The study found therapeutic endoscopy procedures generate more waste and have a higher carbon footprint than diagnostic ones, due to longer duration, higher electricity usage, and additional equipment like cautery, anesthesia, and fluoroscopy, increasing energy consumption
Published Feb 11, 2025 | 7:00 AM ⚊ Updated Feb 11, 2025 | 7:00 AM
Synopsis: A study by AIG Hospitals in Hyderabad, published in Gut journal, analysed the environmental impact of gastrointestinal endoscopy (GIE) procedures. Examining over 3,800 procedures, it found each generates 38.45 kg of CO₂ emissions, equivalent to driving 150+ kilometers. The study highlights areas for sustainable practices to reduce GIE’s carbon footprint and environmental harm in healthcare.
We care about our health, but health is not just harmful to our pocket or mental well-being. Now, a new study has found that it can also cause damage to our environment in different ways.
A study on the environmental impact of gastrointestinal endoscopy (GIE) procedures, conducted by AIG Hospitals in Hyderabad, has been published in the prestigious journal Gut. The research examined over 3,800 endoscopic procedures and revealed that each procedure generates an average of 38.45 kg of CO₂ emissions—comparable to driving more than 150 kilometers.
Titled “Carbon Footprinting and Environmental Impact of Gastrointestinal Endoscopy Procedures at a Tertiary Care Institution: A Prospective Multi-Dimensional Assessment,” the study provides a detailed analysis of the carbon footprint and waste production linked to GIE procedures.
It identifies key areas where sustainable healthcare practices can be implemented to reduce environmental harm.
Published by the British Medical Journal (BMJ) Group, Gut is the highest-impact peer-reviewed journal in gastroenterology worldwide. Known for featuring influential research, the inclusion of this study highlights the urgency of addressing healthcare’s environmental footprint and the growing need for eco-friendly medical practices.
“Healthcare activities, particularly in tertiary care centres, have a significant environmental impact. As a country with a large population and growing healthcare needs, India must lead the way in sustainable healthcare practices. This study highlights the critical need to talk about the environmental impact of healthcare and provides actionable insights for reducing carbon emissions from hospitals. By adopting eco-friendly practices, we can significantly mitigate our environmental footprint while continuing to provide high-quality care,” said Dr. D Nageshwar Reddy, Chairman, AIG Hospitals and one of the researchers in the study.
The most important finding of the study is that gastrointestinal endoscopy (GIE) procedures have a significant environmental impact, with an average carbon footprint of 38.45 kg CO2e per procedure.
While 38.45 kg CO₂e may seem minimal on an individual level, the global impact is substantial. For instance, a single endoscopy unit performing 10,000 procedures annually would produce 384,500 kg CO₂e—a carbon footprint that would require around 17,500 mature trees to offset each year. (assuming 22 kg CO₂/year per tree).
One of the most striking findings of the study is that patient travel is the largest source of emissions, accounting for 83.09 percent of the total carbon footprint. This highlights the need for sustainable transportation solutions and better healthcare accessibility to reduce unnecessary travel emissions.
On a positive note, India’s hospital waste management practices—which include recycling 25.7 percent of medical waste—save 380 kg CO₂e in just two weeks, showcasing the environmental benefits of recycling. Additionally, waste generation per endoscopy procedure in India (0.504 kg) is significantly lower than in Western countries (2–3 kg per procedure), primarily due to greater use of reusable materials and more efficient resource management.
Recycling waste in India avoids significant CO2 emissions, equivalent to generating 9816.6 kWh of solar energy, removing 2.1 cars from Indian roads, or absorbing the annual CO2 emissions of 467 trees.
“This is a crucial step forward in understanding and addressing the environmental impact of high-volume procedure like gastrointestinal endoscopy. By highlighting the significant carbon footprint of these procedures, we aim to drive change in healthcare practices. The findings emphasise the importance of optimising resource use, promoting recycling, and exploring non-invasive diagnostic alternatives. We hope this research will inspire healthcare providers and policymakers to adopt sustainable practices and contribute to global climate change mitigation efforts,” Dr. Hardik Rughwani, Lead Researcher of the study, said in a statement.
The study found that therapeutic endoscopy procedures–medical treatments performed to treat, repair, or manage a disease or condition– generate more waste and have a higher carbon footprint than diagnostic procedures. Why? Therapeutic procedures take longer, use more electricity, and require extra medical equipment like cautery (burning tissues), anesthesia, and fluoroscopy (X-ray guidance). These factors increase their overall energy consumption.
Therapeutic procedures use more disposable tools (like clips, stents, and surgical instruments), leading to twice the amount of waste compared to diagnostic procedures.
Both procedures require cleaning endoscopes, but diagnostic procedures often clean two scopes at once, while therapeutic ones may clean them one at a time or use multiple scopes per patient, increasing water consumption.
Even though a lot of reverse osmosis (RO) water is used for cleaning, hospitals repurpose this for gardening and sanitation, reducing waste.
The study calls for the establishment of dedicated ‘Sustainability’ departments in major hospitals, led by ‘Eco-Visionaries’ and ‘Green Endoscopy Revolutionaries,’ to drive eco-friendly practices and guidelines. The study suggests exploring non-invasive diagnostic alternatives, such as advanced imaging techniques and biochemical markers, to reduce the environmental impact of endoscopy procedures. This aligns with broader efforts to minimise unnecessary medical procedures and their associated emissions.
“This is a novel and timely study, done by Dr Nageshwar Reddy and team at Hyderabad. This study highlighted the significant environmental footprint of gastrointestinal endoscopy (GIE) procedures. A reassuring finding was that the Carbon emissions and total waste generated per procedure were lesser as compared to that of West,” said Hyderabad based Neurologist, Dr Sudhir Kumar.
He added that this study is an important first step to understand the contributors of GHG emissions and waste generations in hospitals. More studies are needed from other hospitals, as well as during other diagnostic and therapeutic procedures.
“Next steps would be to try and reduce the carbon footprint and waste generated during diagnostic and therapeutic procedures.This goal can be achieved by optimising practices to reduce patient travel and repeat procedures, alongside improving electricity and water management for sustainable healthcare,” he said.
(Edited by Ananya Rao)
