The NHS carbon footprint of paediatric tonsillectomies

Background Single-use waste is prevalent in many surgical procedures; it is also a contributor to carbon emissions released during surgery. With high-frequency procedures such as coblation tonsillectomy and adenotonsillectomy it is important that we promote and implement sustainable practices going forward and explore ways of reducing single-use waste. We aimed to investigate the carbon footprint produced postoperatively by the waste and management of the waste from single-use, nonbiosafe, nonrecyclable items used in paediatric coblation tonsillectomy and adenotonsillectomy, hoping to raise awareness and provoke conversation about the vast amount of waste produced. Methods Procedure-specific, single-use, nonrecyclable intraoperative waste was collected and weighed following paediatric intracapsular coblation tonsillectomy and adenotonsillectomy at our institution. Information regarding the production and waste management pathway was collected and carbon dioxide equivalent (CO 2 e) conversion factors from a variety of sources were applied. Results On average, 1.13kg of single-use postoperative waste was collected per procedure. Extrapolated annually, matching ∼200 paediatric tonsillectomy and adenotonsillectomies that take place in our institution, waste amounted to 225.66kg. Overall, 4.36kg of CO 2 e, was produced from single-use nonrecyclable nonbiosafe waste from a paediatric intracapsular coblation tonsillectomy or adenotonsillectomy. Annually, in our institution, this amounts to 867kgCO 2 e. Conclusions Given the threat to public health posed by climate change, efforts should be made to reduce the unsustainable practice of regularly using single-use instruments. This should be done by surgeons and manufacturers, especially in high-frequency procedures like coblation tonsillectomy and adenotonsillectomy.