Pitt researchers discuss operating room sustainability practices

Combating climate change in the healthcare sector is especially important for Melissa Belic, professor in civil and environmental engineering and co-director of the Mascaro Center for Sustainable Innovation.

According to Belic, while many focus on plastic’s effects on climate change, the healthcare sector contributes about 4.6 percent of total greenhouse gas emissions around the world and about 8.5 percent in the United States specifically.

“I am really interested in working in this space because the healthcare sector is responsible for between 8 to 10 percent of our greenhouse gas emissions in the U.S. One way to meet our climate goals is to also engage in the healthcare sector as well,” Belic said.

Orthopedic surgeries, one of the top five highest volume surgical specialties, contribute heavily to the greenhouse gasses emitted by the healthcare sector. The most common orthopedic surgery is knee replacement surgery, the process of artificially replacing all or a partial amount of the knee joint. Every step of the surgery requires precise sterilization and routine energy-intensive practices to ensure that the surgery is a success. Ian Engler, a sports medicine fellow at Pitt’s orthopedic surgery department, said operating rooms need to meet this energy demand “at all times.”

“In surgery, there’s a high risk of infection because anytime you are opening someone’s skin, potential bacteria can get in it,” Engler said. “The operating room is at a really strict temperature and humidity because bacteria like moist, warm environments. So that takes a lot of energy to keep the temperature perfectly right and the humidity perfectly right. The operating room always has that kind of energy demand at all times.”

In response to the growing impacts of climate change, the American Medical Association adopted a new policy that declares climate change a public health crisis that is a danger to all people. The AMA actively works toward developing a plan to change existing policies that carbonize healthcare practices, according to their website.

Many surgeries involve the use of single-use surgical devices that are disposed of shortly after the procedure, according to a Delft University of Technology publication. These instruments are packaged in single-use polypropylene, which ultimately causes environmental pollution. It is estimated that around 115 million kilograms of this type of waste are generated yearly in the United States, according to the publication.

Engler said these devices — along with their packaging — use a lot of energy and generate a lot of waste. 

“We have more implants than other surgical fields,” Engler said. “And each one of those takes a lot of energy to process and they’re all made steadily with sterile packaging. All that packaging is thrown away. So, because there are a lot of implants or orthopedic devices in our field, it makes it particularly energy-intensive.”

While it seems like there are never-ending causes for climate change, there are potential practices that can decrease emissions in the healthcare sector. Because of this, there are growing numbers of researchers working to discover these practices. Andrew Curley, another sports medicine fellow at Pitt’s orthopedic surgery department, said these practices prove beneficial.

“I think a lot of the solutions involve less electricity, less materials, less anesthetic gasses. Not only is it better for the environment, but it is better financially, so it is kind of a win-win,” Curley said.

Recently, the White House issued a press release announcing that 61 hospitals and health sector companies in the United States have committed to reducing greenhouse gas emissions by 50 percent by the year 2030. According to Belic, though the University of Pittsburgh Medical Center is not currently committed to the pledge, she hopes they do in order to promote more sustainable practices in operating rooms and the healthcare sector in general. 

“At this time, I do not believe UPMC has signed onto that. But I hope they will in the future,” Belic said. “On a more positive note, UPMC is part of the Pittsburgh 2030 district, so they do have energy, transportation and water goals that they are trying to meet by the year 2030.”