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Cradle-to-Gate Greenhouse Gas Emissions for Twenty Anesthetic Active Pharmaceutical Ingredients Based on Process Scale-Up and Process Design Calculations
Abstract
Comparative life-cycle assessment (LCA) of pharmaceutical drugs would enable clinicians to choose alternatives with lower environmental impact from options offering equivalent efficacies and comparable costs. However, life-cycle inventory (LCI) data of individual pharmaceutical drugs is limited to only a few compounds. In this study, we use chemical engineering methods for process scale-up and process design to utilize lab-scale synthesis data, available in patents and other public literature, to generate cradle-to-gate LCI data of 20 commonly used injectable drugs in anesthesia care to calculate their greenhouse gas impact. During the process of building the life-cycle trees of these drugs, missing life-cycle inventories for more than 130 other chemical compounds and pharmaceutical intermediates were accounted for using process-based methods and stoichiometric calculations. The cradle-to-gate GHG emissions of the 20 anesthetic drugs range from 11 kg CO2 eq. for succinylcholine to 3,000 kg CO2 eq. for dexmedetomidine. GHG emissions are positively correlated with the number of synthesis steps in the manufacturing of the drug. The LCI methods and data generated in this work greatly expand the available environmental data on APIs and can serve as a guide for LCA practitioners in future analysis of other pharmaceutical drugs. Most importantly, these LCA results can be used by clinical practitioners and administrators building toward sustainability in the health care sector.
... A recent review [4] including 13 studies estimated daily GHG emissions in between 88 and 178 kg of Carbon Dioxide Equivalent (kgCO 2 e) per patient-day. However, these results must be interpreted with caution since the majority of studies were conducted in Australian or American ICUs [5][6][7][8]. Energy use, which is mainly based on fossil fuels in these countries, transport and health systems are different and reduce the external validity. Therefore, the results cannot be generalized worldwide and GHG emissions in Europe are required. ...
... Consequently, GHG emitted during manufacture of active ingredients, excipients and co-formulates wasn't assessed because of the lack of reliable data. Parvatker et al. [8] conducted a process-based estimation of GHG emissions associated with the manufacturing of 20 anesthetic medicine, however few of them were analyzed in our study. In addition, the impact of solvents for injection drugs, like water for injection or saline solutions, which mostly remained on sterilization process, remains unknown. ...
... Among the 47 professionals who responded to transport survey, average home-to-work distance was 14 km (median) [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] (interquartile range). Private car was dominant (83% of travels) with about 50% of the caregivers reporting carpooling with a median frequency of 1 travel over 7. Thirty-four caregivers (72%) reported using occasionally or regularly a sustainable mode of transport. ...
Background
The purpose of this study was to identify the main greenhouse gas (GHG) emitting activities or products among the medical devices (MD) and medicines used in a polyvalent Intensive Care Unit (ICU).
Methods
A pragmatic eco-audit was conducted in a 21-beds polyvalent ICU, in Saint-Brieuc, Bretagne, France. It consisted of estimating GHG emissions of products or activities, considering process-based life cycle analysis (LCA), economic input–output analysis (EIO) and hybrid-LCA. Results were expressed as Carbon Dioxide Equivalent (CO 2 e ) emissions per patient-day considering each medication and MD (including personal protective equipment).
Results
With remaining uncertainty, GHG emissions were estimated at 61.1 kgCO 2 e per patient-day. Two hundred and two individual MD were used per patient-day, equivalent to 5.1 kgCO 2 e per patient-day (process-based LCA). Gloves accounted for the main part of kgCO 2 e emissions (representing 1.8 kgCO 2 e per patient-day). Then, syringes (1.1 kgCO 2 e per patient-day), perfusion tubings (1.0 per patient-day) and gauze pads (0.4 kgCO 2 e per patient-day) were the most important sources of MD related GHG emissions. Forty-seven individual medicines were used per patient-day. Most consumed medications were sterile water for injection, propofol, and sodium chlorure. The GHG emissions of medications were estimated with EIO-LCA at 21.5 kgCO 2 e per patient-day, mostly due to injectable medicines (15.3 kgCO 2 e per patient-day).
Conclusion
Upcoming studies focusing on actions on these particular hot spots would be of interest in order to significantly decrease GHG emissions but also to increase resilience of critical care.
... Nei device, la fase di estrazione dei materiali per gli strumenti monouso, come evidenziato da Chang (22) e Donahue (23), è cruciale, in quanto comporta elevati costi energetici e una maggiore impronta di carbonio. Molto rilevante: L'estrazione di solventi e materiali sintetici, così come la produzione chimica complessa, generano alte emissioni di CO 2 (18,19,24). ...
... Molto rilevante: La fabbricazione di farmaci richiede molta energia. Gli inalatori, per esempio, utilizzano gas HFC, contribuendo al riscaldamento globale (18,25). ...
... Moderatamente rilevante: Il trasporto e lo stoccaggio dei farmaci richiedono risorse significative e generano emissioni (18,19). ...
The healthcare sector significantly contributes to global greenhouse gas emissions. Among the various strategies available, exploring the integration of environmental sustainability into Health Technology Assessment (HTA) presents a potential avenue for addressing these impacts. The HTA Core Model, widely utilized by European HTA agencies, evaluates healthcare technologies across nine domains; however, environmental considerations remain peripheral and are primarily confined to certain safety-related aspects. This paper examines the potential role of Life Cycle Assessment (LCA) in complementing HTA to better address environmental impacts. LCA offers a systematic methodology to evaluate environmental effects across the full lifecycle of a product, from raw material extraction to disposal. Through the analysis of pharmaceuticals, telemedicine, and surgical practices, the study identifies critical environmental impacts at various lifecycle stages, illustrating how LCA could support more informed and sustainable decision-making in healthcare. These findings underscore the diverse environmental impacts associated with healthcare technologies and highlight the need for tailored strategies to mitigate them. This point of view emphasizes the importance of initiating discussions on developing a framework to incorporate environmental impacts into HTA systematically, promoting healthcare decisions that prioritize both human and environmental healths.
... Data on production site, modes of transportation, type of materials and weight of infusion set (sub-) components, including packaging and protective caps, were obtained from the manufacturers. Data on greenhouse gas (GHG) emissions for production of active pharmaceutical ingredients (kg CO 2 -equivalent per produced kg; CO 2 -eq) were taken from Parvatker et al., 15 with modelling of synthesis based on their presented reaction pathways. On the basis of similar chemical structure and manufacturing processes, we used emission data for production of adrenaline as a surrogate for that of noradrenaline, for which published reports were unavailable. ...
... A P value of 0.05 or less was considered statistically significant. Data were analysed using SPSS software [Version 28.0.1.1 (15), SPSS Inc., Chicago, Illinois, USA]. ...
... Of this, only 13 g CO 2 -eq came from medication production, which can be seen as an illustration of pharmaceutical potency. Production includes energy-intensive processes resulting in emission factors for propofol, remifentanil and noradrenaline, of 25.2, 150.4 and 61.1 kg CO 2 -eq per kg of active pharmaceutical ingredient, respectively (adapted from 15 ). However, during anaesthesia, propofol was administered in the range of hundreds of mg, and remifentanil and noradrenaline as hundreds of mg. ...
BACKGROUND
Reusing anaesthesia infusion-set components may reduce the climate impact from plastic waste and discarded medications. Infusion-set contents can be shielded from patient contact by single use of an infusion line fitted with dual antireflux valves, preventing retrograde entry of microorganisms, and eliminating the risk for patient-to-patient cross-contamination. However, infusion-set contamination from compromised aseptic handling could affect quality of care.
INTERVENTIONS
To determine the prevalence of infusion-set bacterial contamination and compare the climate effects, we randomised operating rooms scheduled for total intravenous anaesthesia to handle procedures by infusion-set reuse or single-use. Both methods used dual single-use antireflux valves.
OUTCOMES
The primary outcome was infusion-set bacterial contamination assessed by aerobic culture of infusion-set fluid collected after each procedure. The secondary outcome was CO 2 emissions (CO 2 -eq) estimated by life cycle assessment of component and medication use. To assess feasibility of detecting an inter-method difference in bacterial contamination, an interim analysis was planned after including at least 150 procedures per group.
RESULTS
After allocating 54 operating rooms per method, 189 and 159 procedures of reuse and single use were included. Reuse permitted a median of three procedures per infusion set (range 1 to 8). Positive cultures occurred in two procedures per method [mean (95% CI)]; prevalence 1.15% (0.03 to 2.27); relative risk of reuse versus single use 0.84 (0.12 to 5.93), P = 0.861. As prespecified, inclusion was stopped due to futility. The median (95% CI) per-procedure climate emissions were 0.43 (0.41 to 0.47) and 1.39 (1.37 to 1.40) kg CO 2 -eq for reuse and single-use respectively; difference -0.96 (-0.99 to -0.93), P < 0.0005. The main sources for climate emissions were production of infusion-set components and waste handling.
CONCLUSIONS
We conclude that the prevalence of bacterial contamination was low for both methods. A much larger study would be needed to detect an inter-method difference. Reuse of infusion-set components allowed significantly reduced intravenous anaesthesia climate emissions.
Visual Abstract
http://links.lww.com/EJA/B34
... For some that had been identified as highly polluting, complete life cycle studies have been carried out and are available in the literature. This is the case for certain anesthetic gases and bronchodilators, which has enabled us to quantify their impact more specifically [11,12]. ...
... Category of raw data EcoInvent 3.9 [10] Food Andersen et al, 2012 [19] Anaesthetic gases (sevoflurane, desflurane, isoflurane) Janson et al, 2020 [12] Bronchodilators Parvatker et al, 2019 [11] Anaesthetic gases Finally, we have modelled emission reduction scenarios on the shared socio-economic trajectories published in 2023 by the IPCC [20] (Table 2). These scenarios are quantified objectives, distributed by categories, to align with the IPCC trajectories. ...
... What's more, combating food waste in the catering industry, estimated at around 20% by The Shift Project, would have a significant carbon impact. 11 Waste must be reduced at source. Accordingly, three major lines of action could be following the 3R rule (Reduce, Reuse, Recycle) to prevent the production of incinerable waste. ...
Switzerland, a wealthy country, has a cutting-edge healthcare system, yet per capita, it emits over one ton of CO2, ranking among the world's most polluting healthcare systems. To estimate the carbon footprint of the healthcare system of Geneva’s canton, we collected raw data on the activities of its stakeholders. Our analysis shows that when excluding medicines and medical devices hospitals are the main greenhouse gas emitter by far, accounting for 48% of the healthcare system’s emission, followed by nursing homes (20%), private practice (18%), analysis laboratories (7%), dispensing pharmacies (4%), the homecare institution (3%) and the ambulance services (
... Specifics for the medical equipment and pharmaceuticals (composition, production, packaging, transport and waste disposal) were retrieved using data found in literature and by using the ecoinvent database (Ecoinvent, Zurich, Switzerland). [3][4][5] In addition to the LCA analysis, we performed a contribution (or 'hotspot') analysis, to investigate which component generates the most GHG emissions. Also, a sensitivity analysis was done, to evaluate the influence of the use of proxies (some drugs had no data so a close relative was used 3 ) on the LCA results. ...
... For some plastic disposables and pharmaceuticals, production data could not be retrieved. Therefore, data reported by Parvatker et al. 3 for fentanyl and ondansetron were used to approximate sufentanil and granisetron, respectively. For paracetamol, diclofenac and dexamethasone, the median of all pharmaceuticals reported by Parvatker et al. 3 was used. ...
... Therefore, data reported by Parvatker et al. 3 for fentanyl and ondansetron were used to approximate sufentanil and granisetron, respectively. For paracetamol, diclofenac and dexamethasone, the median of all pharmaceuticals reported by Parvatker et al. 3 was used. For plastic disposables with missing data, we used plastic varieties that are commonly used in hospitals, such as polypropylene and polyvinyl chloride. ...
... For this analysis, only the environmental impact category CO 2 emission (kg) was selected, for which we used the conversion factor "grey energy" (0.523 kg CO 2 /kWh) to convert kWh energy [24]. Greenhouse gas emissions for six anesthetic drugs and/or painkillers were retrieved from previous studies [6,25]. For the remaining medications, an average of 340 g CO 2 emission/g drugs was used [25,26]. ...
... Greenhouse gas emissions for six anesthetic drugs and/or painkillers were retrieved from previous studies [6,25]. For the remaining medications, an average of 340 g CO 2 emission/g drugs was used [25,26]. ...
... To estimate the CO 2 emission of the medication administered during an MR-HIFU treatment, we used CO 2 emission data from previous studies. These studies often did not include the emission of packaging [6,25,26]. McAlister et al. calculated that 90% of morphine CO 2 emissions were caused by sterilization and packaging. Therefore, sterilization and packaging should not be neglected [29]. ...
Objectives
To assess the environmental impact of the non-invasive Magnetic Resonance image-guided High-Intensity Focused Ultrasound (MR-HIFU) treatment of uterine fibroids, we aimed to perform a full Life Cycle Assessment (LCA). However, as a full LCA was not feasible at this time, we evaluated the CO 2 (carbon dioxide) emission from the MRI scanner, MR-HIFU device, and the medication used, and analyzed solid waste produced during treatment.
Methods
Our functional unit was one uterine fibroid MR-HIFU treatment. The moment the patient entered the day care-unit until she left, defined our boundaries of investigation. We retrospectively collected data from 25 treatments to assess the CO 2 emission based on the energy used by the MRI scanner and MR-HIFU device and the amount and type of medication administered. Solid waste was prospectively collected from five treatments.
Results
During an MR-HIFU treatment, the MRI scanner and MR-HIFU device produced 33.2 ± 8.7 kg of CO 2 emission and medication administered 0.13 ± 0.04 kg. A uterine fibroid MR-HIFU treatment produced 1.2 kg (range 1.1–1.4) of solid waste.
Conclusions
Environmental impact should ideally be analyzed for all (new) medical treatments. By assessing part of the CO 2 emission and solid waste produced, we have taken the first steps towards analyzing the total environmental impact of the MR-HIFU treatment of uterine fibroids. These data can contribute to future studies comparing the results of MR-HIFU LCAs with LCAs of other uterine fibroid therapies.
Critical relevance statement
In addition to (cost-) effectiveness, the environmental impact of new treatments should be assessed. We took the first steps towards analyzing the total environmental impact of uterine fibroid MR-HIFU.
Key points
• Life Cycle Assessments (LCAs) should be performed for all (new) medical treatments.
• We took the first steps towards analyzing the environmental impact of uterine fibroid MR-HIFU.
• Energy used by the MRI scanner and MR-HIFU device corresponded to 33.2 ± 8.7 kg of CO 2 emission.
Graphical Abstract
... OR disposables) to identify the most burdensome products and processes. Due to limited data availability, pharmaceuticals were only considered for the global warming potential caused by active pharmaceutical ingredient production and packaging [11,20,21]. To verify the robustness of findings, we performed sensitivity analyses to test the effects of underlying assumptions, database choices, and analysis methods on the identified key areas [13]. ...
... The OR and ICU individually caused 314 [296-333] kg and 77 [68-93] kgCO 2 eq of global warming; patient travel accounted for an additional 23 [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] kgCO 2 eq. OR disposables, energy use, and employee commute contributed most: 162 kg (39%), 48 kg (12%), and 36 kgCO 2 eq (9%), respectively (Fig. 5). ...
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 trajectory of elective coronary artery bypass grafting surgery, from operating room admission until intensive care unit discharge. Data were collected for products, processes, and services required for care delivery in a Dutch academic hospital for 12 patients. The environmental impact was calculated using the ReCiPe 2016 method.
RESULTS
A single patient trajectory caused 414 [IQR 383–461] kg CO2 equivalents of global warming, equal to 2,753km of driving an average Dutch petrol-fuelled car. Other notable environmental impacts were fine particulate matter, (non-)carcinogenic toxicity, land use, and terrestrial acidification. Operating room disposable products (162 kgCO2eq), energy use (48 kgCO2eq), and employee commute (36 kgCO2eq) contributed most to global warming. The extracorporeal circulation set, surgical drapes, intraoperative salvage set, surgical gowns, and cotton gauzes caused most of the disposables’ environmental impact. Most energy use occurred in the operating room via heating, ventilation, and air conditioning.
CONCLUSIONS
A coronary artery bypass grafting trajectory’s environmental impact primarily contributed to global warming. Most impact mitigation could be achieved by avoiding/reducing disposable product use when possible, or replacing these with reusables. Optimising operating room energy systems, switching to renewable energy, and encouraging low-emission employee commute can further reduce the environmental impact.
... Furthermore, depending on the location of the manufacturer, the energy sources and associated emissions can differ drastically. 6 Therefore, the carbon footprints of different APIs have been shown to vary by orders of magnitude, making comparisons, generalizations, or extrapolations unreliable. Nevertheless, in this case, the carbon footprint of the APIs can be determined from previous publications. ...
... De plus, selon l'emplacement de l'usine de fabrication, les sources d'énergie et les émissions associées peuvent différer de façon considérable. 6 Ainsi, il a été démontré que l'empreinte carbone des différents IPA variait d'un ordre de grandeur, ce qui rend les comparaisons, les généralisations ou les extrapolations peu fiables. Néanmoins, dans ce cas, l'empreinte carbone des IPA peut être déterminée à partir de publications antérieures. ...
... For instance, Anastas and colleagues highlighted the lack of LCI data for large-scale production of pharmaceutical drugs and their precursors, performing a comparative cradle-to-gate analysis of different anesthetic APIs using a bottom-up approach (Parvatker et al. 2019). Starting from synthesis data at the lab-scale, these authors used chemical engineering methods for process design and scale-up to calculate the carbon footprint of 20 different anesthetic drugs, obtaining results ranging from 11 to 3000 kg CO 2 eq/ kg of drug. ...
... However, the inventory data extrapolated from lab-scale experiments could produce emission values significantly overestimated, due to the large number of variables related to the scaling-up procedures (Piccinno et al. 2016;Simon et al. 2016;Thonemann and Schulte 2019;Elginoz et al. 2022). Another factor that needs to be emphasized is the choice between many different synthetic pathways available for the same drug, which was done arbitrarily by Parvatker et al. (2019), but it should be conducted according to the common materials and procedures applied in the region of interest. Despite these limitations, the LCI data obtained in this study could be used by LCA practitioners in future works, with the necessary adjustments needed by the case, offering a methodology to possibly develop similar inventories for other pharmaceutical drugs and chemical precursors. ...
Pharmaceuticals are among the most challenging products to assess by life cycle assessment (LCA). The main drawback highlighted by LCA practitioners is the lack of inventory data, both regarding the synthesis of active pharmaceutical ingredient (API) precursors (upstream) and the details concerning the downstream phases (use and end of life). A short critical review of pharma-LCAs found in the literature is here proposed, with discussion of several tools and models used to predict the environmental impacts derived from the life cycle of pharmaceuticals, emphasizing current strengths and weaknesses, and exploring the possibilities for improvements. The case of antibiotics is selected as a representative class of pharmaceuticals, due to their massive use worldwide and the growing related issue of antimicrobial resistance enrichment, which is generally not included in most of LCAs. Also, we comment on drafting product category rules (PCRs) in the relevant field to develop standard methodologies and enhance the comparability of the studies, ultimately advocating collaboration with companies and improving inventory data quality and availability for the whole value chain of products.
... Furthermore, the carbon emissions of medication were estimated using a top-down approach based on medication use as a proportion of the total NHS carbon footprint [16]. This is unlikely to consider the disproportionate emissions generated from the raw material acquisition and manufacturing stages (scope 1 and 2 carbon emissions) of pharmaceutical production as opposed to its use, waste management and endof-life (scope 3 carbon emissions) [51]. For example, quantifying water use (water footprint) across the life cycle of interventions, quantifying waste volumes generated along the care pathway, and human health and biodiversity impacts attributed to the life cycle of interventions [52]. ...
Background
Healthcare accounts for up to 5% of worldwide carbon emissions and costs global economies an estimated $9 trillion annually. Primary care accounts for up to one‐fifth of all NHS carbon emissions, with musculoskeletal (MSK) pain accounting for 14%–30% of all primary care consultations.
Method
A cost‐carbon calculator model was used to undertake a retrospective economic and environmental analysis of resource use for non‐inflammatory MSK pain primary care consulters. Data used to populate the model was derived from Electronic Health Records and patient surveys collected during The Multi‐level Integrated Data for Musculoskeletal Health Intelligence and ActionS GP Study. The model was utilised to estimate the mean (with 95%CI's) cost and carbon output per MSK consulter, while also examining variations at two levels: (a) the Primary Care Network (PCN), and (b) the consulter's index MSK pain site.
Results
One thousand eight hundred seventy‐five individuals from 30 NHS primary care practices across 13 PCNs were eligible for EHR and survey data analysis. The mean carbon and cost output per person (over 6 months) was 46.91 kg CO 2 e (95% CIs; 45.02, 48.81 kg CO 2 e) and £182.65 (95% CIs; £178.69, £190.62), respectively, with substantial variation observed across PCNs. The resource category with the highest carbon footprint was consistently pharmacological intervention across all PCNs. Individuals who consulted for multisite/widespread pain and back pain had the highest mean carbon and cost output respectively.
Conclusion
This is the first study, we are aware of, that presents data on both the environmental and economic impact of the primary care of non‐inflammatory MSK pain. Future work should focus on benchmarking the cost and carbon output of MSK care pathways and standardising methods that are implemented to influence sustainable practice and policy development.
... The need to consider CFP from gaseous anesthesia has led to promotion of LCA research. In our review, the overwhelming majority of reports (15 reports, 31 types) included drugs in the "CNS" category such as anesthetics and painkillers [21,22,[45][46][47][48][49][50][51][52][53][54][55][56][57]. ...
Purpose
Global warming is a known risk factor for chronic kidney disease (CKD), and both progression of the disease and its treatment place a burden on the environment. Life cycle assessment (LCA) is an established method for evaluating the global impact of manufactured products, from materials’ procurement to disposal. We aimed to examine available reports of its application to pharmaceuticals.
Methods
A narrative review focused on LCA studies of any pharmaceuticals according to disease area.
Results
We identified the drug types used for treatment of 13 disease areas described in 51 previous LCA studies, classified using the MIDAS database. Among the drug types, anesthetics, inhalants, and antibiotics have received the most attention. However, LCA studies are lacking for the wide range of pharmaceuticals used in kidney healthcare, in the fields of dialysis therapy, treatment of end-stage kidney disease, and associated cardiovascular, metabolic, and endocrine diseases.
Discussion
As the proportion of the population affected by CKD increases, there is a particular urgency for LCA research into drugs administered for their kidney protective effects, such as renin-–angiotensin system inhibitors and sodium-glucose cotransporter 2 inhibitors. As sustainable practices in drug production and the ability to identify and choose effective drugs with low environmental impact require comprehensive LCA data, clinical physicians and pharmacists involved in kidney healthcare should collaborate with pharmaceutical companies to develop an LCA research system .
Incorporating rating of environmental burden of each drug into daily practice is desirable for achieving sustainable kidney healthcare and reducing its environmental impacts.
... It enables systematically comparing the environmental impact of product alternatives, including describing hotspots in processing technology [ [49] propose a streamlined approach to building life cycle inventory data for laboratory-scale chemical processes to help guide decision making on earlystage technologies. This approach is finding increasing use to identify environmental hotspots in new chemical products and means of production [50,51] and those for which only little data are available [52]. ...
Cellulose, a natural and biodegradable polymer, is finding use as an encapsulation agent for essential oils (EOs) used for food preservation and as a natural pesticide. Here, we evaluate the environmental performance of cellulose encapsulated EOs as alternatives to a commercial pesticide (pyridazine) and preservative (propionic acid) using life cycle assessment (LCA). A cradle-to-gate model of a scaled process that uses cellulose from agricultural residues to encapsulate EOs was evaluated via the ReCiPe 2016 midpoint life cycle impact assessment (LCIA) metrics for climate change impact, fossil resource scarcity and human and ecosystem toxicity. The encapsulated EOs were compared with functionally equivalent quantities of pesticide and preservative expected for application in crop production and food preservation, based on their minimum inhibitory concentrations. Results showed that the encapsulated EOs can significantly lower impacts when used as a pesticide substitute for pyridazine but have comparable or higher impacts if substituting for the preservative propionic acid for all impact categories. To investigate how the LCA results would be affected by variations in process parameters (i.e. energy input) and bridge the limitations of this LCA, of a scale-up process, we varied energy input by +/-10%, which resulted with a minor change in all metrics studied. This LCA finds environmental and resource saving benefits of applying cellulose encapsulated EOs compared to commercial pesticides used in agriculture, which could be extended to food and cosmetic preservation through process optimization.
... 4,10 This may be explained by a lack of life cycle inventory data for pharmaceuticals. 100 Not including potentially relevant factors may leave important contributors unseen or distort the analysis, making the relative share of certain contributors appear larger than it actually is. This in turn may direct carbon reduction efforts toward less impactful areas. ...
Background:
Climate change is the 21st century's biggest global health threat, endangering health care systems worldwide. Health care systems, and hospital care in particular, are also major contributors to greenhouse gas emissions.
Objectives:
This study used a systematic search and screening process to review the carbon footprint of hospital services and care pathways, exploring key contributing factors and outlining the rationale for chosen services and care pathways in the studies.
Methods:
This state-of-the-science review searched the MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), GreenFILE (EBSCOhost), Web of Science, Scopus, and the HealthcareLCA databases for literature published between 1 January 2000 and 1 January 2024. Gray literature was considered up to 1 January 2024. Inclusion criteria comprised original research reporting on the carbon footprint of hospital services or care pathways. Quality of evidence was assessed according to the guidelines for critical review of product life cycle assessment (LCA). PROSPERO registration number: CRD42023398527.
Results:
Of 5,415 records, 76 studies were included, encompassing 151 hospital services and care pathways across multiple medical specialties. Reported carbon footprints varied widely, from 0.01kg carbon dioxide (CO2) equivalents (kgCO2e) for an hour of intravenously administered anesthesia to 10,200 kgCO2e for a year of hemodialysis treatment. Travel, facilities, and consumables were key contributors to carbon footprints, whereas waste disposal had a smaller contribution. Relative importance of carbon hotspots differed per service, pathway, medical specialty, and setting. Studies employed diverse methodologies, including different LCA techniques, functional units, and system boundaries. A quarter of the studies lacked sufficient quality.
Discussion:
Hospital services and care pathways have a large climate impact. Quantifying the carbon footprint and identifying hotspots enables targeted and prioritized mitigation efforts. Even for similar services, the carbon footprint varies considerably between settings, underscoring the necessity of localized studies. The emerging field of health care sustainability research faces substantial methodological heterogeneity, compromising the validity and reproducibility of study results. This review informs future carbon footprint studies by highlighting understudied areas in hospital care and providing guidance for selecting specific services and pathways. https://doi.org/10.1289/EHP14754.
... Growing awareness of the environmental harms of pharmaceuticals is encouraging prescribers to make their prescribing practices more sustainable [53]. Of note, several medical associations and societies have recently argued that prescribers should be making decisions informed by the relative carbon footprint of drugs [52], preferring medicines with "the lowest environmental impact" where clinical efficacy is equal [54]. ...
Pharmaceuticals produce considerable environmental harm. The industry’s resource-intensive nature, coupled with high energy costs for manufacturing and transportation, contribute to the “upstream” harms from greenhouse gas emissions and ecosystem pollution, while factors such as overprescription, overuse, and pharmaceutical waste contribute to the “downstream” harms. Effectively addressing pharmaceutical pollution requires an understanding of the key roles and responsibilities along the product lifecycle. In this commentary, we argue that three actors—producers, regulators, and prescribers—have unique and interdependent responsibilities to address these issues. Producers and market access regulators are upstream actors who can manage and mitigate harms by both shifting manufacturing, business practices, and regulatory requirements and producing transparent, robust data on environmental harms. By contrast, prescribers are downstream actors whose capacity to reduce environmental harms arises principally as a “co-benefit” of reducing inappropriate prescribing and overuse. Potentially complicating the prescriber’s role are the calls for prescribers to recommend “environmentally preferable medicines”. These calls continue to increase, even with the sparsity of transparent and robust data on the impact of pharmaceuticals on the environment. Recognizing the interdependencies among actors, we argue that, rather than being ineffectual, these calls draw needed attention to the critical responsibility for upstream actors to prioritize data production, reporting standards and public transparency to facilitate future downstream efforts to tackle pharmaceutical pollution.
... According to the latest life cycle assessments (LCAs), this is equivalent to a reduction in carbon dioxide emissions of 2.9e4.4 kg. 23 However, TIVA might have other environmental effects not included in the LCA. For example, propofol that is not properly disposed of might have a negative effect on the environment because of its possible ecotoxicological effects. ...
Background
Propofol accounts for a substantial proportion of medication waste. Evidence-based waste reduction methods are scarce.
Methods
In a retrospective analysis of 331 procedures, the total propofol waste per surgery was compared between manual and syringe pump induction of anaesthesia during total intravenous anaesthesia (TIVA), with a syringe pump used to maintain TIVA after induction. The secondary endpoint was the amount of propofol administered. Subgroup analyses examined the influence of biological sex, age, weight or BMI, American Society of Anesthesiologists (ASA) physical status, substance use, and anaesthesia duration on propofol waste.
Results
Syringe pump induction was associated with 32.8% less waste of propofol (P<0.001); this effect was most pronounced in procedures lasting 20–60 min (up to 46.9% less in procedures lasting 20–40 min, P<0.001) and 80–120 min (up to 48.8% less in procedures lasting 100–120 min, P=0.003). The amount of waste was not affected by biological sex, age, weight, BMI, or ASA physical status. Syringe pump induction was consistently associated with less waste, except in patients with obesity. Patients with active substance use had 27.6% more waste with manual induction (P=0.031) but not with syringe pump induction. In patients with and without active substance use, syringe pump induction resulted in less waste (substance use: 48.7% less, P=0.0015; without substance use: 22.7% less, P=0.0045).
Conclusions
Syringe pump induction reduced propofol waste during TIVA, regardless of patient characteristics. Manual induction using a separate syringe should be reconsidered from an environmental and economic viewpoint.
... The production of the API propofol emits 21 g CO 2 per g propofol. 9 Interestingly, the 1% and 2% formulations share identical compositions, differing only in the concentration of API propofol. Producing and disposing of a 50-mL vial of 1% propofol, including vial components and excipients, emits 445 g CO 2 ; for a 2% vial, this is 456 g CO 2 . ...
... The literature indicates that stoichiometry can provide detailed inventory analysis through the combination of chemical reactions and process conditions [71]. Parvatker et al. [72] developed process scale-up techniques, stoichiometric calculations, and proxy data to estimate material and energy inputs. Laboratory-scale procedures were adapted to industrial-scale operations for twenty anesthetic active pharmaceutical ingredients (APIs). ...
Polyvinyl chloride (PVC) resins are widely used in modern society due to their acid and alkali resistance, low cost, and strong insulation properties. However, the high chlorine (Cl) content in PVC poses significant challenges for its recycling. This study reviews the treatment processes, model construction, and economic and environmental assessments to construct a methodological framework for the sustainable development of emerging dechlorination technologies. In terms of treatment processes, this study summarizes three types of processes, pretreatment, simultaneous dechlorination during chemical recycling, product purification, and emphasizes the necessity of dechlorination treatment from a systematic perspective. Additionally, the construction of models for dechlorination processes is investigated from the laboratory to the industrial production system to macro-scale material, in order to evaluate the potential inventory data and material metabolism behaviors. This review also summarized the methodology framework of Techno-Economic Analysis (TEA) and Life Cycle Assessment (LCA), which can be applied for evaluation of the economic and environmental performance of the dechlorination processes. Overall, this review provides readers with a comprehensive perspective on the state-of-the-art for PVC dechlorination technologies, meanwhile offering sustainable guidance for future research and industrial applications of chemical recycling of PVC waste.
... [8][9][10] Anaesthetics emissions are quantified through direct measurement of the gas volume and the specific gas's GWP. 9 Several anaesthetics have GWPs much greater than that of carbon dioxide (CO 2 e >> 1). 11 For inhalers, attention has focused on quantifying and reducing emissions of propellants used to deliver medication into the lungs, some of which have high carbon footprints. 10 These examples demonstrate the value of product-level medicine carbon footprints for identifying, prioritizing and reducing pharmaceutical emissions. ...
Aims
Healthcare accounts for 5% of global greenhouse gas emissions, with medicines making a sizeable contribution. Product‐level medicine emission data is limited, hindering mitigation efforts. To address this, we created Medicine Carbon Footprint (MCF) Classifier, to estimate, standardize, stratify and visualize medicine carbon footprints.
Methods
We used molecular weight and chemical structure to estimate the process mass intensity and global warming potential of the active pharmaceutical ingredient in small molecule medicines. This allowed us to estimate medicine carbon footprints per dose, which we categorized into MCF Ratings, accessible via a searchable web application, MCF Formulary. We performed comparison and sensitivity analyses to validate the ratings, and stratification analyses by therapeutic indication to identify priority areas for emission reduction interventions.
Results
We generated standardized medicine carbon footprints for 2214 products, with 38% rated LOW, 35% MEDIUM, 25% HIGH and 2% VERY HIGH. These products represented 2.2 billion NHS England prescribed doses in January 2023, with a total footprint of 140 000 tonnes CO2e, equivalent to the monthly emissions of 940 000 cars. Notably, three antibiotics—amoxicillin, flucloxacillin and penicillin V—contributed 15% of emissions. We estimate that implementing the recommended 20% antibiotic prescription reduction could save 4200 tonnes CO2e per month, equivalent to removing 29 000 cars.
Conclusions
Standardized medicine carbon footprints have utility in assessing and addressing the carbon emissions of medicines, and the potential to inform and catalyse changes needed to align better healthcare and net zero commitments.
... Of the assumptions, the intensity of active pharmaceutical ingredient synthesis had the largest overall effect. There is currently a relative lack of data to accurately describe the environmental impact of industrial scale manufacture of specific pharmaceutical products, with gross industry average data being a best estimate for most products [16,31]. Further research in this area is necessary to guide mitigation steps and product choice. ...
Objectives
To evaluate the carbon footprint of the perioperative transurethral resection of bladder tumour (TURBT) pathway from decision to treat to postoperative discharge, and model potential greenhouse gas (GHG) emissions reduction strategies.
Materials and Methods
This process‐based attributional cradle‐to‐grave life‐cycle assessment (LCA) of GHG emissions modelled the perioperative TURBT pathway at a hospital in Southwest England. We included travel, energy and water use, all reusable and consumable items, and laundry and equipment sterilisation. Resource use for 30 patients undergoing surgery was recorded to understand average GHG emissions and the inter‐case variability. Sensitivity analysis was performed for manufacturing location, pharmaceutical manufacturing carbon‐intensity, and theatre list utilisation.
Results
The median (interquartile range) perioperative TURBT carbon footprint was 131.8 (119.8–153.6) kg of carbon dioxide equivalent. Major pathway categories contributing to GHG emissions were surgical equipment (22.2%), travel (18.6%), gas and electricity (13.3%), and anaesthesia/drugs and associated adjuncts (27.0%), primarily due to consumable items and processes. Readily modifiable GHG emissions hotspots included patient travel for preoperative assessment, glove use, catheter use, irrigation delivery and extraction, and mitomycin C disposal. GHG emissions were higher for those admitted as inpatients after surgery.
Conclusions
This cradle‐to‐grave LCA found multiple modifiable GHG emissions hotspots. Key mitigation themes include minimising avoidable patient travel, rationalising equipment use, optimally filling operating theatre lists, and safely avoiding postoperative catheterisation and hospital admission where possible. A crucial next step is to design and deliver an implementation strategy for the environmentally sustainable changes demonstrated herein.
... For some that have been identified as highly harmful to the environment, full life-cycle studies have been conducted and are available in the literature. This is the case for certain anaesthetic gases and bronchodilators, allowing us to quantify their effects more precisely [13,14]. ...
Switzerland, a wealthy country, has a cutting-edge healthcare system, yet per capita, it emits over one ton of CO2, ranking among the world’s most polluting healthcare systems. To estimate the carbon footprint of the healthcare system of Geneva’s canton, we collected raw data on the activities of its stakeholders. Our analysis shows that when excluding medicines and medical devices, hospitals are the main greenhouse gas emitter by far, accounting for 48% of the healthcare system’s emission, followed by nursing homes (20%), private practice (18%), medical analysis laboratories (7%), dispensing pharmacies (4%), the homecare institution (3%), and the ambulance services (<1%). The most prominent emission items globally are medicines and medical devices by far, accounting for 59%, followed by building operation (19%), transport (11%), and catering (4%), among others. To actively reduce Geneva’s healthcare carbon emissions, we propose direct and indirect measures, either with an immediate impact or implementing systemic changes concerning medicine prescription, building heating and cooling, low-carbon means of transport, less meaty diets, and health prevention. This study, the first of its kind in Switzerland, deciphers where most of the greenhouse gas emissions arise and proposes action levers to pave the way for ambitious emission reduction policies. We also invite health authorities to engage pharmaceutical and medical suppliers in addressing their own responsibilities, notably through the adaptation of procurement processes and requirements.
Travel and tourism are essential to global economies, generating social, economic, and environmental impacts. However, there is a lack of standardized methodologies to assess the environmental footprint of tourist destinations beyond carbon footprint analysis. This study introduces the Greentour tool, the first of its kind to evaluate the environmental impact of accommodation, restaurants, and tourism activities using nine environmental indicators from a life cycle assessment (LCA) perspective. The tool applies a hybrid bottom-up and top-down approach, integrating data from tourist establishments and destination managers. The tool was tested in four tourist destinations in Spain and Portugal (Rías Baixas, Camino Lebaniego, Lloret de Mar, and Guimarães), revealing that transportation is the primary contributor to environmental impacts, ranging from 60% to 96% of total emissions, particularly in air-travel-dependent destinations. Food and beverage services are the second-largest contributor, accounting for up to 26% of emissions, while accommodation ranks third (1–14%). This study highlights the significant role of electricity consumption and food choices (e.g., red meat and dairy) in greenhouse gas (GHG) emissions, emphasizing the need for sustainable alternatives. Despite challenges in data collection, particularly for food and transport statistics, the Greentour tool has demonstrated robustness and adaptability across diverse destinations, making it applicable worldwide. This tool provides key insights for policymakers, tourism stakeholders, and businesses, supporting the integration of sustainability strategies into public policies and industry best practices. Future research should focus on expanding its use to additional destinations to foster science-based decision-making and promote more sustainable tourism practices globally.
The synthesis of active pharmaceutical ingredients (APIs) is commonly perceived as more efficient when performed using continuous-flow methods, whereas batch processes are often seen as less favorable due to their limitations in yield, heat and mass transfer, and safety. This perception largely stems from existing studies that focus on green metrics such as the E-factor and yield. However, a comprehensive comparison of batch and flow processes through full techno-economic analyses (TEA) and life-cycle assessments (LCA) remains underexplored, leaving key aspects of their environmental and economic impacts inadequately assessed. This work addresses this gap by presenting a detailed comparison of batch and flow syntheses of seven industrially relevant APIs, including amitriptyline hydrochloride, tamoxifen, zolpidem, rufinamide, artesunate, ibuprofen, and phenibut. Eleven environmental impact categories within the framework of nine planetary boundaries were assessed, and the study also included an evaluation of capital and operating costs for both production methods. The results demonstrated that, on average, continuous-flow processes are significantly more sustainable with improvements in energy efficiency, water consumption, and waste reduction. Flow processes also show a marked reduction in carbon emissions and up to a 97% reduction in energy consumption, highlighting their potential for greener API manufacturing. Despite these advantages, the study identified areas where the continuous-flow technology requires further development. Specifically, manufacturing certain APIs in flow show lower-than-average improvements in operating expenditure and land system changes, the latter being directly correlated with the consumption of organic solvents, that can be comparable to or even higher than in batch. These challenges highlight the need for further optimization of flow processes to fully realize their potential in API production.
https://authors.elsevier.com/a/1ka575P-VvZdXZ
Purpose
The aim of the study was to evaluate the environmental impact of a blepharoplasty as performed by a single surgeon at an office-based operating room (OR) versus at an ambulatory surgery center.
Methods
We employed life cycle analyses on routine, uncomplicated bilateral upper lid blepharoplasties as performed by a single surgeon. Life cycle phases of production, use, and end-of-life treatment were included. Study boundaries encompassed all waste products exiting the OR in addition to utility energy and water use. We conducted waste audits to collect data on surgical waste by item, material, and weight. Building energy and water use were approximated using data obtained from utility companies. Environmental impact is reported as global warming potential (GW100a; kg carbon dioxide equivalents).
Results
The office-based OR generated 784 g of physical waste per blepharoplasty as compared to 1323 g at the ambulatory surgery center. The life cycle analyses found that a blepharoplasty contributed a total of 6.42 kg carbon dioxide equivalents at the office-based OR and 7.78 at the ambulatory surgery center. The production phase contributed the majority of these carbon dioxide equivalents. Plastic supplies contributed the most waste by weight and emissions associated with production. Nonwoven polypropylene contributed the largest waste and emissions by material.
Conclusion
The ambulatory surgery center produces more waste and carbon dioxide equivalents per blepharoplasty than the office-based OR. Use of supplies including drapes and gowns made of nonwoven polypropylene can be reduced to increase the environmental sustainability of blepharoplasty.
Background:
Understanding the financial and environmental impact of clinical pathways is important for designing sustainable services. This study aimed to compare the cost and carbon footprint of sub-Tenon's and topical anaesthesia for cataract surgery, benchmark minimum topical anaesthesia utilisation rates, and quantify the benefits of increased topical anaesthesia usage in the United Kingdom National Health Service (NHS).
Methods:
The cost and carbon footprint of products and staffing for topical and sub-Tenon's anaesthesia for cataract surgery were calculated and applied to National Ophthalmology Database audit data. A mainly process-based approach was used to estimate the carbon dioxide equivalent (CO2e) of product production, usage, and waste disposal.
Results:
The typical CO2e per case was 0.71 kg for topical anaesthesia and 1.19 kg for sub-Tenon's anaesthesia. Around a third of CO2e was generated by usage of unneccesary equiptment and wasteful practices. The typical cost per case was £14.60-£17.14 for topical anaesthesia, £27.74 for sub-Tenon's anaesthesia performed by an operating department practitioner and £56.15 for sub-Tenon's anaesthesia performed by a consultant anaesthetist. It is estimated that around 25,000 NHS cataract cases could annually be converted from sub-Tenon's to topical anaesthesia, which would reduce the CO2e emissions of services by 12,000 kg while saving £265,000 on product usage and between £63,500 and £773,750 on staffing.
Conclusions:
Topical anaesthesia is a cheaper and more environmentally sustainable alternative to sub-Tenon's anaesthesia for cataract surgery. Increased topical anaesthesia usage in cataract services could contribute towards the NHS aspiration of becoming "net zero" by 2040.
Purpose of review
Climate change is the biggest threat to human health and survival in the twenty-first century. Emissions associated with healthcare contribute to climate change and there are many personal and professional actions that can reduce carbon emissions. This review highlights why action is necessary and what anaesthetists and healthcare workers can do.
Recent findings
Encouraging continuing research regarding sustainable anaesthesia and expanding education at all levels to include climate action is key. Professionally, actions include limiting use of single-use equipment, reducing reliance on volatile gas inhalational anaesthesia, and adopting low fresh gas flow techniques. Personal actions such as climate-conscious travelling, spending, and eating are important, especially when shared to create climate positive movements.
Summary
This article shows that, while patient safety and quality of care must remain healthcare's top priority, considering the climate implications of care is part of that duty. Many actions that reduce the carbon impact of care simultaneously improve the quality of care and reduce financial cost. More research into sustainable healthcare is needed. Departments and hospitals and must create environments in which climate conversations are welcomed and can result in positive advancements.
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 surgical equipment, energy requirements for cleaning, and operating room energy use. Data for anaesthesia were sourced from our prior study. We used life cycle assessment software to convert inputs of energy and material use into outputs in kg CO2e emissions, using Monte Carlo analyses with 95% confidence intervals. Results The average carbon footprint was 131.7 kg CO2e, (95% confidence interval: 117.7–148.5 kg CO2e); surgery was foremost (104/131.7 kg CO2e, 80%), with lesser contributions from anaesthesia (15.0/131.7 kg CO2e, 11%), and engineering (11.9/131.7 kg CO2e, 9%). The main surgical sources of greenhouse gas emissions were: energy used to disinfect and steam sterilise reusable equipment (43.4/131.7 kg CO2e, 33%), single-use equipment (34.2/131.7 kg CO2e, 26%), with polypropylene alone 13.7/131.7 kg CO2e (11%), and the knee prosthesis 19.6 kg CO2e (15%). For energy use, the main contributors were: gas heating (6.7 kg CO2e) and heating, cooling, and fans (4 kg CO2e). Conclusions The carbon footprint of a total knee replacement was equivalent to driving 914 km in a standard 2022 Australian car, with surgery contributing 80%. Such data provide guidance in reducing an operation’s carbon footprint through prudent equipment use, more efficient steam sterilisation with renewable electricity, and reduced single-use waste.
Importance
Medications are associated with substantial environmental outcomes, yet frequently end up being unused by patients. Waste-minimizing interventions, such as redispensing of quality-approved oral anticancer drugs remaining unused by patients at home, could reduce the environmental footprint of cancer treatment.
Objectives
To assess the environmental outcomes of redispensing quality-assured oral anticancer drugs and to explore how redispensing could be environmentally optimized.
Design, Setting, and Participants
In this quality improvement study, a cradle-to-grave life cycle assessment was performed in the outpatient pharmacy of 4 Dutch hospitals, based on a prospective multicenter trial comprising 1071 patients with a clinical diagnosis of cancer and an active prescription for an oral anticancer drug stored at room temperature from February 1, 2021, to February 1, 2023, with a follow-up of 12 months per patient.
Intervention
Participants received prescribed oral anticancer drugs with additional quality-assurance materials (ie, seal bags and time-temperature indicators), so the pharmacy could redispense quality-assured drugs based on authenticity, appearance, remaining shelf life, and/or adequate storage.
Main Outcomes and Measures
The estimated environmental outcomes avoided due to waste reduction (ie, production and transport and incineration of redispensed oral anticancer drugs) corrected for outcomes of process burdens (ie, quality assurance materials), quantified in 3 outcome measures: human health damage (disability-adjusted life-years), ecosystems damage (species × year), and climate change (kg of carbon dioxide equivalent [CO 2-eq ]) per patient per year.
Results
A volunteer sample of 1071 patients (median age, 70 years [IQR, 62-75 years]; 622 men [58.1%]) participated in the intervention. Redispensing oral anticancer drugs was initially associated with an environmental burden, mainly because of the high impact of time-temperature indicators. However, when quality-assurance materials were selectively used for temperature-sensitive oral anticancer drugs (ie, maximum storage temperature of 25 °C), redispensing was environmentally beneficial to human health and ecosystems, providing estimated climate benefits of 1.9 kg (95% CI, 1.4-2.6 kg) of CO 2-eq per patient per year.
Conclusions and Relevance
In this quality improvement study, redispensing unused oral anticancer drugs was found to be a suitable strategy to reduce waste and improve environmental sustainability of cancer treatment after process optimization. Redispensing unused oral anticancer drugs could contribute to sustainability of cancer treatment through reduced costs and environmental outcomes.
An urgent need for societal transformation exists to reduce the environmental impact of humanity, because environmental health affects human health. Health care causes ~5% of global greenhouse gas emissions and other substantial and ongoing environmental harms. Thus, health-care professionals and managers must lead ongoing efforts to improve the environmental performance of health systems. Life-cycle assessment (LCA) is a methodology that enables estimation of environmental impacts of products and processes. It models environmental effects from 'cradle' (raw material extraction) to 'grave' (end of useful life) and conventionally reports a range of different impact categories. LCA is a valuable tool when used appropriately. Maximizing its utility requires rational assumptions alongside careful consideration of system boundaries and data sources. Well-executed LCAs are detailed and transparently reported, enabling findings to be adapted or generalized to different settings. Attention should be given to modelling mitigation solutions in LCAs. This important step can guide health-care systems towards new and innovative solutions that embed progress towards international climate agreements. Many urological conditions are common, recurrent or chronic, requiring resource-intensive management with large associated environmental impacts. LCAs in urology have predominantly focussed on greenhouse gas emissions and have enabled identification of modifiable 'hotspots' including electricity use, travel, single-use items, irrigation, reprocessing and waste incineration. However, the methodological and reporting quality of published urology LCAs generally requires improvement and standardization. Health-care evaluation and commissioning frameworks that value LCA findings alongside clinical outcomes and cost could accelerate sustainable innovations. Rapid implementation strategies for known environmentally sustainable solutions are also needed.
Effective use of quantitative metrics is fundamental to guiding innovation toward more sustainable chemicals. At present, metrics employed in Green Chemistry, such as the E factor, Process Mass Intensity, or...
Background:
Healthcare's carbon footprint contributes to 4.4% of global net emissions and intensive care units (ICUs) are very resource intensive. Existing studies on environmental sustainability in ICUs focused on carbon footprint generated from energy and electricity consumption, use of medical consumables and equipment, but few studies quantified carbon footprint generated from pharmaceuticals used in ICUs.
Aim:
To evaluate carbon footprint arising from sedation practices in the ICUs.
Study design:
A pilot, prospective observational study was conducted in two ICUs from 1 August to 22 September 2022 in Singapore General Hospital. Adult patients who were consecutively sedated, intubated and expected to be mechanically ventilated for at least 24 h were included. Total amount of analgesia and sedatives used and wasted in eligible patients were collected. Carbon emission from ICU sedation practices were then quantified using available life cycle assessment data.
Results:
A total of 31 patients were recruited. Top analgesia and sedative used in both ICUs were fentanyl and propofol, respectively. Carbon footprint from sedative usage and wastage across 7 weeks in both ICUs were 2.206 kg CO2-e and 0.286 g CO2-e, respectively. In total, this equates to driving 15.8 km by car. Proportion of drug wasted ranged from 5.1% to 25.0%, with the top reason for wastage being the drug was no longer clinically indicated. Recommendations to reduce carbon footprint include choosing sedatives with lower carbon emissions where possible and having effective communication among doctors and nurses regarding management plans to minimize unnecessary wastage.
Conclusion:
Our study quantified carbon footprint arising from sedation practices, mainly drug usage and wastage in two ICUs in Singpore General Hospital.
Relevance to clinical practice:
Adopting a holistic approach to environmental sustainability in the ICU, sedation practices also contribute to generating greenhouse gases, albeit small, and can be targeted to reduce unnecessary carbon footprint.
Purpose of review
The environmental impact of anesthesia far exceeds that of other medical specialties due to our use of inhaled anesthetic agents (which are potent greenhouse gases) and many intravenous medications.
Recent findings
Calls for reducing the carbon footprint of anesthesia are ubiquitous in the anesthesia societies of developed nations and are appearing in proposed changes for hospital accreditation and funding in the United States. The body of research on atmospheric, land and water impacts of anesthetic pharmaceuticals is growing and generally reinforces existing recommendations to reduce the greenhouse gas emissions of anesthesia care.
Summary
The environmental impact of anesthesia care should factor into our clinical decisions. The onus is on clinicians to safely care for our patients in ways that contribute the least harm to the environment. Intravenous anesthesia and regional techniques have less environmental impact than the use of inhaled agents; efforts to reduce and properly dispose of pharmaceutical waste are central to reducing environmental burden; desflurane should not be used; nitrous oxide should be avoided except where clinically necessary; central nitrous pipelines should be abandoned; low fresh gas flows should be utilized whenever inhaled agents are used.
The effectiveness of climate-smart approaches is of significant concern because theatres contribute up to 33% of the hospital carbon footprint and 42% of revenue. Despite overwhelming advancements in climate-smart green theatre research, benchmarking remains a challenge. A single index representing their improvements has significant potential to increase control over and to promote their approaches. That is, this study does not stop at an inquiry about climate-smart approaches but also moves a step further and explores a possible outcome measure for the evolution of magnitudes, particularly in favour of the green theatre index (GTI). A function (clinical_theatre_emissions) was created in the R package Carbonr to calculate carbon emission. A time series emission data by theatre were consolidated as GTI using Fisher ideal index. The GTI proves a feasible and accurate consolidated outcome measure for carbon emissions to track and benchmark climate-smart strategies and could be applied in the real-world settings.
The provision of healthcare is a substantial global contributor to greenhouse gas (GHG) emissions. Several medical specialties and national health systems have begun evaluating their carbon emission contributions. The aim of this review is to summarise and describe the carbon footprint resulting from the provision of adult, paediatric and neonatal critical care.
A systematic search of Embase, Cochrane and Web of Science was performed in January 2023. Studies reporting any assessment of the carbon footprint of critical care were included. No language restrictions were applied. GHG emissions from life cycle assessments (LCA) were reported, in addition to waste, electricity and water use. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed.
In total, 13 studies assessing and describing the environmental impact of 36 adult or paediatric intensive care units (ICUs) were included. Two studies described full LCAs, seven reported waste only, two provided audits of unused medical supplies, one reported electricity use, and one study described a Material Flow Analysis. The estimated carbon emissions from critical care range between 88 kg CO2e/patient/day and 178 kg CO2e/patient/day. The two predominant sources of carbon emissions in critical care originate from electricity and gas use, as well as consumables. Waste production ranged from 1.1 to 13.7 kg/patient/day in the 6 studies where mean waste could be calculated.
There is a significant carbon footprint that results from intensive care provision. Consumables and waste constitute important, measurable, and modifiable components of anthropogenic emissions. There remains uncertainty due to a lack of literature, several unstudied areas of carbon emissions from critical care units, and within measured areas, measurement and reporting of carbon emissions are inconsistent.
Purpose
The manufacturing of pharmaceuticals and their occurrence in the environment generated growing concerns of stakeholders. Life Cycle Assessment (LCA) is a suitable tool to identify potential environmental impacts within the whole pharmaceutical value chain. However, existing pharma-LCAs revealed several methodological shortcomings and challenges. To support the development of future LCAs in the sector, draft Product Category Rules (PCR) for pharmaceuticals for human use and their manufacturing processes are proposed.
Methods
Existing LCA case studies were evaluated and compared based on the methodological requirements according to the ISO 14044 standard. In addition, PCRs from the pharmaceutical sector, generic LCA standards, and product-specific guidelines were reviewed. Subsequently, overlaps between and deviations from these sources were identified. It was determined whether methodological requirements can be adopted from existing standards and guidelines or whether additional rules or specifications for pharmaceutical products are needed.
Results and discussion
The overall PCR structure was established in alignment with ISO 14044, ISO TS 14027, and the Guidance for PCR development (GPCRD). For the definition of product groups, the third level of the Anatomic Therapeutic Chemical (ATC) classification system was determined as appropriate level of detail (granularity). The methodological requirements, e.g., the definition of goal and scope, inventory analysis, as well as the impact assessment, were set considering the intended application and the product system. However, the majority of these proposed methodological requirements go beyond current practice in existing pharma-LCAs (e.g., definition of an effect-based functional unit). Moreover, the need for specific rules depending on the active pharmaceutical ingredient (API), the galenic formulation, and regional aspects was described and discussed.
Conclusions
This work tackles current methodological challenges of LCA application in the pharmaceutical sector by providing harmonized rules to guide future studies on pharmaceutical products and processes. However, modelling the use- and end of life phase as well as considering pharma-specific impacts were revealed as remaining challenges.
Background
Human health is dependent upon environmental health. Air pollution is a leading cause of morbidity and mortality globally, and climate change has been identified as the single greatest public health threat of the 21st century. As a large, resource-intensive sector of the Canadian economy, healthcare itself contributes to pollutant emissions, both directly from facility and vehicle emissions and indirectly through the purchase of emissions-intensive goods and services. Together these are termed life cycle emissions. Here, we estimate the extent of healthcare-associated life cycle emissions as well as the public health damages they cause.
Methods and findings
We use a linked economic-environmental-epidemiological modeling framework to quantify pollutant emissions and their implications for public health, based on Canadian national healthcare expenditures over the period 2009–2015. Expenditures gathered by the Canadian Institute for Health Information (CIHI) are matched to sectors in a national environmentally extended input-output (EEIO) model to estimate emissions of greenhouse gases (GHGs) and >300 other pollutants. Damages to human health are then calculated using the IMPACT2002+ life cycle impact assessment model, considering uncertainty in the damage factors used. On a life cycle basis, Canada’s healthcare system was responsible for 33 million tonnes of carbon dioxide equivalents (CO2e), or 4.6% of the national total, as well as >200,000 tonnes of other pollutants. We link these emissions to a median estimate of 23,000 disability-adjusted life years (DALYs) lost annually from direct exposures to hazardous pollutants and from environmental changes caused by pollution, with an uncertainty range of 4,500–610,000 DALYs lost annually. A limitation of this national-level study is the use of aggregated data and multiple modeling steps to link healthcare expenditures to emissions to health damages. While informative on a national level, the applicability of these findings to guide decision-making at individual institutions is limited. Uncertainties related to national economic and environmental accounts, model representativeness, and classification of healthcare expenditures are discussed.
Conclusions
Our results for GHG emissions corroborate similar estimates for the United Kingdom, Australia, and the United States, with emissions from hospitals and pharmaceuticals being the most significant expenditure categories. Non-GHG emissions are responsible for the majority of health damages, predominantly related to particulate matter (PM). This work can guide efforts by Canadian healthcare professionals toward more sustainable practices.
https://link.springer.com/book/10.1007%2F978-3-319-66981-6
This book provides insight into the implementation of Life Cycle approaches along the entire business value chain, supporting environmental, social and economic sustainability related to the development of industrial technologies, products, services and policies; and the development and management of smart agricultural systems, smart mobility systems, urban infrastructures and energy for the built environment. The book is based on papers presented at the 8th International Life Cycle Management Conference that took place from September 3-6, 2017 in Luxembourg, and which was organized by the Luxembourg Institute of Science and Technology (LIST) and the University of Luxembourg in the framework of the LCM Conference Series.
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 assessment of Australia's health-care system. All expenditure data were obtained from the 15 sectors of the Australian Institute of Health and Welfare for the financial year 2014–15. The Australian Industrial Ecology Virtual Laboratory (IELab) data were used to obtain CO2e emissions per AUS161·6 billion on health care that led to CO2e emissions of about 35 772 (68% CI 25 398–46 146) kilotonnes. Australia's total CO2e emissions in 2014–15 were 494 930 kilotonnes, thus health care represented 35 772 (7%) of 494 930 kilotonnes total CO2e emissions in Australia. The five most important sectors within health care in decreasing order of total CO2e emissions were: public hospitals (12 295 [34%] of 35 772 kilotonnes CO2e), private hospitals (3635 kilotonnes [10%]), other medications (3347 kilotonnes [9%]), benefit-paid drugs (3257 kilotonnes [9%]), and capital expenditure for buildings (2776 kilotonnes [8%]).
Interpretation
The carbon footprint attributed to health care was 7% of Australia's total; with hospitals and pharmaceuticals the major contributors. We quantified Australian carbon footprint attributed to health care and identified health-care sectors that could be ameliorated. Our results suggest the need for carbon-efficient procedures, including greater public health measures, to lower the impact of health-care services on the environment.
Funding
None.
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 and packaging bags of morphine.
Main outcome measures
The environmental effects (eg, CO2 equivalent (‘CO2 e’) emissions and water use) of producing 100 mg of morphine. All aspects of morphine production from poppy farming, pelletising, bulk morphine manufacture through to final formulation. Industry-sourced and inventory-sourced databases were used for most inputs.
Results
Morphine sulfate (100 mg in 100 mL) had a climate change effect of 204 g CO2 e (95% CI 189 to 280 g CO2 e), approximating the CO2 e emissions of driving an average car 1 km. Water use was 7.8 L (95% CI 6.7– to 9.0 L), primarily stemming from farming (6.7 L). All other environmental effects were minor and several orders of magnitude less than CO2 e emissions and water use. Almost 90% of CO2 e emissions occurred during the final stages of 100 mg of morphine manufacture. Morphine's packaging contributed 95 g CO2 e, which accounted for 46% of the total CO2 e (95% CI 82 to 155 g CO2 e). Mixing, filling and sterilisation of 100 mg morphine bags added a further 86 g CO2 e, which accounted for 42% (95% CI 80 to 92 g CO2 e). Poppy farming (6 g CO2 e, 3%), pelletising and manufacturing (18 g CO2 e, 9%) made smaller contributions to CO2 emissions.
Conclusions
The environmental effects of growing opium poppies and manufacturing bulk morphine were small. The final stages of morphine production, particularly sterilisation and packaging, contributed to almost 90% of morphine's carbon footprint. Focused measures to improve the energy efficiency and sources for drug sterilisation and packaging could be explored as these are relevant to all drugs. Comparisons of the environmental effects of the production of other drugs and between oral and intravenous preparations are required.
Continuous processing, as a form of process intensification, is one of the keys of green engineering research and development in the pharmaceutical industry. It has the potential to reduce solvent use and cost of production as well as increase production quality and operational safety. In light of the increased research interest surrounding continuous processing, the goal of this work is to compare the environmental performances of batch (BP) and continuous (CP) processing of 4-D-Erythronolactone (4-DEL) at pilot plant scale as case study. The processing systems are evaluated using green chemistry metrics and a cradle-to-gate life cycle assessment (LCA). The processing serves as the case study for this article’s goal. The LCA system boundary includes raw material extraction, transportation, synthesis of 4-DEL (as part of primary pharmaceutical manufacturing), equipment cleaning, plant utilities and off-site waste management. In order to obtain life cycle inventories to support the LCA study of the BP and CP systems, a modular approach is taken to address their differences. As part of a modular approach, theoretical production campaigns are constructed for the production scale of 49.6 kg 4-DEL within 5 days, the campaigns account for the time-bounded activities which affects the overall rate of production. The analysis shows that, under the assumptions used, using continuous processing for 4-DEL production has a lower environmental burden compared to batch mainly due to less equipment cleaning and a smaller plant footprint. This is reflected in a 30.1% lower cumulative mass intensity and reductions of various life cycle impacts such as global warming potential (-57.5%), human toxicity (-9.37%) and water depletion index (-41.7%). Sensitivity analysis on equipment cleaning and the consideration of various end-of-life waste treatment options illustrates the need to include them in the system boundary for a fair comparison between batch and continuous.
The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation’s pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA) modeling using National Health Expenditures (NHE) for the decade 2003–2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%), greenhouse gas emissions (10%), smog formation (10%) criteria air pollutants (9%), stratospheric ozone depletion (1%), and carcinogenic and non-carcinogenic air toxics (1–2%). The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors) and demand side (NHE categories), as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000–98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety.
Purpose
Good background data are an important requirement in LCA. Practitioners generally make use of LCI databases for such data, and the ecoinvent database is the largest transparent unit-process LCI database worldwide. Since its first release in 2003, it has been continuously updated, and version 3 was published in 2013. The release of version 3 introduced several significant methodological and technological improvements, besides a large number of new and updated datasets. The aim was to expand the content of the database, set the foundation for a truly global database, support regionalized LCIA, offer multiple system models, allow for easier integration of data from different regions, and reduce maintenance efforts. This article describes the methodological developments.
Methods
Modeling choices and raw data were separated in version 3, which enables the application of different sets of modeling choices, or system models, to the same raw data with little effort. This includes one system model for Consequential LCA. Flow properties were added to all exchanges in the database, giving more information on the inventory and allowing a fast calculation of mass and other balances. With version 3.1, the database is generally water-balanced, and water use and consumption can be determined. Consumption mixes called market datasets were consistently added to the database, and global background data was added, often as an extrapolation from regional data.
Results and discussion
In combination with hundreds of new unit processes from regions outside Europe, these changes lead to an improved modeling of global supply chains, and a more realistic distribution of impacts in regionalized LCIA. The new mixes also facilitate further regionalization due to the availability of background data for all regions.
Conclusions
With version 3, the ecoinvent database substantially expands the goals and scopes of LCA studies it can support. The new system models allow new, different studies to be performed. Global supply chains and market datasets significantly increase the relevance of the database outside of Europe, and regionalized LCA is supported by the data. Datasets are more transparent, include more information, and support, e.g., water balances. The developments also support easier collaboration with other database initiatives, as demonstrated by a first successful collaboration with a data project in Québec. Version 3 has set the foundation for expanding ecoinvent from a mostly regional into a truly global database and offers many new insights beyond the thousands of new and updated datasets it also introduced.
The implementation of Life Cycle Assessment and related methods in green chemical process and synthesis design strongly supports the development of greener concepts on the basis of deep and profound insights in the dependencies between the selection of compounds and process parameters and the resulting environmental impacts. This review article provides an overview about things to know about LCA in general, specifics to be considered during its application in the field of chemical (re-)designs and current application examples from emerging research areas such as active pharmaceutical ingredient manufacturing, nanotechnology, flow chemistry, process intensification by harsh synthesis conditions, process integration, waste treatment, use of alternative energy sources or solvents as well as chemistry based on renewable resources.
Background
Antibiotic drug consumption is a major driver of antibiotic resistance. Variations in antibiotic resistance across countries are attributable, in part, to different volumes and patterns for antibiotic consumption. We aimed to assess variations in consumption to assist monitoring of the rise of resistance and development of rational-use policies and to provide a baseline for future assessment.
Methods
With use of sales data for retail and hospital pharmacies from the IMS Health MIDAS database, we reviewed trends for consumption of standard units of antibiotics between 2000 and 2010 for 71 countries. We used compound annual growth rates to assess temporal differences in consumption for each country and Fourier series and regression methods to assess seasonal differences in consumption in 63 of the countries.
Findings
Between 2000 and 2010, consumption of antibiotic drugs increased by 36% (from 54 083 964 813 standard units to 73 620 748 816 standard units). Brazil, Russia, India, China, and South Africa accounted for 76% of this increase. In most countries, antibiotic consumption varied significantly with season. There was increased consumption of carbapenems (45%) and polymixins (13%), two last-resort classes of antibiotic drugs.
Interpretation
The rise of antibiotic consumption and the increase in use of last-resort antibiotic drugs raises serious concerns for public health. Appropriate use of antibiotics in developing countries should be encouraged. However, to prevent a striking rise in resistance in low-income and middle-income countries with large populations and to preserve antibiotic efficacy worldwide, programmes that promote rational use through coordinated efforts by the international community should be a priority.
Funding
US Department of Homeland Security, Bill & Melinda Gates Foundation, US National Institutes of Health, Princeton Grand Challenges Program.
Purpose
Life cycle assessment (LCA) methodology is a well-established analytical method to quantify environmental impacts, which has been mainly applied to products. However, recent literature would suggest that it has also the potential as an analysis and design tool for processes, and stresses that one of the biggest challenges of this decade in the field of process systems engineering (PSE) is the development of tools for environmental considerations.
Method
This article attempts to give an overview of the integration of LCA methodology in the context of industrial ecology, and focuses on the use of this methodology for environmental considerations concerning process design and optimization.
Results
The review identifies that LCA is often used as a multi-objective optimization of processes: practitioners use LCA to obtain the inventory and inject the results into the optimization model. It also shows that most of the LCA studies undertaken on process analysis consider the unit processes as black boxes and build the inventory analysis on fixed operating conditions.
Conclusions
The article highlights the interest to better assimilate PSE tools with LCA methodology, in order to produce a more detailed analysis. This will allow optimizing the influence of process operating conditions on environmental impacts and including detailed environmental results into process industry.
Purpose
Mixtures of organic chemicals are a part of virtually all life cycles, but LCI data exist for only relatively few chemicals. Thus, estimation methods are required. However, these are often either very time-consuming or deliver results of low quality. This article compares existing and new methods in two scenarios and recommends a tiered approach of different methods for an efficient estimation of the production impacts of chemical mixtures.
Methods
Four approaches to estimate impacts of a large number of chemicals are compared in this article: extrapolation from existing data, substitution with generic datasets on chemicals, molecular structure-based models (MSMs, in this case the Finechem tool), and using process-based estimation methods. Two scenarios were analyzed as case studies: soft PVC plastic and a tobacco flavor, a mixture of 20 chemicals.
Results
Process models have the potential to deliver the best estimations, as existing information on production processes can be integrated. However, their estimation quality suffers when such data are not available and they are time-consuming to apply, which is problematic when estimating large numbers of chemicals. Extrapolation from known to unknown components and use of generic datasets are generally not recommended. In both case studies, these two approaches significantly underestimated the impacts of the chemicals compared to the process models. MSMs were generally able to estimate impacts on the same level as the more complex process models. A tiered approach using MSMs to determine the relevance of individual components in mixtures and applying process models to the most relevant components offered a simpler and faster estimation process while delivering results on the level of most process models.
Conclusions
The application of the tiered combination of MSMs and process models allows LCA practitioners a relatively fast and simple estimation of the LCIA results of chemicals, even for mixtures with a large number of components. Such mixtures previously presented a problem, as the application of process models for all components was very time-consuming, while the existing, simple approaches were shown to be inadequate in this study. We recommend the tiered approach as a significant improvement over previous approaches for estimating LCA results of chemical mixtures.
Life cycle assessment offers a unique opportunity to analyze emission reductions across all manufacturing sectors. However, few efforts have been made to apply this method to the pharmaceutical industry. Typically, between 80 and 90% of the total mass used in the production of an active pharmaceutical ingredient (API) may be attributed to solvent use. Manufacture of virgin solvent and solvent waste management contribute significantly more life cycle emissions than comparable processes for commodity chemicals, with the majority of this waste consisting of CO2 and other green house gas emissions. Three case studies from Pfizer, Bristol-Myers Squibb, and Novartis are examined. In these cases, solvent recovery and reduction techniques are integrated into API syntheses. It is shown that the actual extent of the environmental footprint reduction can only be realized with a full life cycle analysis.
There is an increasing need for life cycle data for bio‐based products, which becomes particularly evident with the recent drive for greenhouse gas reporting and carbon footprinting studies. Meeting this need is challenging given that many bio‐products have not yet been studied by life cycle assessment (LCA), and those that have are specific and limited to certain geographic regions. In an attempt to bridge data gaps for bio‐based products, LCA practitioners can use either proxy data sets (e.g., use existing environmental data for apples to represent pears) or extrapolated data (e.g., derive new data for pears by modifying data for apples considering pear‐specific production characteristics). This article explores the challenges and consequences of using these two approaches. Several case studies are used to illustrate the trade‐offs between uncertainty and the ease of application, with carbon footprinting as an example. As shown, the use of proxy data sets is the quickest and easiest solution for bridging data gaps but also has the highest uncertainty. In contrast, data extrapolation methods may require extensive expert knowledge and are thus harder to use but give more robust results in bridging data gaps. They can also provide a sound basis for understanding variability in bio‐based product data. If resources (time, budget, and expertise) are limited, the use of averaged proxy data may be an acceptable compromise for initial or screening assessments. Overall, the article highlights the need for further research on the development and validation of different approaches to bridging data gaps for bio‐based products.
Background, aim, and scopePharmaceuticals have been recently discussed in the press and literature regarding their occurrence in rivers and lakes, mostly
due to emissions after use. The production of active pharmaceutical ingredients (APIs) has been less analyzed for environmental
impacts. In this work, a life cycle assessment (LCA) of the production of an API from cradle to factory gate was carried out.
The main sources of environmental impacts were identified. The resulting environmental profile was compared to a second pharmaceutical
production and to the production of basic chemicals.
Materials and methodsDetailed production data of a pharmaceutical production in Basel, Switzerland were used as the basis of this work. Information
about the production of precursor chemicals was available as well. Using models and the ecoinvent database to cover remaining
data gaps, a full life cycle inventory of the whole production was created. Using several life cycle impact assessment methods,
including Cumulative Energy Demand (CED), Global Warming Potential (GWP), Eco-Indicator 99 (EI99), Ecological Scarcity 2006,
and TRACI, these results were analyzed and the main sources of environmental burdens identified.
ResultsPharmaceutical production was found to have significantly more environmental impacts than basic chemical production in a kilogram-per-kilogram
basis. Compared to average basic chemical production, the API analyzed had a CED 20 times higher, a GWP 25 times higher and
an EI99 (H/A) 17 times higher. This was expected to a degree, as basic chemicals are much less complex molecules and require
significantly fewer chemical transformations and purifications than pharmaceutical compounds. Between 65% and 85% of impacts
were found to be caused by energy production and use. The fraction of energy-related impacts increased throughout the production
process. Feedstock use was another major contributor, while process emissions not caused by energy production were only minor
contributors to the environmental impacts.
DiscussionThe results showed that production of APIs has much higher impacts than basic chemical production. This was to be expected
given the increased complexity of pharmaceutical compounds as compared with basic chemicals, the smaller production volumes,
and the fact that API production lines are often newer and less optimized than the production of more established basic chemicals.
The large contributions of energy-related processes highlight the need for a detailed assessment of energy use in pharmaceutical
production. The analysis of the energy-related contributions to the overall impacts on a process step level allows a comprehensive
understanding of each process’ contribution to overall impacts and their energy intensities.
ConclusionsEnvironmental impacts of API production were estimated in a cradle-to-gate boundary. The major contributors to the environmental
impacts in aggregating methods were resource consumption and emissions from energy production. Process emissions from the
pharmaceutical manufacturing plant itself were less of a concern in developed countries. Producers aiming to increase their
sustainability should increase efforts to reduce mass intensity and to improve energy efficiency.
Recommendations and perspectivesPharmaceutical companies have increased their efforts to optimize resource efficiency and energy use in order to improve their
environmental performance. The results of this study can be used as a first step to perform a full cradle to grave LCA of
pharmaceutical production and use, which could include other important phases of the pharmaceutical product life cycle. To
assess a commercial pharmaceutical, the results of API production have to be compared to the contributions of other ingredients
and formulation.
KeywordsChemical production-Energy efficiency-Energy use-LCA of chemicals-Pharmaceuticals
The global impact of green chemistry and sustainability and the pivotal role of the E factor concept, over the last twenty five years, is reviewed.
A life cycle assessment (LCA) practitioner is often faced with the problem of missing chemical life cycle inventory (LCI) data sets, as current databases cover only a small fraction of chemicals used in commerce. Here, we critically review eight different methods used by LCA practitioners to estimate missing chemical LCI data, including process simulation, engineering process calculations, molecular structure-based models, stoichiometric approaches, use of proxies, and omission. Each method is technically described with examples from the literature, description of advantages and disadvantages, and discussion of suitability depending on availability of data and expertise. Methods are then fully demonstrated and compared for accuracy against reported chemical industry data using case studies of styrene and its downstream product, acrylonitrile-butadiene-styrene (ABS). Resulting LCI and life cycle impact assessment (LCIA) values are compared and discussed, with specific attention to method-specific exclusion of particular flows. Out of the four methods with which full LCIs can be generated, the advanced process-based methods give the most accurate life cycle GHG emission results for styrene and ABS, compared to plant data. Stoichiometric calculations, which are the most commonly used approach, underestimate the actual global warming results by 35-50%. Among the 18 impact categories of the ReCiPe LCIA method, results for the estimated LCI data were within 10% of the actual plant results for only 4-5 categories. Based on the critical review and demonstration results, we provide recommendations for appropriate use of LCI estimation methods in various LCA modeling situations.
Designing efficient and green approaches to complex molecules is a challenge faced by any organization seeking to deliver modern pharmaceutical compounds to patients. The outcome of any route design effort, in terms of efficiency, is largely governed by the disconnections and synthetic strategies generated during the process of route scouting, coupled with the decisions made by the individuals responsible for the research. In this article, we delineate an approach, based on historical data, capable of quantifying the probable efficiency of a proposed synthesis prior to any research being conducted. This decision making strategy can be used to both aid the decision making process of innovators, and to benchmark the outcome performance of the developed process, improving the efficiency of any manufacturing approaches developed. Through improved decision making and outcome bench-marking, this approach holds promise for minimizing the environmental impact of pharmaceutical production.
Life Cycle Assessment (LCA) has recently gained wide acceptance in the environmental impact evaluation of chemicals. Unfortunately, LCA studies require large amounts of data that are hard to gather in practice, a critical limitation when assessing the processes and value chains present in the chemical industry. We here develop an approach that predicts the cradle-to-gate life cycle production impact of organic chemicals from attributes related to their molecular structure and thermodynamic properties. This method is based on a mixed-integer programming (MIP) optimisation framework that systematically constructs short-cut predictive models of life cycle impact. On applying our approach to a data set containing 88 chemicals, 17 molecular descriptors and 15 thermodynamic properties, we estimate with enough accuracy (for the purposes of a standard LCA) several impact categories widely applied in LCA studies, including the cumulative energy demand, global warming potential and Eco-indicator 99. Our framework ultimately leads to linear models that can be easily integrated into existing modelling and optimisation software, thereby facilitating the design of more sustainable processes.
The number of chemicals in the market is rapidly increasing, while our understanding of the life-cycle impacts of these chemicals lags considerably. To address this, we developed deep Artificial Neural Network (ANN) models to estimate life-cycle impacts of chemicals. Using molecular structure information, we trained multilayer ANNs for life-cycle impacts of chemicals using six impact categories, including cumulative energy demand, global warming (IPCC 2007), acidification (TRACI), human health (Impact2000+), ecosystem quality (Impact2000+), and eco-indicator 99 (I,I, total). The Application Domain (AD) of the model was estimated for each impact category, within which the model exhibits higher reliability. We also tested three approaches for selecting molecular descriptors and identified the Principal Component Analysis (PCA) as the best approach. The predictions for acidification, human health and the eco-indicator 99 model showed relatively higher performance with R2 of 0.73, 0.71 and 0.87, respectively, while the global warming model had a lower R2 of 0.48. This study indicates that ANN models can serve as an initial screening tool for estimating life-cycle impacts of chemicals for certain impact categories in the absence of more reliable information. Our analysis also highlights the importance of understanding ADs for interpreting the ANN results.
Ni-based catalysts supported on ceramics are particularly suitable for industrial applications, for instance reforming of hydrocarbons to produce synthesis gas or hydrogen and production of carbon nanofibers. Conventional synthesis processes for all metal/ceramic catalysts are impregnation, precipitation, co-precipitation and others. The authors have previously developed a novel process for the synthesis of Ni-based catalysts supported on reticulated ceramic foams, including impregnation of foams with ultrasonically generated aerosols of dissolved metal chlorides. By using appropriate multi-criteria analysis methods, the authors concluded that the novel process for the synthesis of Ni-based catalysts was superior in terms of economic and technological aspects. The aim of this research was to compare the novel synthesis processes for a Ni-Pd/Al2O3 catalyst and for other Ni-based catalysts by performing life cycle assessment and evaluating the environmental impacts of each synthesis process. Characterisation results showed that the dominant environmental impact results from production of palladium (II) chloride for the Ni-Pd/Al2O3 catalyst synthesis process, while the other catalyst synthesis process had large environmental impacts associated with high energy consumption. The final outcome, obtained from comparison of normalisation results, indicates that the novel Ni-Pd/Al2O3 catalyst synthesis process had the smallest environmental impact.
With healthcare representing a significant portion of the global economy, it is important to be able to understand the environmental impacts of this industry due to its size and nature of its operations. Interviews with people that have intimate knowledge of the healthcare industry indicate that significant efforts and advances have been made over the past ten to fifteen years in developing environmental impact assessment methods and tools tailored for the sector. These methods and tools have been important in helping to improve the overall environmental sustainability of the sector. However, comprehensive literature searches reveal that only a limited portion of the environmental impact assessment work has been published or is publicly available. This lack of visibility to the full scope of environmental impact assessment methods and the results of application of those methods can impair the advancement of these methods. To help facilitate further advancement of environmental assessment methodologies in the healthcare sector, Ghent University and the European Commission’s Joint Research Centre, Sustainability Assessment Unit (JRC IES SA) undertook a study to map current challenges in conducting assessments, identify best practices in assessment and advance the state-of-the-art, and to develop recommendations and priority action points based on the study learnings. The study was accomplished through: (1) conducting a thorough literature review; (2) broad engagement of healthcare sector stakeholders, including industry, academia, NGOs, policy makers, GPs, patients, etc.; (3) execution of a stakeholder survey; (4) expert interviews; and (5) roundtable discussions with sustainability professionals in the field. Upon identifying bottlenecks in current practices, four recommendations and key action points were determined: 1) The integration of the complete healthcare pathway within system boundaries; (2) The establishment of life cycle databases for pharmaceuticals and supplied resources; (3) The integration of LCA calculations directly into ERP systems to work with primary data as much as possible; and (4) The need to further harmonize developments in the field. The authors provide suggested actions to address the recommendations and propose this work as a guidance to steer further research and developments in academia, industry and policy environments in order to serve and support decision making processes.
A methodology is described for developing a gate-to-gate life cycle inventory (LCI) of a chemical manufacturing process to support the application of life cycle assessment in the design and regulation of sustainable chemicals. The inventories were derived by first applying process design and simulation to develop a process flow diagram describing the energy and basic material flows of the system. Additional techniques developed by the U.S. Environmental Protection Agency for estimating uncontrolled emissions from chemical processing equipment were then applied to obtain a detailed emission profile for the process. Finally, land use for the process was estimated using a simple sizing model. The methodology was applied to a case study of acetic acid production based on the Cativa™ process. The results reveal improvements in the qualitative LCI for acetic acid production compared to commonly used databases and top-down methodologies. The modeling techniques improve the quantitative LCI results for inputs and uncontrolled emissions. With provisions for applying appropriate emission controls, the proposed method can provide an estimate of the LCI that can be used for subsequent life cycle assessments.
Life cycle assessments (LCA) of an early research state reaction process only have laboratory experiments data available. While this is helpful in understanding the laboratory process from an environmental perspective, it gives only limited indication on the possible environmental impact of that same material or process at industrial production. Therefore, a comparative LCA study with materials that are already produced at industrial scales is not very meaningful. The scale-up of chemical processes is not such a trivial process and requires a certain understanding of the involved steps. In this paper, we elaborated a framework that helps to scale up chemical production processes for LCA studies when only data from laboratory experiments are available. Focusing on heated liquid phase batch reactions, we identified and simplified the most important calculations for the reaction step's energy use as well as for certain purification and isolation steps. For other LCA in- and output values, we provide estimations and important qualitative considerations to be able to perform such a scale-up study. Being an engineering-based approach mainly, it does not include systematically collected empirical data which would give a better picture about the uncertainty. However, it is a first approach to predict the environmental impact for certain chemical processes at an industrial production already during early laboratory research stage. It is designed to be used by LCA practitioners with limited knowledge in the field of chemistry or chemical engineering and help to perform such a scale-up based on a logical and systematic procedure.
A framework for molecular complexity is established that is based on information theory and consistent with chemical knowledge. The resulting complexity index Cm is derived from abstracting the information content of a molecule by the degrees of freedom in the microenvironments on a per atom base that allows calculating molecular complexity in a simple and additive way. This index allows to universally assess complexities of any molecule and is sensitive to stereochemistry, heteroatoms, and symmetry. The performance of this complexity index is evaluated and compared against the current state of the art. Its additive character gives consistent values also for very large molecules and supports direct comparisons of chemical reactions. Finally, this approach may provide a useful tool for medicinal chemistry in drug design and lead selection, which is demonstrated by correlating molecular complexities of antibiotics with compound specific parameters.
Classical organical synthesis seems to be inefficient and is now under pressure because of increasing environmental awareness. The past, present, and the future of organic synthesis are discussed. The topics include solvents, reagents, dye synthesis, catalysis, and environmental regulation concerns.
Process technology appears to get increasing attention in the whole process of pharmaceutical development. Although the contribution of an efficient manufacturing process to the success and profit of a large pharmaceutical appears small, this contribution is significant when it comes to sustainable manufacturing. Here an efficient process helps to lower environmental impact at the site of production and allows production beyond the patent life of a product. The design and scale-up of a sustainable process comprises route design, use of state-of the art chemical methods and also state-of-the-art process technology such as continuous manufacturing by intensified processes. DSM has developed a set of competences in these fields. Examples and metrics related to the sustainability of the described processes are given.
Pharmaceutical chemicals are complex, high value added products that typically impose significantly greater impacts on the environment per kilogram compared to basic chemicals. A variety of green metrics have been developed to guide the design of chemistries and processes that are more sustainable. Among these Process Mass Intensity (PMI) was selected by the American Chemical Society Green Chemistry Institute Pharmaceutical Roundtable as the key parameter to express sustainability. However, researchers were concerned that these metrics could miss relevant factors that would be addressed by a more comprehensive Life Cycle Assessment (LCA). Lack of inventory data for many chemicals poses a significant barrier to more extensive implementation of LCA for pharmaceuticals. A cradle-to-gate LCA of ViagraTM is used to present a practical approach for constructing inventories using patent and literature data. Details of the improved inventory data were presented for four chemicals to illustrate the methodology, and highlighted the importance of considering out- sourced processing of reagents used in pharmaceutical synthesis. A more comprehensive impact assessment was conducted using ReCiPe v1.11 at both midpoint and endpoint levels. Comparison of two synthesis routes compared well with results from the simpler green metrics. An area for future work is to address the lack of characterization factors for toxicity and other impact categories for many chemicals.
The pharmaceutical and fine chemical industries are eager to strive towards innovative products and technologies. This study first derives hotspots in resource consumption of 2,839 Basic Operations (BOs) in 40 Active Pharmaceutical Ingredient (API) synthesis steps through Exergetic Life Cycle Assessment (ELCA). Second, since companies are increasingly obliged to quantify the environmental sustainability of their products, two alternative ways of simplifying (E)LCA are discussed. The usage of averaged product group values (R² = 3.40E-30) is compared with multiple linear regression models (R² = 8.66E-01) in order to estimate resource consumption of synthesis steps. An optimal set of predictor variables is postulated to balance model complexity and embedded information with usability and capability of merging models with existing Enterprise Resource Planning (ERP) data systems. The amount of organic solvents used, molar efficiency and duration of a synthesis step showed to be the most significant predictor variables. Including additional predictor variables did not contribute to the predictive power and eventually weakens the model interpretation. Ideally an organization should be able to derive its environmental impact from readily available ERP data, linking supply chains back to the cradle of resource extraction, excluding the need for an approximation with product group averages.
As the demand for new drugs is rising, the pharmaceutical industry faces the quest of shortening development time, and thus, reducing the time to market. Environmental aspects typically still play a minor role within the early phase of process development. Nevertheless, it is highly promising to rethink, redesign, and optimize process strategies as early as possible in active pharmaceutical ingredient (API) process development, rather than later at the stage of already established processes. The study presented herein deals with a holistic life-cycle-based process optimization and intensification of a pharmaceutical production process targeting a low-volume, high-value API. Striving for process intensification by transfer from batch to continuous processing, as well as an alternative catalytic system, different process options are evaluated with regard to their environmental impact to identify bottlenecks and improvement potentials for further process development activities.
Life cycle assessment (LCA) has been applied for assessing emerging technologies, where large-scale production data are generally lacking. This study introduces a standardized scheme for technology and manufacturing readiness levels to contextualize a technology's development stage. We applied the scheme to a carbon nanotube (CNT) LCA and found that, regardless of synthesis technique, CNT manufacturing will become less energy intensive with increased levels of readiness. We examined the influence of production volume on LCA results using primary data from a commercial CNT manufacturer with approximately 100 grams per day production volume and engineering design of a scaled-up process with 1 tonne per day production capacity. The results show that scaling up could reduce 84% to 94% of its cradle-to-gate impacts, mainly as a result of the recycling of feedstock that becomes economically viable only beyond certain minimum production volume. This study shows that LCAs on emerging technologies based on immature data should be interpreted in conjunction with their technology and manufacturing readiness levels and reinforces the need of standardizing and communicating information on these readiness levels and scale of production in life cycle inventory practices.
Several synthetic pathways to cyclohex-5-ene-1R,2S,3R,4R-tetrol (conduritol C) and cyclohex-5-ene-1S,2R,3R,4R-tetrol (conduritol F) are compared; each is analyzed for effectiveness of waste minimization. The latest synthesis, reported in this manuscript, combines enzymatic transformations with electrochemical methods. The concept of “effective mass yield” (EMY) is defined and illustrated.
After ingestion, pharmaceuticals are excreted unchanged or metabolized. They subsequently arrive in conventional wastewater treatment plants and are then released into the environment, often without undergoing any degradation. Conventional treatment plants can be upgraded with post treatment, alternatively the removal of pharmaceuticals could be achieved directly at point sources. In the European project PILLS, several solutions for decentralized treatment of pharmaceuticals at hospitals were investigated at both pilot plant and full scale, and were then compared to conventional and upgraded centralized treatment plants using Life Cycle Assessment (LCA). Within the scope of the study, pharmaceuticals were found to have a comparatively minor environmental impact. As a consequence, an additional post treatment does not provide significant benefits. In the comparison of post treatment technologies, ozonation and activated carbon performed better than UV. These results suffer however from high uncertainties due to the assessment models of the toxicity of pharmaceuticals in LCA. Our results should therefore be interpreted with caution. LCA is a holistic approach and does not cover effects or issues on a local level, which may be highly relevant. We should therefore apply the precautionary ALARA principle (As Low As Reasonably Achievable) and not conclude that the effect of pharmaceuticals is negligible in the environment.
In a previous paper, the modeling of chemical batch plants with the help of a top-down model was presented (Bieler et al. Ind. Eng. Chem. Res. 2003, 42, 6135−6144). This approach was not applicable to multipurpose batch plants with highly varying production because of the high variability between products and the complexity of such plants. In the present paper, a bottom-up model is proposed, and its applicability to a multipurpose batch plant is investigated. Extensive measurements of single apparatus and unit operations were conducted, leading to simple, adaptable models for the consumption of steam, electricity, and brine. These single-apparatus and single-unit-operation models are summed according to the production schedule and the corresponding process step procedures or the production records. This leads to a bottom-up model of a complete multipurpose production plant. The energy consumption of the whole plant was modeled for 1 and 2 days, as well as for 1 week and 1 month. The comparison of the bottom-up modeling results with the measurements on the building level showed good agreement and demonstrated the applicability of the proposed approach. It was therefore possible to analyze the consumption of the different energy carriers in more detail on the basis of the bottom-up modeling results. The energy consumption of individual process steps, products, apparatuses, and apparatus groups was analyzed. This analysis revealed the most important saving potentials in the investigated plant and helped to focus optimization efforts. Furthermore, the bottom-up approach enables a proper allocation of energy consumption to different products in a multipurpose batch plant.
In this experiment, which is intended for the introductory organic laboratory, the widely used local anesthetic Lidocaine is synthesized in two steps from 2,6-dimethylaniline. In the first step, the amine is acylated with chloroacetyl chloride. In the second step, the amide is subjected to nucleophilic substitution by diethylamine to give the final product with an overall yield of 71% based on 2,6-dimethylaniline. I have used this experiment in my organic class for several years with excellent results. Average students can isolate the crude product in less than three hours. Keywords (Audience): Second-Year Undergraduate
Solvent use consistently accounts for between 80 and 90% of mass utilization in a typical pharmaceutical/fine chemicals (non-polymer) batch chemical operation. Moreover, within these operations, solvents play a dominant role in the overall toxicity profile of any given process; i.e. on a mass basis, solvents account for the largest proportion of chemicals of concern used in the process. However, for the typical synthetic organic chemist, solvents are just a medium in which a reaction takes place; the interest is in the reactivity and building of a molecule, not in the means by which this is carried out. So, in a typical retrosynthetic analysis, solvent and solvent-reactant interactions, separability, and particle engineering are generally not included. The best means in which this reaction can take place is also not considered; i.e., the reaction space, configuration, order of addition, heat/mass transfer, etc., is generally not considered. This publication presents a case for greater awareness of solvent issues in batch chemical operations typically found in the pharmaceutical industry.
There have been a many publications and much discussion about green metrics. While many have been proposed, The American Chemical Society Green Chemistry Institute’s Pharmaceutical Roundtable has chosen process mass intensity (PMI) as the key, high-level metric for evaluating and benchmarking progress towards more sustainable manufacturing. This paper provides the philosophical and technical arguments on why PMI was chosen above other related metrics such as E factor or atom economy.
Gate-to-gate process energy for 86 chemical manufacturing processes is presented. The estimation of the process energy follows design-based methodology. Results show that the gate-to-gate process energy for half of organic chemicals ranges from 0 to 4 MJ per kg, and for half of inorganic chemicals ranges from −1 to 3 MJ per kg. The main energy source in both organic and inorganic processes is steam energy followed by potential recovered energy. In organic chemicals, the fractions of heating oil and electricity use are relatively low, but these fractions are higher in the inorganic chemicals than in the organic chemicals. Furthermore, about 50% of the energy consumed in chemical processes is used for purifying the product, byproduct or recycled stream, which indicates that there are large opportunities for improving the process energy in chemical processes. The information presented in this study is very important for those in the life cycle assessment community in order for them to identify inaccurate information or information not based on actual process design. However, the range for the entire range of chemicals is very substantial and thus reflects the need of the life cycle inventory to separately evaluate the chemistry and degree of purity for chemical products. Copyright © 2003 Society of Chemical Industry
A formalism is presented which unifies key reaction metrics associated with "greenness" in chemical reactions with respect to raw materials usage. The fundamental basis of this treatment begins with balanced chemical reactions in which byproducts are identified. The primary or kernel metrics are reaction yield, scale of reaction, stoichiometric factor (SF), and Trost's atom economy (AE). The stoichiometric factor is a new metric that is defined to account for reactions run under nonstoichiometric conditions, that is, with one or more reagents in excess. A general relation for reaction mass efficiency (RME) is derived which shows that this metric is a composite of the aforemen-tioned primary metrics and takes into account solvent usage in the reaction and postreaction phases (workup and purifica-tion). The Sheldon environmental impact factor E is treated at various levels of complexity according to what is constituted as waste and is shown to be related to RME by a simple inverse expression. A flowchart is presented which shows other simple relationships connecting all metrics. Raw material costs, opti-mum conditions for recycling or reclaiming catalysts and reaction and postreaction solvents, and the handling of reactions giving isomeric products are also assessed. General algorithms are proposed for determining kernel reaction metrics for linear and convergent sequences that can be used to compare the intrinsic, or best-case scenario, green performances of synthetic plans to a common target structure. All key relationships can be implemented in a spreadsheet format from which reaction histograms or "maps" can be generated. Individual reaction RME performances can be gauged, ranked, and decomposed according to AE, SF, and reaction yield kernel metrics. This allows for the easy identification of best and worst reactions in a process or sequence. Example applications of the present methodology include the following: (a) a comparative analysis of the synthesis of quinine by the classic Woodward-Rabe and the modern greener Stork methods; (b) the analysis of the industrial synthesis of sildenafil (Viagra) by a convergent strategy; and (c) the analysis of kinetic resolution of racemic alcohols by a successive oxidation and recycling reduction cycle.
In many cases, policy makers and laymen perceive harmful emissions from chemical plants as the most important source of environmental impacts in chemical production. As a result, regulations and environmental efforts have tended to focus on this area. Concerns about energy use and greenhouse gas emissions, however, are increasing in all industrial sectors. Using a life cycle assessment (LCA) approach, we analyzed the full environmental impacts of producing 99 chemical products in Western Europe from cradle to factory gate. We applied several life cycle impact assessment (LCIA) methods to cover various impact areas. Our analysis shows that for both organic and inorganic chemical production in industrial countries, energy-related impacts often represent more than half and sometimes up to 80% of the total impacts, according to a range of LCIA methods. Resource use for material feedstock is also important, whereas direct emissions from chemical plants may make up only 5% to 10% of the total environmental impacts. Additionally, the energy-related impacts of organic chemical production increase with the complexity of the chemicals. The results of this study offer important information for policy makers and sustainability experts in the chemical industry striving to reduce environmental impacts. We identify more sustainable energy production and use as an important option for improvements in the environmental profile of chemical production in industrial countries, especially for the production of advanced organic and fine chemicals.
Background, aim, and scope
During the last decade, the interest in estimating environmental life cycle impacts of bioprocesses has markedly risen. To adequately quantify these impacts, accurate life cycle inventories of materials, such as agricultural substrates and enzymes, are required. The goals of this life cycle assessment were (1) to estimate the life cycle inventories (LCIs) and impacts of three supported enzymes produced in-house for pharmaceutical applications (A, B, and C) and (2) to determine the suitability of applying modular life cycle inventory estimation techniques to enzymes when individual enzyme LCIs are not readily available. The scope of this LCA was cradle to gate, covering the production and purification of the enzymes, energy generation, raw material production, waste treatment, and transportation of the raw materials.
Materials and methods
Three immobilized enzymes (A, B, and C) produced industrially for application in pharmaceutical products were studied. Enzyme production information was obtained from internal process descriptions. LCI information was obtained from GlaxoSmithKline’s in-house LCA database FLASC™, from LCA commercial databases, and literature. The LCI for the enzyme support was estimated using its material flows. Mass allocations were applied to multi-output processes in the upstream processes. The life cycle impacts considered were nonrenewable energy consumption, global warming, acidification, eutrophication, and photochemical smog formation.
Results and discussion
Life cycle impacts of the immobilized enzymes A, B, and C were estimated. For instance, nonrenewable energy use is between 117 to 207 MJ/kg of immobilized enzyme and the global warming potential ranges from 16 to 25 kg CO2 eq/kg immobilized enzyme. Contributions of different subprocesses were also estimated. For example, support production accounts for about 31% to 67% of the energy consumption and soybean protein and yeast extract account for about 64% to 72% of the total photochemical smog formation. Uncertainty and sensitivity analysis were performed using Monte Carlo simulation and showed that a standard deviation of the environmental impact is less than 7% of the mean in all the environmental impacts considered. “What if” analysis shows that using biobased glycerin instead of petroleum-based glycerin could reduce global warming impacts between 11% and 44%.
Conclusions, recommendations, and perspectives
The production of immobilized enzyme is, in general, energy intensive. Enzyme A has larger environmental impacts than the other enzymes evaluated because of larger energy intensity and lower enzyme production yield. The media preparation inputs (soybean protein, yeast extract) and immobilization subprocesses are the two major contributors to acidification, eutrophication, and photochemical smog formation. Immobilization is the major contributor for global warming potential. “What if” analysis estimated changes on life cycle impacts for biobased vs. synthetic substrates. The results of this LCA are, in general, comparable with results previously reported in the literature (Nielsen et al., Int J Life Cycle Assess 12(6):432–438, 2007). Therefore, using this technique to estimate LCI of enzymes appears to be suitable for future life cycle assessments of biocatalyzed processes. The results of this study will be integrated into GlaxoSmithKline’s FLASC™ to improve the accuracy of life cycle assessment for biocatalyzed processes and enzymes produced in-house.
Background, Goal and ScopeThe research presented here represents one part of GlaxoSmithKline’s (GSK) efforts to identify and improve the life cycle
impact profile of pharmaceutical products. The main goal of this work was to identify and analyze the cradle-to-gate environmental
impacts in the synthesis of a typical Active Pharmaceutical Ingredient (API). A cradle-to-gate life cycle assessment of a
commercial pharmaceutical product is presented as a case study.
MethodsLife cycle inventory data were obtained using a modular gate-to-gate methodology developed in partnership with North Carolina
State University (NCSU) while the impact assessment was performed utilizing GSK’s sustainability metrics methodology.
Results and DiscussionMajor contributors to the environmental footprint of a typical pharmaceutical product were identified. The results of this
study indicate that solvent use accounts for a majority of the potential cradle-to-gate impacts associated with the manufacture
of the commercial pharmaceutical product under study. If spent solvent is incinerated instead of recovered the life-cycle
profile and impacts are considerably increased.
ConclusionsThis case study provided GSK with key insights into the life-cycle impacts of pharmaceutical products. It also helped to establish
a well-documented approach to using life cycle within GSK and fostered the development of a practical methodology that is
applicable to strategic decision making, internal business processes and other processes and tools.