Reducing the environmental footprint of gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement

Author:

Rodríguez de Santiago Enrique1ORCID,Dinis-Ribeiro Mario2,Pohl Heiko3,Agrawal Deepak4,Arvanitakis Marianna5,Baddeley Robin6,Bak Elzbieta7,Bhandari Pradeep8,Bretthauer Michael9,Burga Patricia10,Donnelly Leigh11,Eickhoff Axel12,Hayee Bu'Hussain13ORCID,Kaminski Michal F.14,Karlović Katarina15,Lorenzo-Zúñiga Vicente16ORCID,Pellisé Maria17ORCID,Pioche Mathieu18,Siau Keith19ORCID,Siersema Peter D.20,Stableforth William19,Tham Tony C.21ORCID,Triantafyllou Konstantinos22ORCID,Tringali Alberto23ORCID,Veitch Andrew24,Voiosu Andrei M.25ORCID,Webster George J.13,Vienne Ariane26,Beilenhoff Ulrike27,Bisschops Raf28ORCID,Hassan Cesare29,Gralnek Ian M.30,Messmann Helmut31

Affiliation:

1. Gastroenterology and Hepatology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain

2. Porto Comprehensive Cancer Center (Porto.CCC), and RISE@CI-IPOP (Health Research Network), Porto, Portugal

3. Dartmouth Geisel School of Medicine, Hanover, New Hampshire, and Section of Gastroenterology and Hepatology, VA White River Junction, Vermont, USA

4. Division of Gastroenterology and Hepatology, Dell Medical School, University of Texas Austin, Texas, USA

5. Department of Gastroenterology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium

6. King’s Health Partners Institute for Therapeutic Endoscopy, King’s College Hospital, and Wolfson Unit for Endoscopy, St Mark’s Hospital, London, United Kingdom

7. Department of Gastroenterology and Internal Medicine, Clinical Hospital of Medical University of Warsaw, Warsaw, Poland

8. Gastroenterology, Portsmouth Hospital NHS Trust, Portsmouth, UK

9. Clinical Effectiveness Research Group, University of Oslo, and Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway

10. Endoscopy Department, University Hospital of Padua, Italy

11. Endoscopy Department, Northumbria Healthcare NHS Trust, Northumberland, United Kingdom

12. Klinik für Gastroenterologie, Diabetologie, Infektiologie, Klinikum Hanau, Hanau, Germany

13. Department of Gastroenterology, University College London Hospitals, London, United Kingdom

14. Department of Cancer Prevention and Department of Oncological Gastroenterology, The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

15. Clinical Hospital Center Rijeka , Department of Gastroenterology, Endoscopy Unit, Rijeka, Croatia

16. Department of Gastroenterology, University and Polytechnic La Fe Hospital/IIS La Fe, Valencia, Spain

17. Department of Gastroenterology, Hospital Clinic of Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), and Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain

18. Endoscopy Unit, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France

19. Department of Gastroenterology, Dudley Group Hospitals NHS Foundation Trust, Dudley, United Kingdom

20. Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands

21. Division of Gastroenterology, Ulster Hospital, Dundonald, Belfast, Northern Ireland

22. Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece

23. Digestive Endoscopy Unit, ULSS 2 Marca Trevigiana, Conegliano Hospital, Conegliano, Italy

24. Department of Gastroenterology, Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom

25. Department of Gastroenterology and Hepatology, Colentina Clinical Hospital, Bucharest, Romania

26. Hôpital Privé d’Antony, Antony, France

27. Ulm, Germany

28. Department of Gastroenterology and Hepatology, Catholic University of Leuven (KUL), TARGID, University Hospitals Leuven, Leuven, Belgium

29. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, and Endoscopy Unit, IRCCS Humanitas Clinical and Research Center, Rozzano, Milan, Italy

30. Ellen and Pinchas Mamber Institute of Gastroenterology and Hepatology, Emek Medical Center, Afula, and Rappaport Faculty of Medicine Technion Israel Institute of Technology, Haifa, Israel

31. III Medizinische Klinik Universitätsklinikum Augsburg, Augsburg, Germany

Abstract

AbstractClimate change and the destruction of ecosystems by human activities are among the greatest challenges of the 21st century and require urgent action. Health care activities significantly contribute to the emission of greenhouse gases and waste production, with gastrointestinal (GI) endoscopy being one of the largest contributors. This Position Statement aims to raise awareness of the ecological footprint of GI endoscopy and provides guidance to reduce its environmental impact. The European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) outline suggestions and recommendations for health care providers, patients, governments, and industry. Main statements 1 GI endoscopy is a resource-intensive activity with a significant yet poorly assessed environmental impact. 2 ESGE-ESGENA recommend adopting immediate actions to reduce the environmental impact of GI endoscopy. 3 ESGE-ESGENA recommend adherence to guidelines and implementation of audit strategies on the appropriateness of GI endoscopy to avoid the environmental impact of unnecessary procedures. 4 ESGE-ESGENA recommend the embedding of reduce, reuse, and recycle programs in the GI endoscopy unit. 5 ESGE-ESGENA suggest that there is an urgent need to reassess and reduce the environmental and economic impact of single-use GI endoscopic devices. 6 ESGE-ESGENA suggest against routine use of single-use GI endoscopes. However, their use could be considered in highly selected patients on a case-by-case basis. 7 ESGE-ESGENA recommend inclusion of sustainability in the training curricula of GI endoscopy and as a quality domain. 8 ESGE-ESGENA recommend conducting high quality research to quantify and minimize the environmental impact of GI endoscopy. 9 ESGE-ESGENA recommend that GI endoscopy companies assess, disclose, and audit the environmental impact of their value chain. 10 ESGE-ESGENA recommend that GI endoscopy should become a net-zero greenhouse gas emissions practice by 2050.

Publisher

Georg Thieme Verlag KG

Subject

Gastroenterology

Reference166 articles.

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