{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:54:06Z","timestamp":1785524046127,"version":"3.56.0"},"reference-count":80,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Glob. Public Health"],"DOI":"10.1186\/s44263-026-00303-9","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T12:46:05Z","timestamp":1785242765000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reducing healthcare emissions in the United States in the era of federal environmental deregulation: established and emerging mitigation opportunities and concomitant benefits"],"prefix":"10.1186","volume":"4","author":[{"given":"Erica","family":"Mascarenhas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluseyi A.","family":"Fayanju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Chen","family":"Arroyo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyothi","family":"Tirumalasetty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"303_CR1","doi-asserted-by":"publisher","first-page":"2071","DOI":"10.1377\/hlthaff.2020.01247","volume":"39","author":"MJ Eckelman","year":"2020","unstructured":"Eckelman MJ, Huang K, Lagasse R, Senay E, Dubrow R, Sherman JD. Health care pollution and public health damage in the United States: an update: study examines health care pollution and public health damage in the United States. Health Aff (Millwood). 2020;39:2071\u20139. https:\/\/doi.org\/10.1377\/hlthaff.2020.01247","journal-title":"Health Aff (Millwood)"},{"key":"303_CR2","doi-asserted-by":"publisher","first-page":"2804","DOI":"10.1016\/S0140-6736(25)01919-1","volume":"406","author":"M Romanello","year":"2025","unstructured":"Romanello M, Walawender M, Hsu SC, Moskeland A, Palmeiro-Silva Y, Scamman D, et al. The 2025 report of the Lancet Countdown on health and climate change: climate change action offers a lifeline. The Lancet. 2025;406:2804\u201357. https:\/\/doi.org\/10.1016\/S0140-6736(25)01919-1","journal-title":"The Lancet"},{"key":"303_CR3","doi-asserted-by":"publisher","first-page":"m3785","DOI":"10.1136\/bmj.m3785","volume":"371","author":"RN Salas","year":"2020","unstructured":"Salas RN, Maibach E, Pencheon D, Watts N, Frumkin H. A pathway to net zero emissions for healthcare. BMJ. 2020;371:m3785 https:\/\/doi.org\/10.1136\/bmj.m3785","journal-title":"BMJ"},{"key":"303_CR4","unstructured":"The White House. 2022 [cited 2026 May 13]. FACT SHEET: Health Sector Leaders Join Biden Administration\u2019s Pledge to Reduce Greenhouse Gas Emissions 50% by 2030. https:\/\/bidenwhitehouse.archives.gov\/briefing-room\/statements-releases\/2022\/06\/30\/fact-sheet-health-sector-leaders-join-biden-administrations-pledge-to-reduce-greenhouse-gas-emissions-50-by-2030\/#:%E2%88%BC:text=The%20Biden-Harris%20Administration%20launched"},{"key":"303_CR5","doi-asserted-by":"publisher","first-page":"1461","DOI":"10.1056\/NEJMp2514370","volume":"394","author":"AW Gaffney","year":"2026","unstructured":"Gaffney AW, Himmelstein D, Woolhandler S, Sehdev S, Landrigan PJ. The dismantling of environmental protections - a grave threat to America\u2019s health. N Engl J Med. 2026;394:1461\u20135. https:\/\/doi.org\/10.1056\/NEJMp2514370","journal-title":"N Engl J Med"},{"key":"303_CR6","doi-asserted-by":"publisher","first-page":"e2434942","DOI":"10.1001\/jamanetworkopen.2024.34942","volume":"7","author":"SAM Khatana","year":"2024","unstructured":"Khatana SAM, Szeto JJ, Eberly LA, Nathan AS, Puvvula J, Chen A. Projections of extreme temperature-related deaths in the US. JAMA Netw Open. 2024;7:e2434942 https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.34942","journal-title":"JAMA Netw Open"},{"key":"303_CR7","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1513\/AnnalsATS.202405-470OC","volume":"22","author":"CR O\u2019Lenick","year":"2025","unstructured":"O\u2019Lenick CR, Cleland SE, Neas LM, Turner MW, Mcinroe EM, Hill KL, et al. Impact of heat on respiratory hospitalizations among older adults in 120 Large U.S. Urban areas. Ann Am Thorac Soc. 2025;22:367\u201377. https:\/\/doi.org\/10.1513\/AnnalsATS.202405-470OC","journal-title":"Ann Am Thorac Soc"},{"key":"303_CR8","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1001\/jama.2024.27274","volume":"333","author":"PS Lee","year":"2025","unstructured":"Lee PS, Swain DL, Johnson R. Climate change and coccidioidomycosis. JAMA. 2025;333:997\u20138. https:\/\/doi.org\/10.1001\/jama.2024.27274","journal-title":"JAMA"},{"key":"303_CR9","doi-asserted-by":"publisher","first-page":"1346","DOI":"10.1016\/j.chest.2020.10.053","volume":"159","author":"PE Pfeffer","year":"2021","unstructured":"Pfeffer PE, Mudway IS, Grigg J. Air pollution and asthma: mechanisms of harm and considerations for clinical interventions. Chest. 2021;159:1346\u201355. https:\/\/doi.org\/10.1016\/j.chest.2020.10.053","journal-title":"Chest"},{"key":"303_CR10","doi-asserted-by":"publisher","first-page":"e124","DOI":"10.1016\/S2542-5196(19)30015-4","volume":"3","author":"LH Ziska","year":"2019","unstructured":"Ziska LH, Makra L, Harry SK, Bruffaerts N, Hendrickx M, Coates F, et al. Temperature-related changes in airborne allergenic pollen abundance and seasonality across the northern hemisphere: a retrospective data analysis. Lancet Planet Health. 2019;3:e124\u201331. https:\/\/doi.org\/10.1016\/S2542-5196(19)30015-4","journal-title":"Lancet Planet Health"},{"key":"303_CR11","doi-asserted-by":"publisher","first-page":"667","DOI":"10.5863\/1551-6776-29.6.667","volume":"29","author":"D Aguero","year":"2024","unstructured":"Aguero D, Allen D. Weathering the storm: commentary on the hurricane helene IV fluid shortage. J Pediatr Pharmacol Ther JPPT Off J PPAG. 2024;29:667\u20139. https:\/\/doi.org\/10.5863\/1551-6776-29.6.667","journal-title":"J Pediatr Pharmacol Ther JPPT Off J PPAG"},{"key":"303_CR12","doi-asserted-by":"publisher","unstructured":"Calvin K, Dasgupta D, Krinner G, Mukherji A, Thorne PW, Trisos C, et al. IPCC, 2023: climate change 2023: synthesis report. Contribution of Working Groups I, II and III to the sixth assessment report of the intergovernmental panel on climate change [Core Writing Team, H. Lee and J. Romero (eds.)]. IPCC, Geneva, Switzerland. First. Arias P, Bustamante M, Elgizouli I, Flato G, Howden M, M\u00e9ndez-Vallejo C, et al., editors. Intergovernmental Panel on Climate Change (IPCC); 2023 Jul [cited 2026 May 10]. https:\/\/www.ipcc.ch\/report\/ar6\/syr\/. https:\/\/doi.org\/10.59327\/IPCC\/AR6-9789291691647","DOI":"10.59327\/IPCC\/AR6-9789291691647"},{"key":"303_CR13","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2025.179692","volume":"982","author":"D Rojas-Rueda","year":"2025","unstructured":"Rojas-Rueda D. Green hospitals: maximizing health and climate benefits globally. Sci Total Environ. 2025;982:179692 https:\/\/doi.org\/10.1016\/j.scitotenv.2025.179692","journal-title":"Sci Total Environ"},{"key":"303_CR14","doi-asserted-by":"publisher","first-page":"e778","DOI":"10.1016\/S2542-5196(24)00206-7","volume":"8","author":"IM Blom","year":"2024","unstructured":"Blom IM, Rasheed FN, Singh H, Eckelman MJ, Dhimal M, Hensher M, et al. Evaluating progress and accountability for achieving COP26 Health Programme international ambitions for sustainable, low-carbon, resilient health-care systems. Lancet Planet Health. 2024;8:e778\u201389. https:\/\/doi.org\/10.1016\/S2542-5196(24)00206-7","journal-title":"Lancet Planet Health"},{"key":"303_CR15","unstructured":"Operational framework for building climate resilient and low carbon health systems. Geneva: World Health Organization; 2023. https:\/\/www.who.int\/publications\/i\/item\/9789240081888"},{"key":"303_CR16","unstructured":"Lancet Commission on Sustainable Healthcare (LCSH). Yale center on climate change and health. [cited 2025 Jul 27]. https:\/\/ysph.yale.edu\/yale-center-on-climate-change-and-health\/healthcare-sustainability-and-public-health\/lancet-commission-on-sustainable-health-care\/"},{"key":"303_CR17","doi-asserted-by":"publisher","first-page":"2469","DOI":"10.1056\/NEJMsb2210022","volume":"387","author":"H Singh","year":"2022","unstructured":"Singh H, Eckelman M, Berwick DM, Sherman JD. Mandatory reporting of emissions to achieve net-zero health care. N Engl J Med. 2022;387:2469\u201376. https:\/\/doi.org\/10.1056\/NEJMsb2210022","journal-title":"N Engl J Med"},{"key":"303_CR18","unstructured":"Sampath B, Jensen M, Lenoci-Edwards J, Singh H, Sherman JD Reducing healthcare carbon emissions: a primer on measures and actions for healthcare organizations to mitigate climate change. 2024 [cited 2025 Nov 8]. https:\/\/web.archive.org\/web\/20241206140804\/https:\/\/www.ahrq.gov\/sites\/default\/files\/wysiwyg\/healthsystemsresearch\/decarbonization\/decarbonization.pdf"},{"key":"303_CR19","doi-asserted-by":"publisher","unstructured":"Vernon W, Guttmann S Regulatory agenda: addressing greenhouse gas emissions from health care building energy use. NAM Perspect. 2025;4. https:\/\/doi.org\/10.31478\/202504b","DOI":"10.31478\/202504b"},{"key":"303_CR20","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1001\/jama.2019.10823","volume":"322","author":"JD Sherman","year":"2019","unstructured":"Sherman JD, MacNeill A, Thiel C. Reducing pollution from the health care industry. JAMA. 2019;322:1043 https:\/\/doi.org\/10.1001\/jama.2019.10823","journal-title":"JAMA"},{"key":"303_CR21","doi-asserted-by":"publisher","first-page":"5","DOI":"10.4103\/0259-1162.84171","volume":"5","author":"H Gadani","year":"2011","unstructured":"Gadani H, Vyas A. Anesthetic gases and global warming: potentials, prevention and future of anesthesia. Anesth Essays Res. 2011;5:5 https:\/\/doi.org\/10.4103\/0259-1162.84171","journal-title":"Anesth Essays Res"},{"key":"303_CR22","doi-asserted-by":"publisher","first-page":"1548","DOI":"10.3390\/ijerph21121548","volume":"21","author":"J Wang","year":"2024","unstructured":"Wang J, DasSarma S. Contributions of medical greenhouse gases to climate change and their possible alternatives. Int J Environ Res Public Health. 2024;21:1548 https:\/\/doi.org\/10.3390\/ijerph21121548","journal-title":"Int J Environ Res Public Health"},{"key":"303_CR23","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1111\/anae.16221","volume":"79","author":"M Bernat","year":"2024","unstructured":"Bernat M, Boyer A, Roche M, Richard C, Bouvet L, Remacle A, et al. Reducing the carbon footprint of general anaesthesia: a comparison of total intravenous anaesthesia vs. a mixed anaesthetic strategy in 47,157 adult patients. Anaesthesia. 2024;79:309\u201317. https:\/\/doi.org\/10.1111\/anae.16221","journal-title":"Anaesthesia"},{"key":"303_CR24","doi-asserted-by":"publisher","first-page":"9157","DOI":"10.34172\/ijhpm.9157","volume":"14","author":"R Wu","year":"2025","unstructured":"Wu R, Liang Y. Ways to build a greener healthcare system comment on \u201cA Review of the Applicability of Current Green Practices in Healthcare Facilities\u201d. Int J Health Policy Manag. 2025;14:9157 https:\/\/doi.org\/10.34172\/ijhpm.9157","journal-title":"Int J Health Policy Manag"},{"key":"303_CR25","unstructured":"Cleveland clinic: establishing green revolving funds in healthcare | better buildings initiative. [cited 2025 Nov 8]. https:\/\/betterbuildingssolutioncenter.energy.gov\/resources\/cleveland-clinic-establishing-green-revolving-funds-healthcare"},{"key":"303_CR26","unstructured":"Intermountain Health celebrates opening of massive solar farm to supply green energy to hospitals & clinics for decades to come. [cited 2025 Nov 8]. Intermountain Health Celebrates Opening of Massive Solar Farm to Supply Green Energy to Hospitals & Clinics for Decades to Come. https:\/\/news.intermountainhealth.org\/intermountain-health-celebrates-opening-of-massive-solar-farm-that-will-supply-green-energy-to-utah-hospitals-and-clinics-for-decades-to-come\/"},{"key":"303_CR27","doi-asserted-by":"publisher","unstructured":"Lee VS, Gerwig K, Hough E, Mate K, Biggio R, Kaplan RS Decarbonizing health care: engaging leaders in change. NEJM Catal. 2023;4. https:\/\/doi.org\/10.1056\/CAT.22.0433","DOI":"10.1056\/CAT.22.0433"},{"key":"303_CR28","unstructured":"NHS England. 2022 [cited 2026 May 10]. Delivering a \u201cNet Zero\u201d national health service. https:\/\/www.england.nhs.uk\/greenernhs\/a-net-zero-nhs\/"},{"key":"303_CR29","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1177\/08404704241258152","volume":"37","author":"DCT Lavoie","year":"2024","unstructured":"Lavoie DCT, Maraj A, Wong GYC, Parascandalo F, Sergeant M. Healthcare procurement in the race to net-zero: practical steps for healthcare leadership. Healthc Manage Forum. 2024;37:384\u20139. https:\/\/doi.org\/10.1177\/08404704241258152","journal-title":"Healthc Manage Forum"},{"key":"303_CR30","doi-asserted-by":"publisher","unstructured":"Singh H, Vernon W, Scannell T, Gerwig K Crossing the decarbonization chasm: a call to action for hospital and health system leaders to reduce their greenhouse gas emissions. NAM Perspect. 2023;2023. https:\/\/doi.org\/10.31478\/202311g","DOI":"10.31478\/202311g"},{"key":"303_CR31","doi-asserted-by":"publisher","first-page":"E986","DOI":"10.1001\/amajethics.2022.986","volume":"24","author":"N Jain","year":"2022","unstructured":"Jain N, LaBeaud D. How should US health care lead global change in plastic waste disposal? AMA J Ethics. 2022;24:E986\u2013993. https:\/\/doi.org\/10.1001\/amajethics.2022.986","journal-title":"AMA J Ethics"},{"key":"303_CR32","unstructured":"sustainabilityadmin. The health care industry must address its pollution problem. Sustainability Annual Report 2024. 2024 Oct 1 [cited 2025 Nov 8]. https:\/\/dev-sustainabilityreport-multi.pantheonsite.io\/2024\/2024\/10\/01\/the-health-care-industry-must-address-its-pollution-problem\/"},{"key":"303_CR33","doi-asserted-by":"publisher","DOI":"10.1016\/j.resconrec.2025.108317","volume":"219","author":"N Silva de Souza Lima Cano","year":"2025","unstructured":"Silva de Souza Lima Cano N, Marino M, Brooks AL, Eckelman MJ, Bilec MM. Advancing the circular economy of healthcare plastics: a systematic literature review. Resour Conserv Recycl. 2025;219:108317 https:\/\/doi.org\/10.1016\/j.resconrec.2025.108317","journal-title":"Resour Conserv Recycl"},{"key":"303_CR34","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1016\/j.ajic.2020.10.013","volume":"49","author":"M McQuerry","year":"2021","unstructured":"McQuerry M, Easter E, Cao A. Disposable versus reusable medical gowns: a performance comparison. Am J Infect Control. 2021;49:563\u201370. https:\/\/doi.org\/10.1016\/j.ajic.2020.10.013","journal-title":"Am J Infect Control"},{"key":"303_CR35","doi-asserted-by":"publisher","first-page":"e196","DOI":"10.1016\/S2542-5196(25)00028-2","volume":"9","author":"RH Hagenaars","year":"2025","unstructured":"Hagenaars RH, Heijungs R, De Koning A, Tukker A, Wang R. The greenhouse gas emissions of pharmaceutical consumption and production: an input\u2013output analysis over time and across global supply chains. Lancet Planet Health. 2025;9:e196\u2013206. https:\/\/doi.org\/10.1016\/S2542-5196(25)00028-2","journal-title":"Lancet Planet Health"},{"key":"303_CR36","doi-asserted-by":"publisher","first-page":"760","DOI":"10.3390\/su17020760","volume":"17","author":"B Ashworth","year":"2025","unstructured":"Ashworth B, Du Plessis MJ, Goedhals-Gerber LL, Van Eeden J. The carbon footprint of pharmaceutical logistics: calculating distribution emissions. Sustainability. 2025;17:760 https:\/\/doi.org\/10.3390\/su17020760","journal-title":"Sustainability"},{"key":"303_CR37","doi-asserted-by":"publisher","first-page":"173","DOI":"10.3390\/pharmacy12060173","volume":"12","author":"G Parker","year":"2024","unstructured":"Parker G, Miller FA. Tackling pharmaceutical pollution along the product lifecycle: roles and responsibilities for producers, regulators and prescribers. Pharmacy. 2024;12:173 https:\/\/doi.org\/10.3390\/pharmacy12060173","journal-title":"Pharmacy"},{"key":"303_CR38","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1001\/jama.2024.15331","volume":"332","author":"J Tirumalasetty","year":"2024","unstructured":"Tirumalasetty J, Miller SA, Prescott HC, DeTata S, Arroyo AC, Wilkinson AJK, et al. Greenhouse gas emissions and costs of inhaler devices in the US. JAMA. 2024;332:1017\u20139. https:\/\/doi.org\/10.1001\/jama.2024.15331","journal-title":"JAMA"},{"key":"303_CR39","doi-asserted-by":"publisher","first-page":"3043","DOI":"10.2147\/DDDT.S262141","volume":"14","author":"JN Pritchard","year":"2020","unstructured":"Pritchard JN. The climate is changing for metered-dose inhalers and action is needed. Drug Des Devel Ther. 2020;14:3043\u201355. https:\/\/doi.org\/10.2147\/DDDT.S262141","journal-title":"Drug Des Devel Ther"},{"key":"303_CR40","doi-asserted-by":"publisher","first-page":"1638","DOI":"10.1001\/jama.2025.16524","volume":"334","author":"WB Feldman","year":"2025","unstructured":"Feldman WB, Han J, Raymakers AJN, Furie GL, Chesebro BB. Inhaler-Related greenhouse gas emissions in the US: A serial cross-sectional analysis. JAMA. 2025;334:1638\u201349. https:\/\/doi.org\/10.1001\/jama.2025.16524","journal-title":"JAMA"},{"key":"303_CR41","unstructured":"Chiesi. 2025 [cited 2026 May 4]. Take Action for Inhaler Recycling (AIR). https:\/\/www.chiesi.uk.com\/collaboration\/our-projects\/take-action-for-inhaler-recycling"},{"key":"303_CR42","doi-asserted-by":"publisher","unstructured":"The Pharmaceutical Journal. 2021 [cited 2026 May 4]. First reusable, propellant-free inhaler launched to cut plastic waste. https:\/\/pharmaceutical-journal.com\/article\/news\/first-reusable-propellant-free-inhaler-launched-to-cut-plastic-waste. https:\/\/doi.org\/10.1211\/PJ.2019.20207067","DOI":"10.1211\/PJ.2019.20207067"},{"key":"303_CR43","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1200\/OP-24-00804","volume":"21","author":"M Zietse","year":"2025","unstructured":"Zietse M, Kooijman T, Malmberg R, Spierings LEAMM, Jager A, Mathijssen RHJ, et al. Environmental impact assessment of intravenous versus subcutaneous monoclonal antibodies: a carbon footprint analysis. JCO Oncol Pract. 2025;21:1287\u201395. https:\/\/doi.org\/10.1200\/OP-24-00804","journal-title":"JCO Oncol Pract"},{"key":"303_CR44","doi-asserted-by":"publisher","first-page":"r2495","DOI":"10.1136\/bmj.r2495","volume":"392","author":"M Adey","year":"2026","unstructured":"Adey M. Weight loss drug waste: what happens to the Ozempic pens? BMJ. 2026;392:r2495 https:\/\/doi.org\/10.1136\/bmj.r2495","journal-title":"BMJ"},{"key":"303_CR45","unstructured":"Novo Nordisk. [cited 2026 May 4]. ReMed: Recycling used devices. https:\/\/www.novonordisk.com\/sustainable-business\/zero-environmental-impact\/recycling-used-devices.html"},{"key":"303_CR46","unstructured":"Novo Nordisk. 2025 [cited 2026 May 13]. Novo Nordisk A\/S: Wegovy\u00ae pill approved in the US as first oral GLP-1 for weight management. https:\/\/www.novonordisk.com\/content\/nncorp\/global\/en\/news-and-media\/news-and-ir-materials\/news-details.html?id=916472"},{"key":"303_CR47","unstructured":"Emissions Mitigation. Sustainable Stanford. [cited 2025 Nov 8]. https:\/\/sustainable.stanford.edu\/progress\/climate-action\/emissions-mitigation\/"},{"key":"303_CR48","unstructured":"Hegwer LR Hospitals save when they reduce food waste. HFMA. 2019 May 27 [cited 2025 Nov 7]. https:\/\/www.hfma.org\/operations-management\/cost-reduction\/hospitals-save-when-they-reduce-food-waste\/"},{"key":"303_CR49","unstructured":"Chapter 446d - Solid waste management. [cited 2025 Nov 9]. https:\/\/www.cga.ct.gov\/current\/pub\/chap_446d.htm"},{"key":"303_CR50","unstructured":"CT.gov - Connecticut\u2019s Official State Website. [cited 2025 Nov 9]. Commercial Organics Recycling Law. https:\/\/portal.ct.gov\/deep\/waste-management-and-disposal\/organics-recycling\/commercial-organics-recycling-law"},{"key":"303_CR51","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2024.105053","volume":"143","author":"Z Or","year":"2024","unstructured":"Or Z, Sepp\u00e4nen AV. The role of the health sector in tackling climate change: a narrative review. Health Policy. 2024;143:105053 https:\/\/doi.org\/10.1016\/j.healthpol.2024.105053","journal-title":"Health Policy"},{"key":"303_CR52","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1038\/s41746-023-00818-7","volume":"6","author":"CL Thiel","year":"2023","unstructured":"Thiel CL, Mehta N, Sejo CS, Qureshi L, Moyer M, Valentino V, et al. Telemedicine and the environment: life cycle environmental emissions from in-person and virtual clinic visits. NPJ Digit Med. 2023;6:87 https:\/\/doi.org\/10.1038\/s41746-023-00818-7","journal-title":"NPJ Digit Med"},{"key":"303_CR53","unstructured":"US EPA. 2024 [cited 2026 Jan 26]. Greenhouse Gas Equivalencies Calculator. https:\/\/www.epa.gov\/energy\/greenhouse-gas-equivalencies-calculator"},{"key":"303_CR54","doi-asserted-by":"publisher","first-page":"e2237545","DOI":"10.1001\/jamanetworkopen.2022.37545","volume":"5","author":"B Welk","year":"2022","unstructured":"Welk B, McArthur E, Zorzi AP. Association of virtual care expansion with environmental sustainability and reduced patient costs during the COVID-19 pandemic in Ontario, Canada. JAMA Netw Open. 2022;5:e2237545 https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.37545","journal-title":"JAMA Netw Open"},{"key":"303_CR55","doi-asserted-by":"publisher","first-page":"331","DOI":"10.3390\/healthcare14030331","volume":"14","author":"J Kim","year":"2026","unstructured":"Kim J, Bailey EV, Hayworth S, Illapperuma-Wood C, Weir R, Fischer A, et al. National trends in telehealth utilization, 2020-2023: post-pandemic trends from the medical expenditure panel survey. Healthcare. 2026;14:331 https:\/\/doi.org\/10.3390\/healthcare14030331","journal-title":"Healthcare"},{"key":"303_CR56","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1002\/hcs2.70033","volume":"4","author":"J Labadorf","year":"2025","unstructured":"Labadorf J, Nichols M, Williams T, Cunanan C, D\u2019Anza B. A smartphone is not enough: telehealth attendance and the digital divide. Health Care Sci. 2025;4:259\u201368. https:\/\/doi.org\/10.1002\/hcs2.70033","journal-title":"Health Care Sci"},{"key":"303_CR57","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2025.1508686","volume":"7","author":"LA Hollimon","year":"2025","unstructured":"Hollimon LA, Taylor KV, Fiegenbaum R, Carrasco M, Garchitorena Gomez L, Chung D, et al. Redefining and solving the digital divide and exclusion to improve healthcare: going beyond access to include availability, adequacy, acceptability, and affordability. Front Digit Health. 2025;7:1508686 https:\/\/doi.org\/10.3389\/fdgth.2025.1508686","journal-title":"Front Digit Health"},{"key":"303_CR58","doi-asserted-by":"publisher","first-page":"1758","DOI":"10.4269\/ajtmh.20-1013","volume":"103","author":"T Bousema","year":"2020","unstructured":"Bousema T, Selvaraj P, Djimde AA, Yakar D, Hagedorn B, Pratt A, et al. Reducing the carbon footprint of academic conferences: the example of the American Society of tropical medicine and hygiene. Am J Trop Med Hyg. 2020;103:1758\u201361. https:\/\/doi.org\/10.4269\/ajtmh.20-1013","journal-title":"Am J Trop Med Hyg"},{"key":"303_CR59","doi-asserted-by":"publisher","DOI":"10.1200\/GO.23.00209","volume":"10","author":"KE Lichter","year":"2024","unstructured":"Lichter KE, Sabbagh A, Demeulenaere S, Drew T, Conway A, Nogueira L, et al. Reducing the environmental impact of health care conferences: a study of emissions and practical solutions. JCO Glob Oncol. 2024;10:e2300209 https:\/\/doi.org\/10.1200\/GO.23.00209","journal-title":"JCO Glob Oncol"},{"key":"303_CR60","doi-asserted-by":"publisher","first-page":"e2035641","DOI":"10.1001\/jamanetworkopen.2020.35641","volume":"4","author":"JR Wortzel","year":"2021","unstructured":"Wortzel JR, Stashevsky A, Wortzel JD, Mark B, Lewis J, Haase E. Estimation of the carbon footprint associated with attendees of the American Psychiatric Association Annual Meeting. JAMA Netw Open. 2021;4:e2035641 https:\/\/doi.org\/10.1001\/jamanetworkopen.2020.35641","journal-title":"JAMA Netw Open"},{"key":"303_CR61","doi-asserted-by":"publisher","DOI":"10.1186\/s13561-025-00704-w","volume":"15","author":"E Bignami","year":"2025","unstructured":"Bignami E, Darhour LJ, Bellini V. Sustainable AI in medicine: navigating innovation, challenges, and environmental impact. Health Econ Rev. 2025;15:110 https:\/\/doi.org\/10.1186\/s13561-025-00704-w","journal-title":"Health Econ Rev"},{"key":"303_CR62","doi-asserted-by":"publisher","unstructured":"Ramachandran A, Sarabu C, Gupta U, Ghose S, Lee VS Sustainably advancing health AI: a decision framework to mitigate the energy, emissions, and cost of AI implementation. NEJM Catal. 2025;6. https:\/\/doi.org\/10.1056\/CAT.25.0125","DOI":"10.1056\/CAT.25.0125"},{"key":"303_CR63","doi-asserted-by":"publisher","unstructured":"Senay E, Cort T, Perkison W, Laestadius JG, Sherman JD What can hospitals learn from the coca-cola company? Health care sustainability reporting. NEJM Catal. 2022;3. https:\/\/doi.org\/10.1056\/CAT.21.0362","DOI":"10.1056\/CAT.21.0362"},{"key":"303_CR64","doi-asserted-by":"publisher","unstructured":"Abel A, McCannon J, Boyden H, Keroack J, Lichter K, Bole A, et al. Emissions disclosures and energy use reporting by hospitals in the United States. NAM Perspect. 2024;2024. https:\/\/doi.org\/10.31478\/202411c","DOI":"10.31478\/202411c"},{"key":"303_CR65","doi-asserted-by":"publisher","first-page":"28","DOI":"10.4300\/JGME-D-24-00067.1","volume":"16","author":"S Vedak","year":"2024","unstructured":"Vedak S, DeTata SR, Sarabu C, Leitner S, Outterson R, Li R, et al. The VITALS framework: empowering programs to leverage health information technology for trainee-led health care decarbonization and climate adaptation. J Grad Med Educ. 2024;16:28\u201334. https:\/\/doi.org\/10.4300\/JGME-D-24-00067.1","journal-title":"J Grad Med Educ"},{"key":"303_CR66","unstructured":"Karliner J, Roschnik S, Boyd R, Ashby B, Steele K Health care without harm. 2021 [cited 2025 Nov 6]. Global road map for health care decarbonization. https:\/\/healthcareclimateaction.org\/roadmap"},{"key":"303_CR67","doi-asserted-by":"publisher","first-page":"e253326","DOI":"10.1001\/jamanetworkopen.2025.3326","volume":"8","author":"YS Jung","year":"2025","unstructured":"Jung YS, Johnson MM, Burke M, Heft-Neal S, Bondy ML, Chinthrajah RS, et al. Fine particulate matter from 2020 california wildfires and mental health-related emergency department visits. JAMA Netw Open. 2025;8:e253326 https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.3326","journal-title":"JAMA Netw Open"},{"key":"303_CR68","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.563358","volume":"8","author":"CL Gallagher","year":"2020","unstructured":"Gallagher CL, Holloway T. Integrating air quality and public health benefits in U.S. decarbonization strategies. Front Public Health. 2020;8:563358 https:\/\/doi.org\/10.3389\/fpubh.2020.563358","journal-title":"Front Public Health"},{"key":"303_CR69","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1007\/s11524-025-00972-1","volume":"102","author":"M Hussain","year":"2025","unstructured":"Hussain M, Khan N, Morton G, Kieffer E, Kurth A. From vulnerability to strength: transforming health systems for climate resilience. J Urban Health Bull N Y Acad Med. 2025;102:680\u201391. https:\/\/doi.org\/10.1007\/s11524-025-00972-1","journal-title":"J Urban Health Bull N Y Acad Med"},{"key":"303_CR70","doi-asserted-by":"publisher","first-page":"88","DOI":"10.7861\/futurehosp.5-2-88","volume":"5","author":"F Mortimer","year":"2018","unstructured":"Mortimer F, Isherwood J, Wilkinson A, Vaux E. Sustainability in quality improvement: redefining value. Future Healthc J. 2018;5:88\u201393. https:\/\/doi.org\/10.7861\/futurehosp.5-2-88","journal-title":"Future Healthc J"},{"key":"303_CR71","doi-asserted-by":"publisher","first-page":"2","DOI":"10.3390\/greenhealth2010002","volume":"2","author":"T Scott","year":"2026","unstructured":"Scott T, Corsi P, Williams AA. Leveraging publicly accessible sustainability tools to quantify health and climate benefits of hospital climate change mitigation strategies. Green Health. 2026;2:2 https:\/\/doi.org\/10.3390\/greenhealth2010002","journal-title":"Green Health"},{"key":"303_CR72","doi-asserted-by":"publisher","first-page":"e59790","DOI":"10.2196\/59790","volume":"7","author":"NK Stachura","year":"2024","unstructured":"Stachura NK, Brar SK, Davidson J, Wilson CA, Dann C, Apostol M, et al. Exploring the knowledge, attitudes, and perceptions of hospital staff and patients on environmental sustainability in the operating room: quality improvement survey study. JMIR Perioper Med. 2024;7:e59790 https:\/\/doi.org\/10.2196\/59790","journal-title":"JMIR Perioper Med"},{"key":"303_CR73","doi-asserted-by":"publisher","unstructured":"U.S. Health Care Workers Want Their Employers to Address Climate Change. 2024 [cited 2025 Nov 8]. https:\/\/www.commonwealthfund.org\/publications\/issue-briefs\/2024\/jan\/us-health-care-workers-want-employers-address-climate-change. https:\/\/doi.org\/10.26099\/j1ra-t957","DOI":"10.26099\/j1ra-t957"},{"key":"303_CR74","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1038\/d41586-025-03618-z","volume":"647","author":"J Tollefson","year":"2025","unstructured":"Tollefson J. Global greenhouse-gas emissions are still rising: when will they peak? Nature. 2025;647:831\u20132. https:\/\/doi.org\/10.1038\/d41586-025-03618-z","journal-title":"Nature"},{"key":"303_CR75","doi-asserted-by":"publisher","unstructured":"European Commission. Joint Research Centre. GHG emissions of all world countries: 2025. LU: Publications Office; 2025 [cited 2026 May 12]. https:\/\/data.europa.eu\/doi\/10.2760\/9816914. https:\/\/doi.org\/10.2760\/9816914","DOI":"10.2760\/9816914"},{"key":"303_CR76","unstructured":"NASA Goddard Institute for Space Studies. 2026 [cited 2026 May 10]. GISTEMP Team, 2026: GISS Surface Temperature Analysis (GISTEMP), version 4. https:\/\/data.giss.nasa.gov\/gistemp\/"},{"key":"303_CR77","unstructured":"UNDRR. [cited 2026 May 19]. The human cost of disasters: an overview of the last 20 years (2000-2019). https:\/\/www.undrr.org\/publication\/human-cost-disasters-overview-last-20-years-2000-2019"},{"key":"303_CR78","unstructured":"Inventory of U.S. Greenhouse Gas Emissions and Sinks | US EPA. [cited 2025 Nov 9]. https:\/\/www.epa.gov\/ghgemissions\/inventory-us-greenhouse-gas-emissions-and-sinks"},{"key":"303_CR79","unstructured":"Borunda A NPR. 2026 [cited 2026 Jan 26]. The EPA is changing how it considers the costs and benefits or air pollution rules. https:\/\/www.npr.org\/2026\/01\/13\/nx-s1-5675307\/epa-air-regulations-health-benefits"},{"key":"303_CR80","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1001\/jama.2025.1894","volume":"333","author":"A Gross","year":"2025","unstructured":"Gross A, Asfaw SH. Defying environmental deregulation: as protections erode, health care must lead sustainably. JAMA. 2025;333:1575 https:\/\/doi.org\/10.1001\/jama.2025.1894","journal-title":"JAMA"}],"container-title":["BMC Global and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s44263-026-00303-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s44263-026-00303-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s44263-026-00303-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:31:17Z","timestamp":1785519077000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s44263-026-00303-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":80,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["303"],"URL":"https:\/\/doi.org\/10.1186\/s44263-026-00303-9","relation":{},"ISSN":["2731-913X"],"issn-type":[{"value":"2731-913X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"assertion":[{"value":"20 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"71"}}