Carbon Footprint Reduction in Shoulder Surgery by the Rationalisation of Single-Use Convenience Packs

Authors:
A Chowdhury, H Imran, H Colaco

Hospital:
Hampshire Hospitals Foundation Trust

Introduction
The NHS is responsible for a vast carbon footprint, with annual carbon dioxide emissions estimated at over 20 million tonnes, comparable to the national emissions of Sri Lanka. Operating theatres contribute up to 25% of a hospital’s emissions. We aimed to rationalise the composition of the single-use convenience packs in arthroscopic and open shoulder surgery, to reduce the annual carbon footprint.

Methods
The individual material composition of all items in the single-use shoulder arthroscopy and open shoulder convenience packs was considered. The carbon footprint of each item was calculated by the application of best available cradle-to-grave emission factors. The items in the packs were then rationalised by consensus (of surgeons and scrub team), removing, reducing, or altering unnecessary items. Two new standardised packs were designed, and a predicted annual carbon footprint reduction was calculated.

Results
In the 2022/2023 financial year, 296 arthroscopic and 154 open shoulder procedures were performed. This resulted in the use of 810.7kg of single-use non-recycled plastic. The new rationalised packs will result in an estimated annual carbon footprint reduction of 607.5 kgCO2e.

Conclusion
Through a simple method of single-use convenience pack rationalisation, we can reduce the annual carbon footprint of shoulder surgery by the equivalent of 1,557 miles driven in an average petrol car. This is an underestimate of saving, as the reduction in waste disposal has not been considered. Ongoing work includes expansion to all orthopaedic procedures, assessment of waste disposal and the adoption of sterilisable/sustainable alternatives.