{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T07:41:44Z","timestamp":1792222904631,"version":"4.4.0"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Gastrointestinal endoscopy is resource\u2010intensive, but no carbon footprint data have been reported from a Japanese facility, and published estimates differ widely in system boundary. We quantified the operational carbon footprint of an endoscopy unit at a Japanese regional hospital and identified which emission sources are amenable to unit\u2010level intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective single\u2010center study, we analyzed 794 consecutive procedures performed over 5\u2009months at a 150\u2010bed regional public hospital. Emissions from electricity, patient travel, medical waste, consumables, reprocessing chemicals, medical gas, and water were estimated according to the Greenhouse Gas Protocol using Japanese national emission factors and published life\u2010cycle data. Patient travel was aggregated at the procedure level under two scenarios: procedure\u2010day travel only (Scenario A) and visit\u2010count\u2010corrected travel (Scenario B). Sensitivity analyses addressed transport mode, air\u2010conditioning load factor, and waste composition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The operational carbon footprint was 6537.5\u2009kg CO\n                      <jats:sub>2<\/jats:sub>\n                      e (CO\n                      <jats:sub>2<\/jats:sub>\n                      e) (8.23\u2009kg CO\n                      <jats:sub>2<\/jats:sub>\n                      e per procedure) in Scenario A and 8042.1\u2009kg CO\n                      <jats:sub>2<\/jats:sub>\n                      e (10.13\u2009kg CO\n                      <jats:sub>2<\/jats:sub>\n                      e per procedure) in Scenario B. In Scenario B, electricity was the largest source (38.8%), followed by patient travel (35.3%) and medical waste (13.5%). Air conditioning accounted for 69.3% of electricity use. Waste generation was 0.80\u2009kg per procedure, of which suction fluid bags represented 36.7%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Electricity, dominated by air conditioning, was the largest operational emission source and is directly modifiable by the unit. Patient travel was of comparable magnitude but reflects healthcare access geography rather than endoscopic practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.70827","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T07:14:27Z","timestamp":1792221267000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Operational Carbon Footprint of a Gastrointestinal Endoscopy Unit at a Regional Hospital in Japan"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1250-6012","authenticated-orcid":false,"given":"Shintaro","family":"Fujihara","sequence":"first","affiliation":[{"name":"Departments of Gastroenterology and Neurology, Faculty of Medicine Kagawa University  Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8508-827X","authenticated-orcid":false,"given":"Hideki","family":"Kobara","sequence":"additional","affiliation":[{"name":"Departments of Gastroenterology and Neurology, Faculty of Medicine Kagawa University  Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2641-4995","authenticated-orcid":false,"given":"Atsushi","family":"Imagawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Imagawa Medical Clinic  Mitoyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3707-9317","authenticated-orcid":false,"given":"Noriko","family":"Nishiyama","sequence":"additional","affiliation":[{"name":"Departments of Gastroenterology and Neurology, Faculty of Medicine Kagawa University  Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruo","family":"Oba","sequence":"additional","affiliation":[{"name":"Department of Engineering and Design Kagawa University  Takamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Team Green K (Green Endoscopy for Earth Neo\u2010Kagawa)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-078464","article-title":"Carbon Footprint of Healthcare Systems: A Systematic Review of Evidence and Methods","volume":"14","author":"Keil M.","year":"2024","journal-title":"BMJ Open"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"E968","DOI":"10.1055\/a-2303-8621","article-title":"Green Endoscopy, One Step Toward a Sustainable Future: Literature Review","volume":"12","author":"Maida M.","year":"2024","journal-title":"Endosc Int Open"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1055\/a-2739-4080","article-title":"Environmental Footprint of Gastrointestinal Endoscopy Services: A Systematic Review","volume":"58","author":"Vegting B.","year":"2026","journal-title":"Endoscopy"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"493","DOI":"10.5946\/ce.2024.332","article-title":"Current Status and Trends of Green Endoscopy","volume":"58","author":"Ryu K.","year":"2025","journal-title":"Clin Endosc"},{"key":"e_1_2_10_6_1","first-page":"1","article-title":"A Definition of 'Carbon Footprint'","volume":"1","author":"Wiedmann T.","year":"2008","journal-title":"Ecological Economics Research Trends"},{"key":"e_1_2_10_7_1","volume-title":"Greenhouse Gas Protocol: Corporate Accounting and Reporting Standard","author":"World Resources Institute","year":"2004"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.m3785","article-title":"A Pathway to Net Zero Emissions for Healthcare","volume":"371","author":"Salas R. 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