Scott McAlister

• PhD
• Senior Research Fellow at University of Melbourne

OBJECTIVES An urgent transition to environmentally sustainable healthcare is required. The purpose of this study was to identified key areas for environmental impact mitigation for a coronary artery bypass grafting trajectory. METHODS An ISO14040/44-standardised life cycle assessment was conducted for the functional unit of an individual patient t...

Background Replacing single‐use operating theatre equipment with reusables might be one strategy for reducing the carbon footprint of operating theatres. However, in Australia, where the energy mix is predominantly fossil‐fuel‐based, the re‐sterilization of reusables may increase the carbon footprint. We analyzed the financial and environmental imp...

Objective Detailed quantifications of the environmental footprint of operations that include surgery, anaesthesia, and engineering are rare. We examined all such aspects to find the greenhouse gas emissions of an operation. Methods We undertook a life cycle assessment of 10 patients undergoing total knee replacements, collecting data for all surgic...

Cardiovascular disease is the leading cause of morbidity and mortality worldwide, with a substantial amount of health-care resources targeted towards its diagnosis and management. Environmental sustainability in cardiovascular care can have an important role in reducing greenhouse gas emissions and pollution and could be beneficial for improving he...

Background As climate change escalates with increasing health impacts, healthcare must address its carbon footprint. A critical first step is understanding the sources and extent of emissions from commonly utilised clinical care pathways. Methods We used attributional process-based life cycle analysis to quantify CO 2 equivalent emissions associat...

Objectives Hypophosphatemia occurs frequently. Enteral, rather than IV, phosphate replacement may reduce fluid replacement, cost, and waste. Design Prospective, randomized, parallel group, noninferiority clinical trial. Setting Single center, 42-bed state trauma, medical and surgical ICUs, from April 20, 2022, to July 1, 2022. Patients Patients...

Health care is a major contributor to climate change, and critical care is one of the sector’s highest carbon emitters. Health economic evaluations form an important component of critical care and may be useful in identifying economically efficient and environmentally sustainable strategies. The purpose of this scoping review was to synthesise avai...

Importance The healthcare sector is essential to human health and well-being, yet its significant carbon footprint contributes to climate change-related threats to health. Objective To review systematically published studies on environmental impacts, including carbon dioxide equivalent (CO 2 e) emissions, of contemporary cardiovascular healthcare...

At the UN Climate Change Conference 26 in Glasgow, 50 countries committed to low-carbon health services, with 14 countries further committing to net-zero carbon health services by 2050. Reaching this target will require decision makers to include carbon emissions when evaluating new and existing health technologies (tests and treatments). There is...

Objective To undertake an assessment of the health, financial and environmental impacts of a well-recognised example of low-value care; inappropriate vitamin D testing. Design Combination of systematic literature search, analysis of routinely collected healthcare data and environmental analysis. Setting Australian healthcare system. Participants...

Background Pathology testing and diagnostic imaging together contribute 9% of healthcare's carbon footprint. Whilst the carbon footprint of pathology testing has been undertaken, to date, the carbon footprint of the four most common imaging modalities is unclear. Methods We performed a prospective life cycle assessment at two Australian university...

Editor - Small changes in practice, when implemented throughout healthcare systems around the world, can have sizable positive impacts on the environment and on health- care costs. It is important for the medical profession to review legacy practices and reconsider interventions with no or low benefit to patients ...

Background As healthcare is responsible for 7% of Australia's carbon emissions, it was recognised that a policy implemented at St George Hospital, Sydney to reduce non-urgent pathology testing to two days per week and on other days only if essential, would also result in a reduction in carbon emissions. The aim of the study was to measure the impac...

Background Health care itself contributes to climate change. Anesthesia is a “carbon hotspot,” yet few data exist to compare anesthetic choices. The authors examined the carbon dioxide equivalent emissions associated with general anesthesia, spinal anesthesia, and combined (general and spinal anesthesia) during a total knee replacement. Methods A...

Purpose There is increasing interest within the healthcare sector about the environmental impacts associated with the provision of health services, with the sector being responsible for approximately 4.4% of global greenhouse gas emissions. The aim of this study is to develop an LCA of six commonly used pathology tests in hospitals in Australia, as...

Editor - We read with interest last year’s article by Zhong and colleagues1 on the environmental and economic impact of using increased fresh gas flow (FGF) to reduce carbon dioxide (CO2) absorbent consumption in the absence of inhalation anaesthetics, and the subsequent correspondence regarding the article, particularly calls to conserve O2 during...

Objectives To estimate the carbon footprint of five common hospital pathology tests: full blood examination; urea and electrolyte levels; coagulation profile; C‐reactive protein concentration; and arterial blood gases. Design, setting Prospective life cycle assessment of five pathology tests in two university‐affiliated health services in Melbourn...

Objective: To use life cycle assessment to determine the environmental footprint of the care of patients with septic shock in the intensive care unit (ICU). Design, setting and participants: Prospective, observational life cycle assessment examining the use of energy for heating, ventilation and air conditioning; lighting; machines; and all cons...

Background Carbon footprints stemming from health care have been found to be variable, from 3% of the total national CO2 equivalent (CO2e) emissions in England to 10% of the national CO2e emissions in the USA. We aimed to measure the carbon footprint of Australia's health-care system. Methods We did an observational economic input–output lifecycle...

Background.: An innovative approach to choosing hospital equipment is to consider the environmental costs in addition to other costs and benefits. Methods.: We used life cycle assessment to model the environmental and financial costs of different scenarios of replacing reusable anaesthetic equipment with single-use variants. The primary environm...

Objective To examine the environmental life cycle from poppy farming through to production of 100 mg in 100 mL of intravenous morphine (standard infusion bag). Design ‘Cradle-to-grave’ process-based life cycle assessment (observational). Settings Australian opium poppy farms, and facilities for pelletising, manufacturing morphine, and sterilising...

For most items used in operating rooms, it is unclear whether reusable items are environmentally and financially advantageous in comparison with single-use variants. We examined the life cycles of reusable and single-use central venous catheter kits used to aid the insertion of single-use, central venous catheters in operating rooms. We did not exa...

Economic and environmental sustainability are essential to maintaining delivery of high quality healthcare. Numerous medical innovations in recent times demonstrate that modern cardiovascular care is in quick and constant flux. Examples are the novel minimally-invasive interventions, improved disease management in heart failure, innovative methods...

We modelled the financial and environmental costs of two commonly used anaesthetic plastic drug trays. We proposed that, compared with single-use trays, reusable trays are less expensive, consume less water and produce less carbon dioxide, and that routinely adding cotton and paper increases financial and environmental costs. We used life cycle ass...