{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T13:06:28Z","timestamp":1773839188637,"version":"3.50.1"},"reference-count":24,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Gut"],"accepted":{"date-parts":[[2022,8,2]]},"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Endoscopy is healthcare\u2019s third largest generator of medical waste in hospitals. This prospective study aimed to measure a single unit\u2019s waste carbon footprint and perform a pioneer intervention towards a more sustainable endoscopy practice. The relation of regulated medical waste (RMW; material fully contaminated with blood or body fluids or containing infectious agents) versus landfill waste (non-recyclable material not fully contaminated) may play a critical role.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>\n                      In a four-stage prospective study, following a 4-week observational audit with daily weighing of both waste types (stage 1), stage 2 consisted of a 1-week intervention with team education of waste handling. Recycling bins were placed in endoscopy rooms, landfill and RMW bins were relocated. During stages 3 (1\u2009month after intervention) and 4 (4\u2009months after intervention), daily endoscopic waste was weighed. Equivalence of 1\u2009kg of landfill waste to 1\u2009kg carbon dioxide equivalent (CO\n                      <jats:sub>2e<\/jats:sub>\n                      ) and 1\u2009kg of RMW to 3kgCO\n                      <jats:sub>2e<\/jats:sub>\n                      was assumed. Paired samples t-tests for comparisons.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From stage 1 to stage 3, mean total waste and RMW were reduced by 12.9% (p=0.155) and 41.4% (p=0.010), respectively, whereas landfill (p=0.059) and recycling waste increased (paper: p=0.001; plastic: p=0.007). While mean endoscopy load was similar (46.2 vs 44.5, p=0.275), a total decrease of CO\n                      <jats:sub>2e<\/jats:sub>\n                      by 31.6% (138.8kgCO\n                      <jats:sub>2e<\/jats:sub>\n                      ) was found (mean kgCO\n                      <jats:sub>2e<\/jats:sub>\n                      109.7 vs 74.9, p=0.018). The annual reduction was calculated at 1665.6kgCO\n                      <jats:sub>2e<\/jats:sub>\n                      . All these effects were sustained 4\u2009months after the intervention (stage 4) without objections by responsible endoscopy personnel.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this interventional study, applying sustainability measures to a real-world scenario, RMW reduction and daily recycling were achieved and sustained over time, without compromising endoscopy productivity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/gutjnl-2022-327005","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T13:28:37Z","timestamp":1660915717000},"page":"306-313","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Targeted intervention to achieve waste reduction in gastrointestinal endoscopy"],"prefix":"10.1136","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8354-1619","authenticated-orcid":false,"given":"Jo\u00e3o A","family":"Cunha Neves","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Algarve University Hospital Centre, Portim\u00e3o, Portugal"},{"name":"ABC\u2014Algarve Biomedical Centre, University of Algarve, Faro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5098-8729","authenticated-orcid":false,"given":"Joana","family":"Roseira","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Algarve University Hospital Centre, Portim\u00e3o, Portugal"},{"name":"ABC\u2014Algarve Biomedical Centre, University of Algarve, Faro, Portugal"}]},{"given":"Patr\u00edcia","family":"Queir\u00f3s","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Algarve University Hospital Centre, Portim\u00e3o, Portugal"},{"name":"ABC\u2014Algarve Biomedical Centre, University of Algarve, Faro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6626-205X","authenticated-orcid":false,"given":"Helena Tavares","family":"Sousa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Algarve University Hospital Centre, Portim\u00e3o, Portugal"},{"name":"ABC\u2014Algarve Biomedical Centre, University of Algarve, Faro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8322-6421","authenticated-orcid":false,"given":"Gianluca","family":"Pellino","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy"},{"name":"Department of Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7353-2425","authenticated-orcid":false,"given":"Miguel F","family":"Cunha","sequence":"additional","affiliation":[{"name":"ABC\u2014Algarve Biomedical Centre, University of Algarve, Faro, Portugal"},{"name":"Colorectal Disease Group\u2014Department of General Surgery, Algarve University Hospital Centre, Portim\u00e3o, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2022,8,19]]},"reference":[{"key":"2025121308592462000_72.2.306.1","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.tige.2021.06.005","article-title":"Endoscopy\u2019s Current Carbon Footprint","volume":"23","author":"Siau","year":"2021","journal-title":"Tech Innov Gastrointest Endosc"},{"key":"2025121308592462000_72.2.306.2","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1177\/0734242X17739968","article-title":"Costs associated with the management of waste from healthcare facilities: an analysis at national and site level","volume":"36","author":"Vaccari","year":"2018","journal-title":"Waste Manag Res"},{"key":"2025121308592462000_72.2.306.3","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1016\/S2468-1253(20)30157-6","article-title":"Green endoscopy: a 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