The environmental impact and sustainability of infection control practices: a systematic scoping review

Infection prevention and control (IPC) programs form the basis of minimizing spread of pathogens in the healthcare setting and beyond. The COVID-19 pandemic amplified the demand for IPC. However, the environmental impact of IPC practices has yet to be addressed and attempts to quantify its climate implications have been sparse. We performed a scoping review to identify current evidence regarding the environmental footprint of IPC measures and to highlight existing gaps in the literature. We included 30 articles, with 23 quantifying the environmental impact by mass of waste generated, six via carbon emissions, and one reporting on the concentration of volatile organic compounds. The mass of infectious waste ranged from 0.16 to 3.95 kg/bed/day, with large variability between countries. In general, higher-income countries produced more waste than lower-income countries. Significant carbon emission savings resulted from substituting reusable gowns and sharps containers, compared to single use items. The most significant gaps are the overall lack of standardisation in quantifying the environmental footprint of IPC-related practices, and a lack of studies on carbon emissions stemming from low and lower-middle income countries. We quantify the environmental impact of IPC practices, suggest areas of infection control that warrant further evaluation, and an approach to standardising environmental metrics in an attempt to better map out the climate implications of adopted IPC measures.