Sustainability Infrastructure

How can operating rooms cut their carbon footprint?

Operating rooms make up a large proportion of hospitals’ energy usage and waste production, while the U.S. healthcare sector accounts for around 10 percent of the country’s greenhouse gas emissions.
Empty operating room.
iStock.

Story at a glance


  • Researchers assessed 23 studies that explored interventions aimed at reducing operating rooms’ carbon footprint.

  • They identified 28 different ways to improve sustainability that also yield cost savings. 

  • Interventions include reducing regulated medical waste and adopting wider recycling programs at hospitals. 

The U.S. health care industry accounts for around 10 percent of the country’s greenhouse gas emissions, while operating rooms represent the main culprit of energy consumption and waste production. 

In a new review, experts outlined how quality improvement initiatives for operating rooms can combat emissions, cut waste and reduce hospitals’ overall costs.

Writing in the Journal of the American College of Surgeons, authors identified 28 different interventions that yielded potential annual cost savings ranging from more than $2000 to nearly $700,000. 

It’s estimated operating rooms can use up to six times the amount of energy than the rest of the hospital and can produce more than half of the entire hospital’s waste.

“Surgeons have an opportunity to really be leaders in this space. Mainly because the single biggest producer of waste is indeed the operating room,” said study author Mehul V. Raval, of the Ann & Robert H. Lurie Children’s Hospital in Chicago, in a release.


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“The opportunity to reduce our carbon footprint falls squarely on us, and I see surgeons taking a prominent role in leading efforts, not just locally with their green implementation teams, but in setting national standards and policies that will move this effort forward for an overall sustainable way of approaching healthcare delivery.”

One intervention identified was transitioning rooms to a waterless surgical scrub. Doing so would save around $2,200 per year and 2.7 million liters of water annually. 

Providing education on reducing regulated medical waste — which is more expensive to dispose of than regular trash — could lead to a 30 percent reduction of this waste source and save around $694,000 per year. 

Additional initiatives include ensuring waste is deposited into the correct bins, adopting wider recycling programs at hospitals, shutting down equipment and lights overnight and decreasing the frequency of washing noncontaminated anesthetic equipment.

“If we can come together just to think about what we are using, we can lower the amount of waste that we are producing overall, and reduce our emissions,” added study author Gwyneth A. Sullivan. Sullivan is a surgical resident at Rush University and a research fellow at Northwestern University Surgical Outcomes & Quality Improvement Center in Chicago.

A total of 23 studies were included in the review, and all initiatives incorporated the “triple bottom line framework” which considers the impact of social, environmental, and financial interventions. 

Studies were also broken down into five sustainability approaches: refuse, reduce, reuse, repurpose and recycle. More than one-third of the studies included initiatives on refuse whereby surgical teams use fewer supplies or alternative supplies of a specific item. These interventions often required no additional material or personnel investments, making them more feasible to implement.

Refuse initiatives could include removing unnecessary disposable items from premade packs of gowns, gloves, and surgical equipment.

“At the end of every day and every case, it’s disturbing how many bags of trash we are throwing away, especially with the use of disposables and plastics that we see growing in use as time goes on,” Raval said.

Future research could explore interventions to reduce anesthetic gases which make up around half of greenhouse gas emissions from operating rooms, authors added. They also conceded there may be resistance and barriers to the uptake of sustainability initiatives. 

However, recent national initiatives prioritizing the decarbonization of the U.S. health system could ease the transition to a greener future. In April 2022, the department of Health and Human Services launched an initiative to encourage organizations to reach net-zero greenhouse gas emissions by 2050 and cut emissions in half by 2030. In addition, the health care sector can take advantage of certain provisions in the Inflation Reduction Act

Several organizations are also working to reduce the sector’s environmental footprint.