S2980 Reducing Single Use Waste in GI Endoscopy: A QA/QI Audit of Personal Protective Equipment Usage at the East Orange VA Medical Center

Introduction: The GI endoscopy suite, with over 22.2 million procedures performed annually by 2019, contributes significantly to environmental waste through the use of disposable personal protective equipment (PPE) and single-use materials. A study performed by Sharma et al at a VA medical center found that esophagogastroduodenoscopy suites produce 303 kg of solid waste, with potentially recyclable materials accounting for 20% of the total waste. Our study aims to examine the amount of medical waste generated at the East Orange VA Medical Center’s GI suite in order to identify opportunities to reduce unnecessary environmental burden. Methods: The East Orange VA Medical Center GI endoscopy suite was audited from 3/10/2025 to 4/6/2025. Data on the number of GI interventions known to use significant amounts of PPE and other single use materials was collected. The usage of PPE including gloves, masks, gowns, and surgical lubricant packets was then evaluated across several procedures and extrapolated to cover the whole month. These numbers were then adjusted for the total number of participants per procedure, defined as 3-4 participants per endoscopy/endoscopic ultrasound and 4-5 participants per colonoscopy/endoscopic retrograde cholangiopancreatography/flexible sigmoidoscopy. Results: Over the course of 1 month, 217 total procedures were performed at the East Orange VA Medical Center GI endoscopy suite: 130 colonoscopies (59.91%), 76 endoscopies (35.02%), 5 upper EUS (2.3%), 2 flexible sigmoidoscopies (0.92%) and 1 endoscopic retrograde cholangiopancreatography (0.46%); 3 video capsule endoscopies were performed but did not require any PPE (1.38%). In total, 1,764 gloves, 224 masks, 775 gowns, and 428 packets of surgical lubricant were used; all numbers adjusted for fluctuating number of participants and re-use of items such as gowns and masks across multiple procedures. The total estimated weight in environmental waste across all procedures, adjusted for the total amount of boxes of products used, was 148.225 kg. Conclusion: There is a substantial environmental footprint of routine GI procedures at our site, with over 148.2 kg of solid waste accounted for by the usage of single-use PPE and single-use materials. These estimates, though extrapolated, align with prior studies on endoscopy waste. Colonoscopies represented the majority of procedures and accounted for the largest share of PPE use. We identified several opportunities for reduction of this estimate, including improved recycling protocols, more efficient PPE use, and sustainable sourcing. Future studies are warranted to reassess environmental impact once these interventions have been implemented.