Irish Doctors for the Enviroment
An Induction in Sustainable Anaesthesiology
For the first time, the College of Anaesthesiologists of Ireland will have an environmental focus at their Annual Congress of Anaesthesiology. The event will take place on the 21-22nd May 2020 in University College Dublin.
Why are so many doctors concerned with the health industry’s impact on the environment? Why is a growing body of anaesthesiologists in particular demanding a shift towards sustainable practice?
A recent report by the NGO Healthcare Without Harm estimated that globally the health industry emits 1.6 giga-tonnes of carbon dioxide equivalents* (CO2e) on an annual basis. Were the global health industry a country, it would lie fifth, sitting behind Russia, in terms of its CO2e emissions We clinicians are part of a system that contributes significantly to global warming. We are therefore contributing to the global burden of climate change induced disease and to the plummeting levels of biodiversity which is leading to the collapse in ecosystems all over the planet.
The carbon footprint relating to anaesthesiology is particularly high for several reasons: our specialty is very reliant on pharmaceuticals, single use medical equipment and plastics – the manufacture and disposal of which require the burning of large amounts of fossil fuels. The inhalational agents used to provide general anaesthesia are also extremely potent greenhouse gases. This means that when the anaesthetic gases are released into the atmosphere, their molecular structures prevent infrared heatwaves leaving the earth and contribute to global temperature rise. It is thought that anaesthetic gases contribute to about 5% of total CO2e emissions from acute hospitals.
For the first time, the impact of anaesthesiology on the environment will be a focus at the Annual Congress of Anaesthesiology on the 21st of May 2020. This event is a sign of our specialty’s growing environmental concerns and will be hosted by the College of Anaesthesiologists of Ireland at University College Dublin. Three distinguished speakers will participate in the assembly on climate change and sustainable practice.
Among the speakers will be Professor Jennifer McElwain - Professor of Plant Paleobiology and Paleoecology and Chair of Botany Trinity College Dublin. Prof McElwain has studied the connection between ancient plant remains (fossil plants) and past climate change. Her work on past climates has shown a link between elevated levels of greenhouse gases and the melting of ice sheets, a phenomenon that is re-occurring today, this time as a direct result of human activity.
Our second speaker, Dr Cathy Lawson, has recently completed the new Fellowship in Environmentally Sustainable Anaesthesia at Newcastle upon Tyne Hospitals. Dr Lawson has been exploring ways to reduce the impact of our anaesthetic gases on the environment. Dr Lawson and other environmentally conscious anaesthesiologists would argue that we already have the means to significantly reduce our CO2e emissions from anaesthetic gases. A move towards intravenous anaesthesia as an alternative to inhalational agents is one example. The discontinuation of routine use of nitrous oxide and a preferential use of sevoflurane rather than desflurane which is particularly damaging, would also have a positive impact. Finally, a greater use of regional anaesthesia and nerve blocks would obviate the need for general anaesthetic agents in many cases.
Our third and final speaker will be well known climate activist and journalist John Gibbons. Mr Gibbons has been writing and campaigning on the environmental and climate crises for the last decade. This included a two-and-a-half-year stint as weekly environmental columnist with the Irish Times. He also maintains an environmental blog at ThinkOrSwim.ie. He has appeared on RTE, the BBC and has written for the Guardian newspaper among others.
As doctors, we pride ourselves on our scientific method for developing an evidence base for improving patient health. Our fellow scientists of the Intergovernmental Panel on Climate Change - the United Nations body that is tasked with assessing the science related to climate change - state that the human impact on warming of the planet is unequivocal. Their research also leads to the conclusion that limiting the global temperature rise to 1.5°C more than pre industrial times is imperative to prevent a cycle of events that could lead to drought, food shortages, mass migration and other health catastrophes.
Currently we are not on course to achieve this target – and anaesthesia needs to play its part in addressing this existential challenge for humanity.
‘Places of healing should be leading the way, not contributing to the burden of disease.’
Tedros Ghebreyesus, Director General of the World Health Organization.
* A CO2 equivalent is a way to express the impact of different greenhouse gases in terms of the amount of CO2 that would create the same amount of warming over a hundred-year time period.
Oscar Duffy is an anaesthesiology trainee in Galway. He is a member of Irish Doctors for the Environment (IDE) and is Chair of IDE’s Anaesthesiology Working Group. IDE is a collective of medical professionals in Ireland who are focused on promoting, improving and sustaining the health of humans by striving to improve the health of the environment.