{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T20:51:34Z","timestamp":1784926294030,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:00:00Z","timestamp":1708387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To quantify the environmental impact of standard direct laryngoscopy surgery and model the environmental benefit of three feasible alternative scenarios that meet safe decontamination reprocessing requirements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>This is a life cycle assessment (LCA) modeling study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Yale\u2010New Haven Hospital (YNHH), a 1541\u2010bed tertiary medical center in New Haven, Connecticut, USA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed cradle\u2010to\u2010grave LCA of DLS at Yale New Haven Hospital in 2022, including global warming potential (GWP), water consumption, and fine particulate matter formation. Three alternative scenarios were modeled: disinfecting surgical tools using high\u2010level disinfection rather than steam sterilization, substituting non\u2010sterile for sterile gloves and gowns; and reducing surgical towel and drape sizes by 30%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Changes in disinfection practices would decrease procedure GWP by 11% in each environmental impact category. Substituting non\u2010sterile gowns and gloves reduced GWP by 15%, with nominal changes to water consumption. Linen size reduction resulted in 28% less procedure\u2010related water consumption. Together, a nearly 30% reduction across all environmental impact categories could be achieved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Not exceeding minimum Center for Disease Control (CDC) decontamination standards for reusable devices and optimizing non\u2010sterile consumable materials could dramatically reduce healthcare\u2010associated emissions without compromising safety, thereby minimizing the negative consequences of hospital operations to environmental and human health. Findings extend to other non\u2010sterile surgical procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 134:3206\u20133214, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31341","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T05:15:08Z","timestamp":1708492508000},"page":"3206-3214","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Environmental Impact of a Direct Laryngoscopy: Opportunities for Pollution Mitigation"],"prefix":"10.1002","volume":"134","author":[{"given":"Grace I.","family":"Filley","sequence":"first","affiliation":[{"name":"Department of Civil and Environmental Engineering Northeastern University  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darpan","family":"Kayastha","sequence":"additional","affiliation":[{"name":"Department of Surgery (Division of Otolaryngology) Yale School of Medicine  New Haven Connecticut U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesley","family":"Hayes","sequence":"additional","affiliation":[{"name":"Department of Civil and Environmental Engineering Northeastern University  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saral","family":"Mehra","sequence":"additional","affiliation":[{"name":"Department of Surgery (Division of Otolaryngology) Yale School of Medicine  New Haven Connecticut U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4157-9728","authenticated-orcid":false,"given":"Jodi D.","family":"Sherman","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Yale School of Medicine  New Haven Connecticut U.S.A."},{"name":"Department of Environmental Health Sciences Yale School of Public Health  New Haven Connecticut U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Eckelman","sequence":"additional","affiliation":[{"name":"Department of Civil and Environmental Engineering Northeastern University  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(22)01540-9"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(21)01787-6"},{"key":"e_1_2_8_4_1","volume-title":"The United Nations World Water Development Report 2022: Groundwater: Making the Invisible Visible","author":"UNESCO World Water Assessment Programme","year":"2022"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(22)00090-0"},{"key":"e_1_2_8_6_1","unstructured":"United Nations Framework Convention on Climate Change Paris Agreement.2015Paris."},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2020.01118"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.06.055"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0157014"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2020.01247"},{"key":"e_1_2_8_11_1","unstructured":"HuijbregtsMAJS SteinmannZJN ElshoutPMF et al.ReCiPe 2016 v1.1 a harmonized life cycle impact assessment method at midpoint and endpoint level report I: characterization National Institute for public health and the environment Ministry of Health Welfare and Sport.2017."},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-071421-051937"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resconrec.2020.104882"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.189"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002759"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2019-009703"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n1323"},{"key":"e_1_2_8_18_1","first-page":"1767","volume-title":"Clinical Anaesthesia","author":"Hopf HWC","year":"2013"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1086\/503164"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/123.6.437"},{"key":"e_1_2_8_21_1","unstructured":"RutalaWAW DavidJ.Healthcare Infection Control Practices Advisory Committee (HICPAC). 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