Imperial College London

Academic Institute

Bob Klaber

Unknown

No

NIBDAPC_2023_0029

Climate change refers to long-term changes to the Earth’s climate caused by human activities, and its effects include increased frequency and severity of heatwaves and storms, along with overall changes in weather, such as certain areas becoming overall warmer or overall rainier. The main cause of climate change is air pollution from greenhouse gases, which we release into the air when we do things like drive a car or fly in a plane. Healthcare has a large climate change impact, with close to 5% of greenhouse gas emissions in England coming from the NHS (Delivering a Net Zero NHS, 2022). This is like if you could represent all of England’s greenhouse gas emissions as a fleet of 20 airplanes in the sky, 1 of those planes would be the NHS. The NHS recognises that it must do its part to reduce climate change, especially given that climate change has bad health impacts, such as heatstroke from higher temperatures and injuries from storms. That is why the NHS in England has committed to ‘net zero healthcare’, which means reducing its overall contribution to climate change to zero by reducing how many greenhouse gases it emits. To do that, we need to understand where greenhouse gas emissions are coming from, which we can do using data collected during patient care. The total amount of greenhouse gases emitted by an organisation or a process is called a carbon footprint, and calculating carbon footprint using data can help us to reduce climate change impact. Medicines—especially when they are wasted or not used properly—are part of the reason why healthcare has such a large climate impact. Manufacturing of most medicines involves burning fuel that produces greenhouse gases, and some medicines (e.g. anaesthetic gases) also have direct climate impacts when they are used for care. If we can use hospital data to find out how much medicine gets thrown away without ever being used, we can better understand hospital contributions to climate change, so that we can find ways to improve. Some commonly used medicines are supplied to the ward and stored there in anticipation of being prescribed to patients, rather than being supplied to the ward after being prescribed. Sometimes, these medicines can expire on the ward without ever being used and must be thrown away. We are interested in finding out how much medicine is wasted through the supply on the ward so that we can consider ways to reduce that wastage. To learn about medicines wastage on the ward, we plan to use dispensing, prescribing, and administration data to understand trends in how much of each medicine is used over time and how that compares with the amount of each medicine that is given to the ward. This will help us to understand how and why medicines are being wasted on the ward so that we can develop future projects to address that wastage.

Since this research is focused on the environmental impacts of hospital operations, we cannot guarantee that the project will have direct benefits for patients. However, we expect that insights from this project will benefit the public by addressing climate change impacts from healthcare and may have indirect benefits for patients at Imperial College Healthcare NHS Trust (ICHT) hospitals and in the wider Northwest London community. The primary benefit of this project to the public is its contribution to NHS efforts to mitigate climate change. Climate change is a major threat to human health, affecting the right to a livable climate for people all over the world. In the United Kingdom, climate change is likely to lead to increased temperatures and frequency of heatwaves, as well as increased rainfall in winter (Met Office, 2022). Heatwaves, especially in the context of reduced resiliency, can lead to a variety of heat-related illnesses, such as heatstroke, worsened cardiovascular disease, adverse pregnancy outcomes, and impacts on sleep (Romanello et al., 2022). Large institutions, like the NHS, can have a large impact on climate change reduction because they have the power to make large scale changes with sweeping effects. It is therefore vital that the NHS, and each trust within it, make good on its promise to take action on an institutional level. Reducing the carbon footprint (carbon footprint: measure of climate change impact) of Imperial College Healthcare NHS Trust (ICHT) is important for preventing the worst possible public health consequences of climate change. In this project, we aim to characterise the climate change impact of unused medicines, taking into account greenhouse gas emissions from their manufacture, transportation, and disposal, for the ultimate goal of developing tools to reduce that impact. In addition to their climate change impact, the disposal of unused medicines can create a kind of air pollution that has direct negative effects on health when inhaled. Unused medicines must be incinerated, which causes air pollution by releasing small particles into the air around hospital incineration sites. When inhaled, these small particles (often called “particulate matter”), can enter the bloodstream and bring toxins into the body, which can negatively affect lung and heart health, as well as affecting pregnancy outcomes and certain brain conditions. Insights from our project may help Imperial College Healthcare NHS Trust (ICHT) to reduce air pollution from its hospitals, especially coming from expired medicines that need to be disposed of via incineration. Reduced medicines wastage would improve the overall health and wellbeing of people living and working near hospital incineration sites by reducing exposure to harmful air pollution from incineration of unused medicines. Insights from our study may benefit patients in ICHT hospitals by supporting strategies to optimise the supply pathway for on-ward medicines, improving hospital efficiency by reducing the number of expired drugs on ward. With improved efficiency, patients would be able to receive needed medicines more quickly, improving overall patient safety as well as patient comfort.

Public Health Research

18/01/2024

22/12/2023

De-Personalised

Not applicable

Not applicable

One-off

18/01/2024

TRE