Towards a more sustainable operating theatre: the opinions of Belgian surgeons, anesthesiolo-gists, nurses, and other operating theatre professionals

Background: Hospitals generate significant amounts of waste and operating rooms (ORs) are major contributors to pollution and greenhouse gas (GHG) emissions. Segregation habits often differ significantly between homes and workplaces. Objectives: This study investigated the opinions, barriers, and commitments perceived by OR professionals in Belgium to act more sustainably, focusing on waste segregation and recycling within ORs. We also surveyed the habits of anesthesiologists that influence greenhouse gas emissions. Methods: We conducted a cross-sectional study using an online questionnaire targeting professionals in Belgian ORs, including anesthesiologists, surgeons, nurses, and other operating theatre staff members. The questionnaire was distributed in three languages (Dutch, French, and English), and included closed questions using Likert scales and multiple-choice questions. Statistical analysis was performed using Pearson’s chi- squared and Fisher’s exact tests for group comparisons. Results and Discussion: Of 673 participants, nurses constituted the largest group. More than 60% of the participants had extensive experience (>10 years in OR). The vast majority segregated waste at home, but much less waste was segregated in the ORs, despite high willingness. Unlike other waste categories, hazardous medical waste is universally segregated. Papers and plastics are often treated as non-hazardous wastes. The main perceived barriers were proper waste facilities and time and space constraints, indicating that effective implementation was hampered by structural deficiencies. A sub-study showed that most anesthesiologists used sevoflurane with a low or very low fresh gas flow, contributing to lower GHG emissions. Potent GHG such as nitrous oxide and desflurane are infrequently used. Conclusions: This study showed a gap between Belgian OR professionals’ willingness to act sustainably and their actual implementation. Improving infrastructure and providing training and information are essential steps for promoting sustainable waste management in hospitals. These changes can lead to a more sustainable health care environment.