Carbon footprint reduction associated with a surgical outreach clinic

Abstract

Background: Healthcare systems generate substantial carbon footprints that may be targeted to decrease greenhouse gas emissions. Outreach clinics may represent tools to assist in this reduction by optimizing patient related travel. Therefore, we sought to estimate the carbon footprint savings associated with a head and neck surgery outreach clinic.

Methods: This study was a cross-sectional survey of patient travel patterns to a surgical outreach clinic compared to a regional cancer treatment centre from December 2019 to February 2020. Participants completed a self-administered survey of 12 items eliciting travel distance, vehicle details, and ability to combine medical appointments. Canadian datasets of manufacturer provided vehicular efficiency were used to estimate carbon emissions for each participant. Geographic information systems were used for analyses.

Results: One hundred thirteen patients were included for analysis. The majority of patients (85.8%) used their own personal vehicle to travel to the outreach clinic. The median distance to the clinic and regional centre were 29.0 km (IQR 6.0-51.9) and 327.0 km (IQR 309.0-337.0) respectively. The mean carbon emission reduction per person was therefore 117,495.4 g (SD: 29,040.0) to 143,570.9 g (SD: 40,236.0). This represents up to 2.5% of an average individual's yearly carbon footprint. Fewer than 10% of patients indicated they were able to carpool or group their appointments.

Conclusion: Surgical outreach clinics decrease carbon footprints associated with patient travel compared to continued care at a regional centre. Further research is needed to determine possible interventions to further reduce carbon emissions associated with the surgical care of patients.

Keywords: Carbon footprint; Head and neck neoplasms; Outreach.

Fig. 1

Patient travel to the surgical outreach clinic visualized as straight-line travel created through a Geographic Information System (GIS) mapping platform. The central point where all straight lines converge represents the clinic location. The inner most circle has a 5 km radius, followed by 10 km, 25 km, 50 km, 100 km and > 100 km. Actual driving distances are expected to be of greater distances

Fig. 2

The observed (associated with travel to the outreach clinic) and expected (associated with potential travel to the regional centre) per patient carbon emissions, including both high (right, light grey) and low (left, dark grey) estimates (see text) and differences between observed and expected. Error bars represent the standard error