{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T18:35:12Z","timestamp":1765910112908,"version":"3.48.0"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>As healthcare systems grapple with their 5% global carbon footprint contribution, sustainable medical device selection emerges as a critical decarbonization lever. This life cycle assessment (LCA) quantifies environmental disparities among three prevalent video intubation tools\u2014Disposable video laryngoscopes (VLs), reusable VLs, and video Stylets\u2014to guide evidence-based procurement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using International Organization for Standardization (ISO)14040 compliant life cycle assessment (LCA) methodology\u2014the international standard defining LCA principles and framework\u2014we quantified cradle-to-grave emissions for three video intubation devices manufactured by Zhejiang UE Medical Corp. The functional unit (one tracheal intubation) incorporated material extraction, manufacturing, low-temperature LTPS\/ HLD, transportation, and disposal. SimaPro 9.4.0 with Ecoinvent 3.8 database calculated CO\u2082 equivalents (kg CO\u2082e), validated through sensitivity analyses of sterilization loading (10\u201380 devices\/cycle) and regional grids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The HLD-disinfected video stylet demonstrated superior environmental performance, emitting 98.24 kg CO\u2082e per 500 procedures\u201445.8% and 42.0% lower than reusable VLs (181.45 kg CO\u2082e) and disposable VLs (169.47 kg CO\u2082e), respectively. Sensitivity analyses identified sterilization loading as the dominant variable: half-load (50% chamber utilization) reduced emissions by 89\u201391% versus single-device processing, with full-load optimization yielding incremental 11\u201314% reductions. Process and regional variability further revealed that HLD decreased emissions by 19\u201324% compared to LTPS, while grid carbon intensity caused 24\u201333% variability (India vs. EU). Scenario comparisons confirmed the video stylet\u2019s environmental dominance across sterilization methods\u2014even with LTPS (349.99 kg CO\u2082e\/500 uses), it maintained a 45% reduction over reusable VL baselines, whereas HLD-treated video stylets (94.32 kg CO\u2082e) showed 6.7-fold lower emissions than disposable VLs and 59% below HLD-reprocessed reusable VLs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HLD-reprocessed video stylets are the environmentally optimal choice for high-volume, low-infection-risk settings. For low-throughput or high-risk scenarios, providers should balance environmental impacts with clinical requirements through frequency and resource assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0339058","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T18:29:26Z","timestamp":1765909766000},"page":"e0339058","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Carbon footprint comparison of video intubation tools: Disposable laryngoscopes, reusable laryngoscopes, and 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