The contribution of anaesthesia and surgery to global warming: A carbon footprinting study of operating theatres in three different surgical specialties—A prospective observational analysis

• Author Details:   
• Rangalakshmi Srinivasan
• Sowmya Madihalli Janardhan Iyengar
• Dilip Kumar M ^*
• Harigovindh Adalarasu

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Background: Climate change is one of the most pressing global challenges, with significant consequences for public health. As healthcare services are major contributors to greenhouse gas (GHG) emissions, understanding their carbon footprint is critical in the fight against global warming. This study aimed to quantify the carbon footprint of operation theatres (OTs) in three different surgical specialties.

Materials and Methods: A prospective observational study was conducted over 8 weeks in three OTs, representing different surgical specialties: OT1 (Obstetrics) with regional anaesthesia (RA), OT2 (Surgical-Laparoscopy) with general anaesthesia (GA), and OT3 (Urology), which used both RA and GA as needed. Carbon emissions were measured across three scopes defined by the GHG protocol: Scope 1 (direct emissions from inhaled anaesthetics), Scope 2 (indirect emissions from electricity consumption), and Scope 3 (emissions from biomedical waste disposal). Emissions were reported as CO2 equivalents (CO2e).

Results: In OT1, no emissions were recorded for Scope 1, whereas OT2 generated 6904.78 kg of CO2e from isoflurane and 325.39 kg from sevoflurane. OT3 produced 2861.1 kg of CO2e from isoflurane and 157.76 kg from sevoflurane. Scope 2 emissions were 2957.05 kg for OT1, 1988.75 kg for OT2, and 2777.64 kg for OT3. Scope 3 emissions from biomedical waste disposal were similar across all OTs. Total CO2e emissions were 4131.41 kg (20%) for OT1, 10273.96 kg (48%) for OT2, and 6840.82 kg (32%) for OT3. The emissions from OT1 were significantly lower than OT2 (p<0.05).

Conclusion: The study demonstrates that operating theatres are significant contributors to GHG emissions, with anaesthetic gases and energy consumption being the primary sources. Reducing these emissions should be a priority for healthcare sustainability efforts.