Environmental Life Cycle Assessment and Costs of Phacoemulsification at Aravind Eye Hospital in Pondicherry, India

Abstract

Purpose : There are increasing concerns about the environmental footprint and greenhouse gas emissions of healthcare, and the operating room is of particular focus. The Aravind Eye Care System has created an effective surgical model based on efficiency of time and cost, but what is the environmental footprint of this model? This study analyzes material use at Aravind Eye Hospital in Pondicherry (AEH-PDY), India and calculates the environmental emissions through Life Cycle Assessment (LCA).

Methods : We quantified and weighed surgical materials used in phacoemulsification (phaco) at (AEH-PDY). Material flow maps documented the reuse and disposal of all surgical materials for each site; average costs of materials and their disposal were calculated using hospital accounting records. Collected data were input into an LCA framework using one phaco (one eye) as the functional unit and the perioperative period as the study boundaries. Emissions throughout materials’ life cycles were calculated using the robust life cycle inventory database ecoinvent 3 and the global impact assessment method CML-IA v3.02 World 2000.

Results : Key contributors to the life-cycle environmental footprint of a single phaco at AEH-PDY include electricity, water use, and the production of single-use materials (Fig 1). Carbon emissions from surgical materials and their disposal (including reusable and single-use items, Fig 2) average about 0.8kg CO₂-eq per phaco, well below the reported average of 63.5kg CO₂-eq per phaco in the UK (Morris, et al. 2013).

Conclusions : Results show that Aravind’s efficiency-focused surgical model minimizes environmental emissions and costs associated with phaco. Aravind’s current initiative to install solar photovoltaic panels for electricity generation will likely further reduce their overall footprint. Given Aravind’s proven surgical outcomes (Haripriya, et al. 2012), other hospitals should consider components of this model when attempting to reduce the environmental and cost burdens of surgical care.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Life-Cycle Environmental Impacts of Phacoemulsification (Phaco) at Aravind Eye Hospital, Pondicherry (AEH-PDY); *Cost does not include water or capital equipment

 

Material Flow for Surgical Materials Used in Phacoemulsification (Phaco) at Aravind Eye Hospital, Pondicherry (AEH-PDY); RO-Reverse Osmosis, IOL- Intraocular Lens, ETO- ethylene oxide