Introduction This paper quantifies the environment impact of single use (disposable) endoscopes compared to reusable scopes. Recently there has been a rising interest in disposable scopes to reduce risk of iatrogenic infections. The environmental impact of this has not been evaluated.

Maurice et.al. [1] highlighted the need for gastroenterologists to change endoscopy practice aligning it with core principles of environmentally sustainable healthcare. Lyndon et al [2] found that most of the impact of single-use duodenoscopes comes from production. Sathvik et al [3] estimated that waste volume generated per reusable endoscope procedure was 2.1kg, excluding reprocessing. But as processing in an EDU is energy and water intensive, previous studies may have led to an underestimate of the LCA for reusable duodenoscopes.

This study outlines a simplified Life Cycle Analysis (LCA) of single and reusable (reprocessed) endoscopes summarising the energy consumption and embodied CO₂ involved in endoscope manufacture and comparing the total carbon footprint of both single-use and reusable endoscopes, per procedure.

Methods For the LCA, software common in engineering (‘openLCA’) was used. This allowed a simplified LCA because the scope is limited to factors already investigated in the energy and climate science sectors such as the potential for energy demand reduction, abiotic depletion, global warming, acidification of watercourses and particulate matter impacts. A single score indicator (SSI) is used aggregating 18 impact categories contributing to human health, ecosystem quality and resource availability. Embodied energy of disposable and reusable endoscopes are expressed as greenhouse gas emissions (as tons of CO₂). This, in turn, allows scenario-planning to investigate water and carbon reduction strategies that have no negative health care impact and can be focussed on, forming the foundation of best practice in a resource-restricted future. A blend of quantified data and justified assumptions where necessary were used to create the framework, allowing later refinement and customisation for particular sites.

Results Per single use, the CO₂ equivalent and embodied energy of a disposable endoscopes is about half that of reusable. In practice this trend reverses when usage over the lifecycle of a reusable endoscope is considered with disposable endoscopes generating greater annual CO₂ tonnage than reusable.

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Abstract O27 Figure 1

Conclusions An LCA based on typical current practices showed that reusable endoscopes have significantly lower environmental impact than that of the disposable endoscopes over a suitable timeframe. A scenario based sensitivity analysis would reveal the best approach to providing more sustainable services and greater whole-process value.