{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:21:29Z","timestamp":1790619689758,"version":"4.1.0"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Gastrointestinal endoscopy is a major contributor of medical waste and greenhouse gas\n        (GHG) emissions. Sustainable waste management practices could help reduce its environmental\n        footprint.<\/jats:p>\n                  <jats:p>A prospective exploratory study was conducted at IRCCS Humanitas Research Hospital from\n        April to June 2023. The intervention included installing recycling bins for paper and\n        plastic in five endoscopy suites, alongside existing regulated medical waste (RMW) and\n        non-regulated medical waste bins. Comprehensive staff training on waste segregation was\n        provided, and a \u201cGreen Endoscopy\u201d nurse monitored compliance during the intervention. Data\n        on RMW, its emissions (in kg carbon dioxide equivalents [CO2e] per procedure), and costs\n        were collected and compared with pre-intervention values.<\/jats:p>\n                  <jats:p>RMW production decreased by 24.1%, from 1.91 kg per procedure (95%CI 1.54\u20132.28) to 1.45\n        kg per procedure (95%CI 1.16\u20131.73; P = 0.02), with sustained reductions during follow-up\n        (1.48 kg per procedure; 95%CI 0.84\u20132.12). The intervention led to a 33.3% reduction in GHG\n        emissions (with a net difference of 1.23 kg CO2e per procedure; P = 0.02), and cost savings\n        of approximately \u20ac3542 (\u00b1384) were achieved. This effect was consistent across different\n        procedure types.<\/jats:p>\n                  <jats:p>Targeted interventions such as staff education and structured waste segregation\n        protocols substantially reduced RMW and associated GHG emissions in a high-volume endoscopy\n        unit. These results suggest that simple, low-cost changes may improve environmental\n        sustainability in clinical practice.<\/jats:p>","DOI":"10.1055\/a-2661-1820","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T22:57:35Z","timestamp":1755644255000},"page":"64-69","source":"Crossref","is-referenced-by-count":6,"title":["Reducing the environmental impact of gastrointestinal endoscopy: a prospective study on waste management through waste segregation and staff education"],"prefix":"10.1055","volume":"58","author":[{"given":"Maddalena","family":"Menini","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Digestive Endoscopy Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta","family":"Crisciotti","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Digestive Endoscopy Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9084-6504","authenticated-orcid":false,"given":"Cesare","family":"Hassan","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Digestive Endoscopy Unit"]},{"name":"Humanitas University, Italy","place":["Milan"],"department":["Department of Biomedical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommy","family":"Rizkala","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Digestive Endoscopy Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Di Stefano","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Digestive Endoscopy Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Spadaccini","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Digestive Endoscopy Unit"]},{"name":"Humanitas University, Italy","place":["Milan"],"department":["Department of Biomedical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Fumagalli","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Digestive Endoscopy Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0485-4903","authenticated-orcid":false,"given":"Alessandro","family":"Fugazza","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Digestive Endoscopy Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Vanni","sequence":"additional","affiliation":[{"name":"Humanitas University, Italy","place":["Milan"],"department":["Department of Biomedical Sciences"]},{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Business Operating Officer"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Oliva","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano, Milan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosaria","family":"Iacovino","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Digestive Endoscopy Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Giordano","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Digestive Endoscopy Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Repici","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Digestive Endoscopy Unit"]},{"name":"Humanitas University, Italy","place":["Milan"],"department":["Department of Biomedical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1016\/S0140-6736(16)32124-9","article-title":"The Lancet Countdown: tracking progress on health and climate change","volume":"389","author":"N Watts","year":"2017","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"crossref","DOI":"10.1088\/1748-9326\/ab19e1","article-title":"International comparison of health care carbon footprints","volume":"14","author":"PP 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