Aravind Eye Care System Reduces Waste and Carbon Footprint From Cataract Surgeries Interview with:

Cassandra Thiel, PhD Assistant Professor in the Departments of Population Health and Opthamology at NYU Langone Health, and Assistant Professor at NYU Wagner and NYU Tandon School of Engineering

Dr. Thiel

Cassandra Thiel, PhD
Assistant Professor in the Departments of Population Health and Opthamology at NYU Langone Health, and Assistant Professor at NYU Wagner and
NYU Tandon School of Engineering What is the background for this study?

Response: Everyone is concerned about the health impacts of climate change, from the United Nations to the Lancet. While other industries are trying to monitor and minimize their environmental footprint, healthcare services have been largely overlooked. Yet, the US healthcare sector emits 10% of the US’s total greenhouse gases.

Cataract surgery is one of the most commonly performed procedures in the world. In the US, these surgeries generate large quantities of waste due to the use of single-use, disposable materials and supplies. However, at Aravind Eye Care System in southern India, the outcomes for this procedure are the same as in the US, but the materials they use are mostly reusable. This study assessed the environmental footprint of Aravind’s surgical process, to determine how their process design and material selection affected their emissions. What are the main findings?

Response: Aravind generates 250g of waste per cataract surgery (via a surgery type called phacoemulsification) and nearly 6kg CO2-equivalents in greenhouse gases. This is the same amount of greenhouse gases released from driving a car about 25 km. Compared to the same procedure (phacoemulsification) in the United Kingdom, Aravind generates less than 10% of the waste and about 5% of the carbon footprint, all with comparable outcomes and far lower costs. What should readers take away from your report?

Response: Given the cost and footprint of healthcare in the US, we need to start taking steps to reduce all forms of waste in medical services, particularly in resource-intensive operating rooms. Aravind shows that resource-efficient and safe surgical care is possible with effective process design, standardized procedures and material lists, and careful material selection and sterilization protocols. What recommendations do you have for future research as a result of this study?

Response: Some of the methods Aravind employs to reduce their environmental footprint can be used immediately by medical facilities in more developed countries. (These include streamlining patient flow, minimizing unnecessary tasks for members of the operating team, safely increasing throughput, reducing and standardizing surgical supplies for individual cases, and switching to reusable or reprocess-able supplies where applicable.) However, there are other strategies which may be beneficial but need further research and policy modification to safely enact within the US. (These include Immediate Use Sterile Supplies sterilization, multi-use pharmaceuticals, and reduction of packaging on supplies.) Given the reach of medicine overall, there is a large need to continue to assess and monitor the environmental emissions and efficiency improvements in healthcare. Is there anything else you would like to add?

Response: Anyone interested in greening their surgical (or medical) services should see if their facility has a “sustainability coordinator” or value-based management team, with whom they can connect. If not, there are many steps individuals can take to “green” their work place, starting with communication. In our work, we have seen that individual physicians have been able to reduce the waste of supplies in their operating rooms by simply telling their surgical team to be aware of the issue. International groups such as Healthcare Without Harm offer both a community of healthcare professionals interested in sustainability, and guidance and case studies for sustainability in healthcare. Thank you for your contribution to the community.


Cataract surgery and environmental sustainability: Waste and lifecycle assessment of phacoemulsification at a private healthcare facility

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.







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