ReviewEnvironmental health perspectives2021
Operating in a Climate Crisis: A State-of-the-Science Review of Life Cycle Assessment within Surgical and Anesthetic Care.
Review in Environmental health perspectives, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 72 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Sustainability of Laparoscopic Appendectomy. Variability of Determining Factors.
Sustainable Anesthesia in Myocardial Revascularization Surgery: a Non-randomized Interventional Study
Who cites it
72 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Quantifying the environmental footprint of primary hip and knee arthroplasty: a systematic review and pooled-analysis of waste generation and carbon emissions.International orthopaedics · 2026Pooled it
- Environmental footprint of gastrointestinal endoscopy services: a systematic review.Endoscopy · 2026Pooled it
- Evidence-based Integration of Environmental Sustainability into Clinical Guidelines for Operating Rooms: A Systematic Review.Annals of surgery · 2026Pooled it
- Clinician and health service interventions to reduce the greenhouse gas emissions generated by healthcare: a systematic review.BMJ evidence-based medicine · 2024Pooled it
- The impact of switching from single-use to reusable healthcare products: a transparency checklist and systematic review of life-cycle assessments.European journal of public health · 2023Pooled it
- A Transparency Checklist for Carbon Footprint Calculations Applied within a Systematic Review of Virtual Care Interventions.International journal of environmental research and public health · 2022Pooled it
- The Impact of Anaesthesia Method on the Use of Anaesthesia Department Resources in Total Knee Arthroplasty.Acta anaesthesiologica Scandinavica · 2026Trial
- From carbon cost to climate care: Greening our intensive care units.World journal of critical care medicine · 2026Review
- The environmental impact of diagnostic imaging: opportunities for pediatric radiologists.Pediatric radiology · 2026Review
- Sustainable anaesthesia: beyond carbon and towards system-level change.Anaesthesia · 2026Article
- Environmental Impact of a Vaginal Pelvic Organ Prolapse Procedure: A Life Cycle Assessment with Scenario Modelling of Mitigation Strategies.International urogynecology journal · 2026Article
- Sustainable Healthcare: A Perspective on the Current Landscape, Frameworks, Barriers, and Implementation Model in a Quaternary Hospital System.International journal of environmental research and public health · 2026Review
- Green Surgery: Current Evidence, Challenges, and Future Directions.International journal of environmental research and public health · 2026Review
- Life Cycle Assessment of Impacted Tooth Surgery Under Different Clinical Scenarios.Dentistry journal · 2026Article
- Choosing Wisely Canada climate-conscious recommendations for critical care medicine.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2026Article
- Life Cycle Assessment of HoLEP: Quantifying Environmental Impact and Opportunities for Sustainable Urologic Surgery.European urology open science · 2026Article
- Understanding Sustainability in Operating Theaters: An Ethnographic Study to Determine Drivers of Unsustainable Behaviors.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Multicenter study protocol on clinical, environmental, and economic outcomes of hybrid versus disposable surgical trays (project rEUsable).International journal of surgery protocols · 2026Article
- Eco-audit of the Nail Bed Injury Treatment Pathway at a Tertiary Care Hospital.Plastic and reconstructive surgery. Global open · 2026Article
- Climate Impact of Laryngeal Masks: Climate and Other Environmental Impacts of Reusable and Single-Use Laryngeal Masks in Sweden.Acta anaesthesiologica Scandinavica · 2026Article
12 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBoth human health and the health systems we depend on are increasingly threatened by a range of environmental crises, including climate change. Paradoxically, health care provision is a significant driver of environmental pollution, with surgical and anesthetic services among the most resource-intensive components of the health system.
objectivesThis analysis aimed to summarize the state of life cycle assessment (LCA) practice as applied to surgical and anesthetic care via review of extant literature assessing environmental impacts of related services, procedures, equipment, and pharmaceuticals.
methodsA state-of-the-science review was undertaken following a registered protocol and a standardized, LCA-specific reporting framework. Three bibliographic databases (Scopus®, PubMed, and Embase®) and the gray literature were searched. Inclusion criteria were applied, eligible entries critically appraised, and key methodological data and results extracted.
resultsFrom 1,316 identified records, 44 studies were eligible for inclusion. The annual climate impact of operating surgical suites ranged between 3,200,000 and DISCUSSION: Despite the recent proliferation of surgical and anesthesiology-related LCAs, extant studies address a miniscule fraction of the numerous services, procedures, and products available today. Methodological heterogeneity, external validity, and a lack of background life cycle inventory data related to many essential surgical and anesthetic inputs are key limitations of the current evidence base. This review provides an indication of the spectrum of environmental impacts associated with surgical and anesthetic care at various scales. https://doi.org/10.1289/EHP8666.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.