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NetZero deep brain stimulation: A carbon footprint minimisation audit and environmental impact analysis
Teresa Scott1, Erlick Ac Pereira1, Michael G Hart1
1Department of Psychology and Neuroscience, St George's School of Health and Medical Sciences, City St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK.
Introduction:
The NHS accounts for around 5% of the UK's total carbon emissions, with surgical care contributing a significant proportion. We developed a "NetZero-DBS" workflow that we used to implement 5 high-impact changes to making surgery greener.
Research Question:
To what extent can an optimised "NetZero-DBS" workflow reduce the environmental impact of DBS surgery through changes in waste management, consumable use, and product carbon footprint?
Material And Methods:
A prospective audit compared sixteen consecutive DBS cases (eight before and eight after workflow implementation). Effectiveness was assessed through a structured waste audit, deep-dive product carbon footprint assessment, and consumable use appraisal.
Results:
The mean total waste generated per procedure before and after implementing our changes was 19 kg and 15.5 kg, respectively, but neither this nor individual waste categories were statistically significantly changed. The reusable DBS probe had the highest product carbon footprint, PCF (0.34 kgCO2e) compared to the single-use alternatives (0.117 kgCO2e and 0.145 kgCO2e). However, its environmental impact could be reduced by up to 56% per use when reused as intended and hence would make a net impact after three operations. Consumable use was reduced by 21.36kgCO2e or 12% of total per procedure.
Discussion And Conclusion:
We provide a workflow that allows hospitals undertaking deep brain stimulation neurosurgery to minimise their carbon impact depending on individual features of their service. Implementation of our "NetZero-DBS workflow" is estimated to yield annual carbon savings of approximately 854.5 kgCO2e per year, equivalent to the emissions produced by driving 2176 miles in an average car.
