carolina
| | - Nitin K Ahuja
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Swapna Gayam
- West Virginia University, Morgantown, West Virginia
| | - Rohit Kohli
- Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Deepak Agrawal
- Dell Medical School, University of Texas at Austin Dell Medical School, Austin, Texas
| | - M Bishr Omary
- Robert Wood Johnson Medical School and Center for Advanced Biotechnology and Medicine, Rutgers University, New Brunswick, New Jersey
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10
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Pohl H, de Latour R, Reuben A, Ahuja NK, Gayam S, Kohli R, Agrawal D, Omary MB. GI multisociety strategic plan on environmental sustainability. Hepatology 2022; 76:1836-1844. [PMID: 36256467 DOI: 10.1002/hep.32810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 12/08/2022]
Affiliation(s)
- Heiko Pohl
- Veterans Affairs Medical Center, White River JunctionVermontUSA.,Geisel School of Medicine at DartmouthHanoverNew HampshireUSA
| | - Rabia de Latour
- NYU Grossman School of MedicineBellevue HospitalNew YorkNew YorkUSA
| | - Adrian Reuben
- Medical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Nitin K Ahuja
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Swapna Gayam
- West Virginia UniversityMorgantownWest VirginiaUSA
| | - Rohit Kohli
- Children's Hospital Los AngelesUniversity of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
| | - Deepak Agrawal
- Dell Medical SchoolUniversity of Texas at Austin Dell Medical SchoolAustinTexasUSA
| | - M Bishr Omary
- Robert Wood Johnson Medical School and Center for Advanced Biotechnology and MedicineRutgers UniversityNew BrunswickNew JerseyUSA
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GI Multisociety Strategic Plan on Environmental Sustainability. Am J Gastroenterol 2022; 117:1911-1916. [PMID: 36255194 DOI: 10.14309/ajg.0000000000002031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 11/06/2022]
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12
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Pohl H, de Latour R, Reuben A, Ahuja NK, Gayam S, Kohli R, Agrawal D, Omary MB. GI multisociety strategic plan on environmental sustainability. Gastrointest Endosc 2022; 96:881-886.e2. [PMID: 36270824 DOI: 10.1016/j.gie.2022.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 01/21/2023]
Affiliation(s)
- Heiko Pohl
- Veterans Affairs Medical Center, White River Junction, Vermont, USA; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Rabia de Latour
- Bellevue Hospital, NYU Grossman School of Medicine, New York, New York, USA
| | - Adrian Reuben
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Nitin K Ahuja
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Swapna Gayam
- West Virginia University, Morgantown, West Virginia, USA
| | - Rohit Kohli
- Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Deepak Agrawal
- Dell Medical School, University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - M Bishr Omary
- Robert Wood Johnson Medical School and Center for Advanced Biotechnology and Medicine, Rutgers University, New Brunswick, New Jersey, USA
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Clough J, Donnelly L, Leddin D, Hayee B. FGTwitter debate: green gastroenterology - are we nearly there yet? Frontline Gastroenterol 2022; 14:158-161. [PMID: 36818799 PMCID: PMC9933594 DOI: 10.1136/flgastro-2022-102301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/04/2022] [Indexed: 02/24/2023] Open
Affiliation(s)
- Jennie Clough
- Gastroenterology, Guys and St Thomas NHS Trust, London, UK
- School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Leigh Donnelly
- Endoscopy, Northumbria Healthcare NHS Foundation Trust, Northumberland, UK
| | - Desmond Leddin
- Department of Medicine, Dalhousie University, Halifax, New Brunswick, Canada
| | - Bu'Hussain Hayee
- Department of Gastroenterology, King's College Hospital, London, UK
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