Page 154 - Ebook-Book JCMS 2025

The Carbon Footprint Difference in Diagnostic Upper GI
Endoscopy Performed by Staff Versus Trainee
Ponthakorn Pichayanont1*, Rapat Pittayanon2, Piyapoom Pakvisal2, Suthirat Kittipongvises3
,
Nantamol Limphitakphong3, Atima Dubsok3, Wilailuk Niyommaneerat3, Kittiwoot Chaloeytoy3
,
Rungsun Rerknimitr2
1 Department of Medicine, Faculty of Medicine, Chulalongkorn University
2 Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University
3 Environmental Research Institute Chulalongkorn University
*Corresponding Author E-mail: ponthakorn.pi@gmail.com
Background: Methods: Results: Abstract
GI endoscopy is a significant contributor to carbon emissions. This study compared the
carbon footprint (CF) of diagnostic EGD performed by gastroenterologists and first-year
fellows, establishing baseline CF values and differences between two groups.
Data were prospectively collected from patients undergoing diagnostic EGD between
October and November 2024. The procedure’s duration and CF were measured at each step
(pre-, during, and post-EGD), considering energy consumption, equipment and medication
use, waste management, and endoscope reprocessing, comparing CF values between
diagnostic EGD performed by staff and trainees.
The study included 20 patients undergoing diagnostic EGD; 7 procedures were performed
by staff and 13 by trainees. The median CF for the staff group was 1.98 kgCO2e (1.96–2.05
kgCO2e), significantly lower compared to the trainee group, which was 2.16 kgCO2e (2.06–
2.27 kgCO2e), (p < 0.001, Figure). CF during pre- and post-endoscopy phases was identical
in both groups. However, the CF during the endoscopy phase was lower in the staff group
(0.75 kgCO2e vs. 0.93 kgCO2e; p< 0.001) (Table), attributed to shorter procedural time
(4.17 ± 1.38 vs. 7.85 ± 2.32 minutes; p = 0.001). Each minute contributed 0.021 kgCO2e due
to increased electricity consumption, prolonged oxygen supplementation, sedation, and
CO2 insufflation. The fellow’s group also used more gowns and gloves due to supervisor
involvement. Key contributors to CF included extension T connector (0.21 kgCO2e) in
pre-endoscopy phase, gowns (0.28 kgCO2e in the staff group, 0.37 kgCO2e in the fellows
group) in endoscopy phase, and water for endoscope reprocessing (0.29 kgCO2e) in
post-endoscopy phase.
Conclusion: This study establishes baseline CF values for diagnostic EGD. Staff procedures produced
lower CF mainly due to shorter procedure time and less gown usage.
152 Joint Conference in Medical Sciences 2025