Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

The carbon footprint of French hospital ophthalmology consultations

Subjects

Abstract

Background

France carbon footprint, with 604 million tons of CO2 equivalent (CO2eq) annual emissions, far exceeds the worldwide scientific specifications to not exceed 2 °C of warming in 2100. The healthcare sector is one of the biggest contributors to greenhouse gas emissions. The aim of this study is to quantify and evaluate the carbon footprint of the consultation activity of an ophthalmology department at a single institution in France.

Methods

The perimeter of the investigation included consultations and excluded the surgeries and the hospitalisation. We calculated the carbon footprint of a single day of practice in our scope of investigation. We included consumption of energy, patient travel, staff travel, pharmaceutics and medical devices purchases, computer hardware, biomedical equipment/exam materials, and waste. We used the official French public database of emission factors: Base Empreinte® of the Environmental and Energy Management Agency of France.

Results

The carbon footprint of a single day of our department was estimated at 1 688.65 kgCO2eq. It represents an average of 9.28 kgCO2eq per patient. Energy consumption contributed for 114.80 kgCO2eq (6.8%), travel for 1324.76 kgCO2eq (78.4%), pharmaceutics and medical devices for 208.33 kgCO2eq (12.3%), equipment for 14.38 kgCO2eq (0.9%) and waste for 26.38 kgCO2eq (1.6%).

Conclusions

This study highlights the importance of patient travels, and possibly pharmaceutics, in the carbon footprint of hospital ophthalmology practice in France. More studies are needed to establish it at the national or international scale, as well as more carbon footprint analyses on products, especially those of high prices, to increase the accuracy of these studies.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: GHG emissions for a single day of practice of our department of ophthalmology excluding surgeries and hospitalization, split by scope of emission, and excluding intravitreal injections (IVI).
Fig. 2: GHG emissions for a single day of practice of our department of ophthalmology excluding surgeries and hospitalization, split by scope of emission, including intravitreal injections (IVI).

References

  1. Ministry of Ecological Transition and Territorial Cohesion. Data and statistical studies: For climate change, energy, environment, housing, and transportation. 2022. https://www.statistiques.developpement-durable.gouv.fr/node/917956.

  2. Pichler PP, Jaccard IS, Weisz U, Weisz H. International comparison of health care carbon footprints. Environ Res Lett. 2019;14:064004.

    Article  Google Scholar 

  3. The shift project. Decarbonizing health for sustainable care: 2023 edition of the shift project report. 2023. https://theshiftproject.org/article/decarboner-sante-rapport-2023/.

  4. Watts N, Adger WN, Agnolucci P, Blackstock J, Byass P, Cai W, et al. Health and climate change: policy responses to protect public health. Lancet. 2015;386:1861–914.

    Article  PubMed  Google Scholar 

  5. World Business Council for Sustainable Development, World Resources Institute. The Greenhouse Gas Protocol: A Corporate Accounting and Reporting Standard (revised edition). 2015. www.ghgprotocol.org.

  6. ADEME. 2023. https://base-empreinte.ademe.fr/.

  7. ISO 14040:2006(en) - Environmental management — Life cycle assessment — Principles and framework. Last reviewed in 2022.

  8. ADEME. 2020. https://base-carbone.ademe.fr/docutheque/Guides%20Sectoriels%20MAJ%20V5/Guides%20sectoriels/Guide%20sectoriel%20sante.pdf.

  9. ADEME. 2023. https://impactco2.fr/transport.

  10. Self-governance Paris Transport (RATP). 2023. www.ratp.fr/groupe-ratp/programmebus2025.

  11. Raffin N Taxis: In Paris, the G7 company is asking for help from the city to electrify its vehicles. 2021. www.20minutes.fr/economie/3147443-20211013-taxis-paris-compagnie-g7-reclame-aide-ville-electrifier-vehicules.

  12. The shift project. Drug Emission Factors - Intermediate Technical Note. 2023. https://theshiftproject.org/wp-content/uploads/2023/04/Note-technique-Facteurs-demissions-des-medicaments-18042023.pdf.

  13. European medicines agency. Press release. European and US regulators agree on mutual recognition of inspections of medicines manufacturers. 2017. https://www.ema.europa.eu/en/documents/press-release/european-us-regulators-agree-mutual-recognition-inspections-medicines-manufacturers_en.pdf.

  14. Lacroute J, Marcantoni J, Petitot S, Weber J, Levy P, Dirrenberger B et al. The carbon footprint of ambulatory gastrointestinal endoscopy. Endoscopy 2023. https://doi.org/10.1055/a-2088-4062].

  15. Ditac G, Cottinet PJ, Le MQ, Grinberg D, Duchateau J, Gardey K, et al. Carbon footprint of atrial fibrillation catheter ablation. Europace. 2023;25:331–40.

    Article  PubMed  Google Scholar 

  16. Morris DS, Wright T, Somner JEA, Connor A. The carbon footprint of cataract surgery. Eye. 2013;27:495–501. https://doi.org/10.1038/eye.2013.9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Ferrero A, Thouvenin R, Hoogewoud F, Marcireau I, Offret O, Louison P, et al. The carbon footprint of cataract surgery in a French University Hospital. J Fr Ophtalmol. 2022;45:57–64. https://doi.org/10.1016/j.jfo.2021.08.004.

    Article  CAS  PubMed  Google Scholar 

  18. Somner JE, Connor A, Benjamin L. Eyes, economics and the environment: should green issues drive changes in ophthalmic care?–yes. Eye. 2010;24:1309–11. https://doi.org/10.1038/eye.2010.64.

    Article  CAS  PubMed  Google Scholar 

  19. Lockington D, Dutton GN. Eyes, economics and the environment: should green issues drive changes in ophthalmic care?–no. Eye. 2010;24:1312–4.

    Article  CAS  PubMed  Google Scholar 

  20. Power B, Brady R, Connell P. Analyzing the Carbon Footprint of an Intravitreal Injection. J Ophthalmic Vis Res. 2021;16:367–76. https://doi.org/10.18502/jovr.v16i3.9433.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Chandra P, Welch S, Oliver GF, Gale J. The carbon footprint of intravitreal injections. Clin Exp Ophthalmol. 2022;50:347–9. https://doi.org/10.1111/ceo.14055.

    Article  PubMed  Google Scholar 

  22. McGain F, Burnham JP, Lau R, Aye L, Kollef MH, McAlister S. The carbon footprint of treating patients with septic shock in the intensive care unit. Crit Care Resusc. 2018;20:304–12.

    PubMed  Google Scholar 

  23. Hernández Olivan P, Jósa V, Long A Reducing the carbon footprint of healthcare through sustainable procurement. Health Care Without Harm (HCWH) Europe. 2018 https://europe.noharm.org/sites/default/files/documentsfiles/5624/2018-09-25_Reducing_carbon_footprint_healthcare%20WEB.pdf.

  24. Sherman JD, McGain F, Lem M, Mortimer F, Jonas WB, MacNeill AJ. Net zero healthcare: a call for clinician action. BMJ. 2021;374:n1323.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Holmner A, Ebi KL, Lazuardi L, Nilsson M. Carbon footprint of telemedicine solutions – unexplored opportunity for reducing carbon emissions in the health sector. PLoSOne. 2014;9:e105040.

    Article  Google Scholar 

  26. Ministry of Ecological Transition and Territorial Cohesion. Energy key figures. 2021. https://www.statistiques.developpement-durable.gouv.fr/edition-numerique/chiffres-cles-energie-2021/6-bilan-energetique-de-la-france.

  27. Schlömer S, Bruckner T, Fulton L, Hertwich E, McKinnon A, Perczyk D et al. 2014: Annex III: Technology-specific cost and performance parameters. In: Climate Change 2014: Mitigation of Climate Change. Contribution of Working Group III to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press, Cambridge, United Kingdom and New York, NY, USA.

  28. ADEME. Energy for hospitals and clinics. 2022. https://expertises.ademe.fr/professionnels/entreprises/performance-energetique-energies-renouvelables/dossier/lenergie-hopitaux-cliniques/saviez.

  29. The shift project. Lean ICT: Towards digital sobriety. 2019.

Download references

Acknowledgements

Non-authors contributors: Maria Deposo (Civic Service); Jean-Louis Favrat (hospital pharmacy); Inès De Maisoncelle (Carbon footprint project manager at strategy and transformation department, Assistance Publique Hôpitaux de Paris).

Author information

Authors and Affiliations

Authors

Contributions

FDF was responsible for designing the study protocol, writing the protocol and report, conducting the search, extracting and analyzing data, interpreting results, and updating reference lists. FM was responsible for designing the study protocol and interpreting results. He provided feedback on the report. BB provided feedback on the report.

Corresponding author

Correspondence to Fabien Di Felici.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Di Felici, F., Maestri, F. & Bodaghi, B. The carbon footprint of French hospital ophthalmology consultations. Eye (2024). https://doi.org/10.1038/s41433-024-03257-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41433-024-03257-0

Search

Quick links