gms | German Medical Science

Introduction: Climate change is a global challenge and health systems are relevant contributors to CO₂ emissions. Hence, concepts of Planetary Health have been implemented into urological practice. Earlier studies have specifically focused on Life Cycle Assessment (LCA) of single-use or reusable flexible ureterorenoscopes (fURS). The methodology used is highly data-dependent and knowledge on intra-hospital emissions is still limited. Here, we present a methodical approach for intra-institutional processes of LCA for fURS.

Methods: LCA was performed to assess the CO₂ equivalents of single-use and reusable fURS (production, use-phase, reprocessing, maintenance, disposal) to approximate the Global Warming Potential (GWP) per use. Associated human health impacts were evaluated using the impact assessment method ReCiPe2016(H) and Disability-adjusted Life Years (DALYs).

Results: Assuming 133 usages per fURS and maintenance after each 11^th use, 1.24 kg CO₂ eq equal to 1.15E-06 DALYs resulted for one application of a reusable fURS. 4.93 kg CO₂ eq and 4.57E-06 DALYs resulted for single-use fURS. Most influential parameters were the production and reprocessing stages for the life cycles of single-use and reusable fURS, respectively.

Conclusion: Ureterorenoscopy, as many medical procedures, has an impact on Planetary Health. Its impact is measurable to a Human Health level. In this Life Cycle Analysis, single-use devices had a higher impact on Human Health. This study may act as a basis for similar analyses and provide research in the field of climate change and health with stronger evidence.

Figure 1 [Fig. 1]