부산대학교 도서관

Introduction The World Health Organization has declared climate change as the greatest health threat to humanity.1 The consequences of rising atmospheric green house gas (GHG) concentrations are evident in extreme weather events across the world, with major implications on biodiversity, water scarcity and food security. Endoscopy services have a duty to the environment, as they are the third largest generator of hazardous waste in healthcare.2 While endoscopy-related patient travel has been identified as a modifiable contributor of GHG emission, there is little data investigating the scale of pre-endoscopy patient travel's carbon footprint.3 Green endoscopy online (GEO) is a Vimeo-based platform designed and accessed by our patients on mobile devices to facilitate patient and carer pre-endoscopy and colonoscopy education. This obviates the need to attend hospital for in-person education. We aim to quantify the reduction in GHG emission at a metropolitan endoscopy service, as well as patient time saved by omitting patient travel through the utilisation of online education. Materials and methods We performed a retrospective, single centre study using our endoscopy database (Provation MD) at a metropolitan hospital in Queensland, Australia, which performs over 6,000 colonoscopies annually. We analysed all outpatient colonoscopies and endoscopies between January 2019 and May 2022. Inpatient and emergency procedures were excluded. GEO is patient-centred online videos series provided to all patients awaiting endoscopic procedures at our centre via text message. To calculate the patient travel distance, patient home postcodes were extracted from encrypted electronic medical records. Using publicly available geodata, travel distance (kilometres) was calculated between patient home postcodes and the hospital. The primary outcome was carbon dioxide (CO2) emission avoided in tonnes, calculated using the Australian National Transport Commission's estimate of average CO2 emissions for light passenger vehicles as 149.5g/km and 115g/km for air travel. The secondary outcome was working days saved for both patients and carers through use of GEO. This was estimated based on average clinic wait time, consultation length and time spent travelling to hospital. Results and discussion 20,333 procedures (14,187 colonoscopies and 6,146 endoscopies) were performed by 35 endoscopists during the study period. The total round-trip patient travel distance averted was 803,316 km (vehicle and air travel). Based on average CO2 emission from car and air travel, 115.8 tonnes of CO2 emission was averted (Table 1). The secondary outcome found a total of 9,586 work days of patient and carer time saved, equating to 1,917.2 work weeks (Table 2). Conclusion GEO platform reduces CO2 emission while addressing the 'reduce' aspect of green endoscopy using a novel online health education format to minimise patient travel.3 This has led to improved patient and carer education, patient reported experience measures and time saved. Our study quantifies the carbon footprint of pre-endoscopy patient travel and encourages implementation of effective, evidence-based alternatives to limit preventable GHG emission from endoscopy. [ABSTRACT FROM AUTHOR]