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Oral Paper Presentation

Annual Scientific Meeting

Session: Plenary Session 2B - Colon / General Endoscopy / GI Bleed / Practice Management

32 - Recycling in Ambulatory Gastrointestinal Endoscopy: A Single Center Experience

Tuesday, October 29, 2024
9:10 AM – 9:20 AM ET
Location: Terrace Ballroom 2-3
ACG Award Winner Livestream On-Demand Video
Award: ACG Outstanding Research Award in the General Endoscopy Category

Immanuel K. Ho, MD, FACG1, Mary Coniglio, 2, Carolyn Simeonides, RN2, Daniel V. Carr, MSN, RN3, Karen Rodriguez, 2, Frederick A. Nunes, MD1
1Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; 2University of Pennsylvania Health System, Philadelphia, PA; 3Penn Medicine, Marlton, NJ

Introduction: Gastrointestinal endoscopy is associated with significant generation of waste, much of it is due to single use equipment and devices. Waste disposal leads to production of CO2 which can contribute to climate change. Recycling is one strategy that could decrease the carbon footprint from endoscopic activities and reduce landfill waste. Aim: To assess the impact of recycling of endoscopic materials in a high-volume university outpatient ambulatory endoscopy center.

Methods: 1858 patients underwent procedures (765 M, 1093 F; 1511 colonoscopy, 315 EGD, 22 flex sigmoidoscopy, 10 other) over a 3-month period from 1/15/2024 to 4/15/2024. Endoscopy kits (pictured), consisting of cinchpad, gauze, lubricating gel, sponge, tubing, water jet connector, and brushes, were recycled after use. A single kit was utilized per patient encounter. Working with industry partners, the materials were packaged in sealed containers after use and transported by UPS to a recycling processing center in Carthage, Texas. Snares and biopsy forceps were not recycled. Data was collected through analysis of invoices. Greenhouse gas avoidance was determined based on national averages and waste composition similar to municipal solid waste, and was calculated on a lifecycle basis, using the 20-year global warming potential of methane (https://www.reworldwaste.com/news-resources/resource-library/waste-impact-calculator).

Results: Total amount recycled = 1032.4 kg or 0.56 kg per procedure. The total red waste per case = 0.747 kg vs. 0.751 kg in the three months prior to recycling (p=0.84). Recycling avoided 3000 kg of greenhouse gas emissions and reduced the need for 181.7 liters of fuel oil. CO2e for transport of material from Philadelphia to recycle processing center was 132.2 kg.

Discussion: Conclusion: Recycling endoscopy equipment is feasible and can reduce the carbon footprint generated by GI endoscopy.


Disclosures:
Immanuel Ho: Merck – Stock-publicly held company(excluding mutual/index funds). Novartis – Stock-publicly held company(excluding mutual/index funds).
Mary Coniglio indicated no relevant financial relationships.
Carolyn Simeonides indicated no relevant financial relationships.
Daniel Carr indicated no relevant financial relationships.
Karen Rodriguez indicated no relevant financial relationships.
Frederick Nunes indicated no relevant financial relationships.


Immanuel K. Ho, MD, FACG1, Mary Coniglio, 2, Carolyn Simeonides, RN2, Daniel V. Carr, MSN, RN3, Karen Rodriguez, 2, Frederick A. Nunes, MD1, 32, Recycling in Ambulatory Gastrointestinal Endoscopy: A Single Center Experience, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.