Reducing the environmental impact of gastrointestinal endoscopy: a prospective study on waste management through waste segregation and staff education

Abstract

Background

Gastrointestinal endoscopy is a major contributor of medical waste and greenhouse gas (GHG) emissions. Sustainable waste management practices could help reduce its environmental footprint.

Methods

A prospective exploratory study was conducted at IRCCS Humanitas Research Hospital from April to June 2023. The intervention included installing recycling bins for paper and plastic in five endoscopy suites, alongside existing regulated medical waste (RMW) and non-regulated medical waste bins. Comprehensive staff training on waste segregation was provided, and a “Green Endoscopy” nurse monitored compliance during the intervention. Data on RMW, its emissions (in kg carbon dioxide equivalents [CO2e] per procedure), and costs were collected and compared with pre-intervention values.

Results

RMW production decreased by 24.1%, from 1.91 kg per procedure (95%CI 1.54–2.28) to 1.45 kg per procedure (95%CI 1.16–1.73; P = 0.02), with sustained reductions during follow-up (1.48 kg per procedure; 95%CI 0.84–2.12). The intervention led to a 33.3% reduction in GHG emissions (with a net difference of 1.23 kg CO2e per procedure; P = 0.02), and cost savings of approximately €3542 (±384) were achieved. This effect was consistent across different procedure types.

Conclusions

Targeted interventions such as staff education and structured waste segregation protocols substantially reduced RMW and associated GHG emissions in a high-volume endoscopy unit. These results suggest that simple, low-cost changes may improve environmental sustainability in clinical practice.

Publication History

Received: 03 December 2024

Accepted after revision: 06 July 2025

Article published online:
19 August 2025

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