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Environmentally-sustainable anaesthesia

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Globally, healthcare is responsible for nearly 5% of total global greenhouse gas emissions and similar fractions of harmful air pollutants.

Estimates of global emissions stemming from anaesthesia practice are unavailable due to data gaps. However, a UK study found that inhalational anaesthetic agents alone are estimated to contribute nearly 3% of healthcare-related emissions in the NHS. 

Regardless of the exact level of impact of anaesthesia gases in individual countries, their total global impact on the climate is substantial and can no longer be ignored.

WFSA convened an international group of experts to identify achievable recommendations that clinicians around the globe can adopt to reduce the environmental impact of anaesthesia services without negatively impacting on patient outcomes.

The findings and recommendations from this working group were published in the journal Anaesthesia as Principles of environmentally-sustainable anaesthesia: a global consensus statement from the World Federation of Societies of Anaesthesiologists

The WFSA Global Working Group on Environmental Sustainability in Anaesthesia agreed on seven principles that any anaesthesia provider in the world should strive to achieve:

  1. Minimise the environmental impact of their clinical practice.
  2. Use environmentally preferable medications and equipment when clinically safe to do so
  3. Minimise the overuse/waste of medications, equipment, energy and water.
  4. Incorporate environmental sustainability principles within formal anaesthesia education.
  5. Embed environmental sustainability principles within anaesthesia research and quality improvement programmes.
  6. Lead environmental sustainability activity within their healthcare organisations
  7. Collaborate with industry to improve environmental sustainability.

The WFSA Working Group noted that the mission to reduce the environmental impact of anaesthesia must align with three underlying fundamentals: patient safety should not be compromised by sustainable anaesthetic practices; high-, middle- and low-income countries should support each other appropriately in delivering sustainable healthcare (including anaesthesia); and healthcare systems should be mandated/monitored to reduce their contribution to global warming.

The group’s recommendations are designed to be achievable globally, with minimal material resources and financial investment. A number of resources already exist on how to implement the recommendations made in this paper, which anaesthesia providers should discuss regularly at institutional and national meetings. This work is iterative, with opinion forming much of the basis for the recommendations, informed by published evidence.

The WFSA Global consensus statement is available to download in ArabicChineseEnglishFrench; RussianSpanish