S1284 Analyzing the Awareness of Sustainability and Green Endoscopy in the Current GI Workforce: A Systematic Review

Introduction: Gastrointestinal (GI) endoscopy is a high-volume, resource-intensive specialty with a substantial environmental footprint. As sustainable healthcare gains global momentum, “green endoscopy” has emerged as a critical focus. However, the workforce’s awareness, practices, and perceived barriers remain poorly understood. This study aimed to assess healthcare professionals’ awareness, attitudes, and perceived barriers regarding sustainability in endoscopy and synthesize existing data on workforce engagement with green endoscopy practices. Methods: A systematic search of PubMed, Embase, Cochrane Library, and Google Scholar (up to April 1, 2025) identified original studies reporting on healthcare professionals’ knowledge, attitudes, or practices related to sustainable endoscopy. Two independent reviewers screened and extracted data. Study quality was assessed using the Joanna Briggs Institute checklist. Given methodological heterogeneity, a synthesis without meta-analysis (SWiM) approach was applied. Results: Five cross-sectional studies with 1,684 participants from diverse global regions were included. Awareness of green endoscopy ranged widely, from 16.3% to 67%. Although 81.1% of respondents acknowledged climate change as a human-driven concern, only ∼34% were familiar with green endoscopy concepts, and just 13.9% reported institutional guidelines or policies. Barriers were consistently reported across studies: lack of knowledge (35%), absence of policy (32%), infection control concerns with reusable equipment (41%), and financial constraints (26%). Only 23.4% reported regular departmental audits, and fewer than 20% had attended formal sustainability training. Recycling awareness and practice varied, with 73% reporting knowledge of waste segregation but only 18.7% participating in formal training sessions. Notably, senior staff (>50 years) showed significantly greater environmental concern compared to younger professionals, indicating a generational awareness gap. Conclusion: Despite growing global emphasis on sustainability, substantial gaps exist between environmental awareness and practical implementation within GI endoscopy units. To bridge this gap, coordinated efforts are needed to strengthen workforce education, establish institutional policies, promote departmental audits, and address key barriers such as infection concerns and perceived costs.