Cutting Waste in Bronchoscopy: A Multicenter Observational Study in the German Health Care System

Area of Science:

• Environmental Science
• Medical Waste Management
• Pulmonology

Background:

• Pulmonary endoscopy procedures contribute significantly to medical waste.
• Previous estimates suggest approximately 1.03 kg of waste per bronchoscopy, but scalable data are limited.

Purpose of the Study:

• To quantify waste generated by pulmonary procedures (bronchoscopy and EBUS) using reusable endoscopes in German centers.
• To estimate the national impact of this waste.
• To identify strategies for waste reduction.

Main Methods:

• A prospective, multicenter observational study was conducted over four weeks per center.
• Waste from 107 procedures in 79 patients was collected, categorized, and weighed.
• National waste production was extrapolated using health insurance data.

Main Results:

• An average of 1479.7 g of waste was generated per patient.
• Standalone bronchoscopy produced 1276.5 g, while bronchoscopy plus EBUS generated 1849.7 g.
• Extrapolated nationally, this equates to 551.6 tons of waste and 270 tons of CO2 emissions annually.
• Using reusable gowns could reduce waste by 61.5%.
• 28.7% of the waste was potentially recyclable.
• Single-use endoscopes could increase waste burden.

Conclusions:

• Pulmonary endoscopies generate substantial medical waste.
• Procedural bundling, reusable protective equipment, and recycling are key strategies for reducing the environmental footprint.
• Disposable endoscopes may increase overall waste.