An article entitled “A Roadmap to Zero Emissions Healthcare” published in April, uses data from a 2019 Lancet article about health care and climate change, to raise concerns about the environmental “costs” of keeping people in good health. It is an obscenity that these themes are being drawn upon by UN climate leader Mark Carney and other institutions at this time of pandemic and dramatic healthcare deficits.
It’s not just cement, motor vehicles, and air conditioners that are destroying the planet, according to these neo-Malthusian crusaders; surgery must be added to the list:
“Surgical, obstetric, and anesthesia care is one of the major contributors to climate change within the health sector,” according to an article published this month in The Lancet scientific journal by doctors and researchers from the Harvard T.H. Chan School of Public Health. They worry that the climate impact of current surgical practices will get worse as lifesaving procedures become accessible to the 5 billion people around the world, mostly in low- and middle-income countries, who currently can’t get them.
“We do need to get more people surgical care,” says Dr. Aaron Bernstein, co-author of the article and interim director of the Center for Climate Health and the Global Environment at Harvard University. “But if we do it in a model that has been developed in rich countries, it will break the climate — and we can’t afford that.”
Globally, health care is responsible for about 4.6% of so-called greenhouse gas emissions, according to a 2019 report in The Lancet. A quarter of that is from the U.S., despite it having 4% of the global population.
“If the health sector globally were a country, it would be the fifth [largest] emitter of greenhouse gases,” says Susan Wilburn, international sustainability director at Health Care Without Harm, an organization working to reduce the environmental footprint of health care globally. The article zeroes in on surgical care, because it’s the most energy- and waste-intensive specialty in health care. Operating rooms can consume three to six times more energy per square foot than elsewhere in a hospital, according to another Lancet study. That’s because heating, ventilation, and air conditioning in operating rooms run on high, even when no patients are in them. The article says that if hospitals ventilated operating rooms only when they were occupied, this would significantly reduce energy consumption.
Operating rooms also produce 20% to 30% of a facility’s waste, by some estimates, and a third of its biohazard waste, which must be disposed of specially.
The use of certain anesthetic gases, such as nitrous oxide and desflurane, is another major source of greenhouse gases in operating rooms, according to the article. Anesthetics that are injected instead of inhaled, on the other hand, leave a minimal carbon footprint. Perhaps they will next propose that preventing the patient from breathing will further reduce future carbon emissions!
“The easiest thing we can do is stop wasting so much,” says Dr. Jodi Sherman, associate professor of anesthesiology and of epidemiology in environmental health sciences at Yale University. “We waste a tremendous amount.”