{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:29:52Z","timestamp":1747150192695,"version":"3.40.5"},"reference-count":12,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T00:00:00Z","timestamp":1693612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>With vast improvements in imaging and endoscopic technology, there has been a massive shift towards in office procedures for various laryngeal disorders with significant health system and patient benefits. Another benefit which has yet to be investigated is the potential environmental effects and waste reduction of in\u2010office laryngeal procedures over traditional operating room surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The purpose of this study is to perform a waste audit and compare the results between operating room and in\u2010office laser laryngeal surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ten cases of in\u2010office and operating room laser laryngeal surgery, performed for recurrent respiratory papillomatosis, were subjected to a waste audit with four waste streams identified. Recyclable, general waste, anesthesia source and sharps. All waste was included from the time of case preparation to termination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cases were extremely homogeneous in the waste produced. The mean waste total produced for the operating room laser surgery was 2972 g of which 18% was recoverable\/recyclable. Contamination rate was very low. Recycling was performed very well by nursing\/prep staff; however, anesthesia was not recovering 13% of potential materials.<\/jats:p><jats:p>The in\u2010office waste produced was approximately one tenth of the operating room waste with almost all delegated into general waste. Potentially divertible\/recyclable materials accounted for 38% of the waste in\u2010office procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In\u2010office laryngeal procedures produce 13% of waste compared to surgery performed for similar pathology. These procedures are cost effective, safe and have been demonstrated to enhance environmental sustainability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 134:803\u2013806, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31005","type":"journal-article","created":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T10:13:40Z","timestamp":1693649620000},"page":"803-806","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Environmental Sustainability: Waste Audit Comparison Operating Roomand In\u2010Office Laryngeal Surgery"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7080-9567","authenticated-orcid":false,"given":"Jennifer","family":"Anderson","sequence":"first","affiliation":[{"name":"St Michaels Hospital, Department of Otolaryngology \u2010 Head and Neck Surgery University of Toronto  Toronto Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huixin","family":"Hu","sequence":"additional","affiliation":[{"name":"St Michaels Hospital, Department of Otolaryngology \u2010 Head and Neck Surgery University of Toronto  Toronto Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0157014","article-title":"Environmental impacts of the US health care system and effects on public health","volume":"11","author":"Ecklelman M","year":"2016","journal-title":"PLoS One"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.112139"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2017.303846"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.13978"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0734242X17739968"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-21-01254"},{"key":"e_1_2_6_8_1","unstructured":"https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/health-care-waste"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945499814544449"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818774511"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2018.01.011"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2011.10.003"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23781"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T06:11:28Z","timestamp":1705903888000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.31005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,2]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/lary.31005"],"URL":"https:\/\/doi.org\/10.1002\/lary.31005","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"type":"print","value":"0023-852X"},{"type":"electronic","value":"1531-4995"}],"subject":[],"published":{"date-parts":[[2023,9,2]]},"assertion":[{"value":"2023-04-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}