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We have with great interest read the excellent paper by Leddin et al, 1 in which they address the carbon footprint (CaF) and plastic waste from the vast number of colonoscopies performed in the USA annually. We feel obliged to elaborate on measures to bring down the environmental impact of endoscopic procedures. A single colonoscopy generates approximately 1.5 kg of plastic waste, and the CaF from all endoscopic procedures in the USA equals about 36 000 tCO2.2 This calculation does not include the CaF from incinerated waste and the manufacturing process of endoscopy consumables. The ‘3 Rs’ (reduce, reuse and recycle)3 can be applied as an action-oriented approach to lessen the CaF from endoscopy procedures. Reducing the excessive number of colonoscopies is the obvious first step in a more environmental-friendly process. In recent years, there has been a steep increase in the number of performed colonoscopies, with a concurrent rise in …
Contributors TB-M, AK and ET conceived the ideas and designed the paper. AK and ET were involved in critical revision of the manuscript. All authors contributed to and approved the final manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests AK is a consultant for Jinshan. He is director of iCERV Ltd and cofounder of AJM Medicaps Ltd. He has received a GivenImaging Ltd-ESGE grant, and material support for clinical research from SynMed/Intromedic. In the last 10 years, he has received honoraria and lecture fees from Jinshan, Dr FalkPharma UK and Ferring. He has also received educational travel support from Aquilant, Jinshan, Dr FalkPharma, Almirall, Ferring, and has participated in advisory board meetings for Tillots, Ankon, and Dr FalkPharmaUK. ET has received a research grant from the Swedish Cancer Society and the Swedish ALF agreement.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; internally peer reviewed.