Environmental sustainability in pediatric otolaryngology: An international survey of operating room practice patterns

The primary objective of this study was to evaluate international practice patterns related to environmental sustainability in pediatric otolaryngology ORs, with a focus on the use of single-use versus reusable supplies.

An electronic survey was distributed using REDCap to members of an international pediatric otolaryngology WhatsApp group (n = 324). The survey included multiple-choice, Likert-scale, and open-ended questions regarding drape, gown, and glove usage for adenotonsillectomy, ear tube insertion, and laryngoscopy/bronchoscopy procedures, and broader sustainability practices including barriers and enablers.

Response rate was 16.0 % (n = 52/324). Respondents were from North America (30.8 %), Europe (25.0 %), Australia/New Zealand (23.1 %), Asia (15.4 %), South America (3.8 %), and Africa (1.9 %). For adenotonsillectomy 61.5 % reported using single-use patient drapes, 61.5 % use single-use table drapes, and 44.2 % use single-use gowns. For ear tube insertions, single-use table drapes (53.8 %) were most frequently reported; single-use patient drapes (38.4 %) and gowns (21.2 %) were less common. For laryngoscopy/bronchoscopy, the majority did not use patient drapes (31.4 %) or gowns (32.7 %), while 62.8 % use single-use table drapes. Top barriers to improving sustainability in the OR were cost (51.9 %) and infection prevention and control (IPAC) practices (44.2 %). Enablers included sufficient technological (46.2 %) and financial (36.6 %) resources, dedicated policies (30.8 %), and supportive leadership (34.6 %).

There remains a strong reliance on single-use materials in pediatric otolaryngology ORs globally. Cost, IPAC, education, and leadership are important considerations in sustainability efforts. These findings identify actionable targets for waste reduction and support the need for specialty-specific sustainability interventions.