Decrease emissions from gases
Many anaesthetics are known to contribute significantly to healthcare’s carbon footprint. They are powerful greenhouse gases and some are also ozone depleting substances. Consequently, staff at the Aga Khan University Hospitals are looking at ways to reduce emissions from these products, which in many cases also reduces costs.
In 2020, AKU started identifying the type and volume of gases being used - accounting for just under 5 percent of AKU's operational emissions - and is now actively working to reducing the impacts of these gases by:
Substituting high carbon with lower carbon and more ozone friendly alternative gases, where clinically possible.
Exploring the reduction of nitrous oxide as a carrier gas and replace with oxygen or medical air.
Using digital flow meters for low flow anaesthesia and to dose the amount of anaesthetic gas more accurately and reduce carrier gas.
Using intravenous anaesthesia where clinically possible.
Exploring gas capture technology.
Propellant inhalers like pressurised metered dose inhalers, pMDIs, use potent greenhouse gases to deliver medications, gases that are up to 3,350 times more potent at causing climate change than carbon dioxide. A single pMDI can release as much emissions as a small car driven 250 km and many patients use more than 12 such inhalers a year.
AKU has started collecting data on prescribed and dispensed inhalers. While these contribute less than 1 percent of AKU's operational emissions, it is a small but important area to address. The University is now working with clinicians on alternatives to pMDIs such as dry powder-based inhalers - just as clinically effective but with a much smaller environmental impact – and pMDIs with less environmental impact. Other actions include the safe disposal of used pMDIs and reviewing prescription practices.
Gases used as coolants in air conditioning and refrigeration systems can leak and need to be topped up for systems to function. Many such gases have detrimental climate impacts, often thousands of times more potent than carbon dioxide, and many are already banned in more industralised nations.
Refrigerant gas leaks result in around 6.5 percent of AKU's operational emissions and steps to reduce these emissions include:
Detailed measurement of top-up gases, gas types and locations as well as system specifications.
Developing plans to phase out the most harmful gases especially from older air conditioning systems.
Working with suppliers to encourage them to bring systems and gases into the country that are international best in kind and least polluting.
Improving equipment maintenance.