Joseph John

Sep 27, 2024 | nature.com | Joseph John |William Gray |John McGrath |Tim W. R. Briggs

An urgent need for societal transformation exists to reduce the environmental impact of humanity, because environmental health affects human health. Health care causes ~5% of global greenhouse gas emissions and other substantial and ongoing environmental harms. Thus, health-care professionals and managers must lead ongoing efforts to improve the environmental performance of health systems. Life-cycle assessment (LCA) is a methodology that enables estimation of environmental impacts of products and processes. It models environmental effects from ‘cradle’ (raw material extraction) to ‘grave’ (end of useful life) and conventionally reports a range of different impact categories. LCA is a valuable tool when used appropriately. Maximizing its utility requires rational assumptions alongside careful consideration of system boundaries and data sources. Well-executed LCAs are detailed and transparently reported, enabling findings to be adapted or generalized to different settings. Attention should be given to modelling mitigation solutions in LCAs. This important step can guide health-care systems towards new and innovative solutions that embed progress towards international climate agreements. Many urological conditions are common, recurrent or chronic, requiring resource-intensive management with large associated environmental impacts. LCAs in urology have predominantly focussed on greenhouse gas emissions and have enabled identification of modifiable ‘hotspots’ including electricity use, travel, single-use items, irrigation, reprocessing and waste incineration. However, the methodological and reporting quality of published urology LCAs generally requires improvement and standardization. Health-care evaluation and commissioning frameworks that value LCA findings alongside clinical outcomes and cost could accelerate sustainable innovations. Rapid implementation strategies for known environmentally sustainable solutions are also needed. This Perspectives provides an overview of life-cycle assessment and its use in urological academic literature to date. The authors explain how life-cycle assessment can be interpreted and used to help to reduce the environmental impact of urology.

Feb 29, 2024 | bmjopen.bmj.com | Joseph John |Kieran O'Flynn |Tim Briggs |Michael Collins

DiscussionThis life-cycle inventory analysis describes the GHG emissions associated with a large hospital laundry unit, and makes estimates per laundry item type and per-unit mass. By presenting a breakdown of the relative GHG emission contributions from different processes, we identify where the greatest improvements can be made. The three foremost areas are:Boiler and dryer electrification as renewable electricity generation increases. Optimally loading delivery vehicles.