Green endoscopy - Impact of endoscopy on environmental health: in the past, now and in the future?

Climate change and the destruction of ecosystems by human activities are among the greatest challenges of the 21st century and require urgent action. Health care activities significantly contribute to the emission of greenhouse gases and waste production, with gastrointestinal (GI) endoscopy being one of the largest contributors. Recetnly the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology and Endoscopy Nurses and Associates published a position statement to raise awareness of the ecological footprint of GI endoscopy and provides guidance to reduceits environmental impact. The main suggestions and recommendations for health care providers, patients, governments, and industry are as follows:
GI endoscopy is a resource-intensive activity with a significant yet poorly assessed environmental impact. Therefore ESGE-ESGENA recommend adopting immediate actions to reduce the environmental impact of GI endoscopy. ESGE-ESGENA recommends adherence to guidelines and implementation of audit strategies on the appropriateness of GI endoscopy to avoid the environmental impact of unnecessary procedures. Furhtermore ESGE-ESGENA recommend the embedding of reduce, reuse, and recycle programs in the GI endoscopy unit. ESGE-ESGENA suggest that there is an urgent need to reassess and reduce the environmental and economic impact of single-use GI endoscopic devices and therefore suggest against routine use of single-use GI endoscopes. However, their use could be considered in highly selected patients on a case by-case basis. ESGE-ESGENA recommend inclusion of sustainability in the training curricula of GI endoscopy and as a quality domain. ESGE-ESGENA recommend conducting high quality research to quantify and minimize the environmental impact of GI endoscopy. ESGE-ESGENA also recommend that GI endoscopy companies assess, disclose, and audit the environmental impact of their value chain. ESGE-ESGENA recommend that GI endoscopy should become a net-zero greenhouse gas emissions practice by 2050.