Environmentally Sustainable Gastroenterology Practice: A Review of Current State and Future Goals

Document Type


Publication Title

Digestive Endoscopy


Background: The healthcare sector contributes 4.6% of global greenhouse gas (GHG) emissions, with gastroenterology playing a significant role due to the widespread use of gastrointestinal endoscopy.

Methodology: A comprehensive search of PubMed, Embase, and Cochrane Library was conducted to explore the carbon footprint in gastroenterology practice, focusing on endoscopy, in-patient and outpatient settings, and recruitment practices. Recommendations for mitigating the carbon footprint were derived.

Results: This narrative review analyzed 34 articles on the carbon footprint in gastroenterology practice. Carbon footprint of endoscopy in the USA is approximately 85,768 metric tons of CO2 emission annually, equivalent to 9 million gallons of gasoline consumed, or 94 million pounds of coal burned. Each endoscopy generates 2.1 kg of disposable waste (46 L volume), of which 64% of waste goes to the landfill, 28% represents biohazard waste, and 9% is recycled. The per-case manufacturing carbon footprint for single-use devices and reusable devices is 1.37 kg CO2 and 0.0017 kg CO2 respectively. Inpatient and outpatient services contributed through unnecessary procedures, prolonged hospital stays, and excessive use of single-use items. Fellowship recruitment and GI conferences added to the footprint, mainly due to air travel and hotel stays.

Conclusion: GI endoscopy and practice contribute to the carbon footprint through the use of disposables such as single-use endoscopes, and waste generation. To achieve environmental sustainability, measures such as promoting reusable endoscopy equipment over single-use endoscopes, calculating institutional carbon footprints, establishing benchmarking standards, and embracing virtual platforms such as telemedicine and research meetings should be implemented.



Publication Date



Carbon footprint, Endoscopy, Gastroenterology, Greenhouse Gases, Waste Management