Survey: Most Ophthalmologists Support Efforts to Reduce Medicine’s Big Carbon Footprint

Newswise — A just published survey¹ of more than 1,300 U.S. cataract surgeons and nurses shows 93 percent believe that something needs to be done to reduce the excessive amount of waste produced by surgery, and 87 percent want their medical societies to lead the effort to reduce medicine’s big carbon footprint. Today, the American Academy of Ophthalmology and ASCRS (American Society of Cataract and Refractive Surgery), the two largest and most respected societies in ophthalmology, heed our members call to action by adding our voice to the 27 other medical societies that make up the Medical Society Consortium on Climate & Health. It is time ophthalmologists engage more directly in the fight to limit climate change.

The Medical Society Consortium on Climate & Health brings together associations representing more than 600,000 clinical practitioners to inform the public and policymakers about the harmful health impact of climate change. They also support education for their colleagues through CME and offer guidance to physicians looking to improve the environmental sustainability in their own workplaces.

At its core, the Consortium believes that addressing climate change is the greatest public health opportunity of the 21st century, and failure to adequately address it could undo most of the progress in global health over the past century. The harm climate change has inflicted on patients is already evident – most commonly in the form of increased cardiorespiratory disease (related to air quality and heat), more severe and longer-lasting allergy symptoms, and injuries attributed to extreme weather.

“We are delighted to welcome the Academy and ASCRS to the Consortium,” said Mona Sarfaty, M.D., director of the Consortium. “Their specialty practice allows them to see health effects related to climate change that other physicians may not see but should hear about. Their surgical practice gives them direct experience of aspects of surgical care that should be addressed as part of the carbon footprint of the larger health system. I hope many members of the Academy and ASCRS will sign up on our website to be in close touch with the Consortium and consider becoming more involved in speaking for climate solutions.”

“Doctors hold a privileged position in society as trusted health authorities,” said David W. Parke II, M.D., CEO for the American Academy of Ophthalmology. “We can help inform people and policymakers about the benefits of moving to greener solutions. We know that addressing climate change will lead to cleaner air and water and to immediate health benefits for all Americans.”

U.S. Health care has a greenhouse gas emissions problem. Were health care a country, it would rank seventh in the world in total emissions.² Ophthalmology has an opportunity to improve medicine’s big carbon footprint because ophthalmologists perform one of the most commonly performed, not to mention most successful, surgical procedures in the world: cataract surgery.

Lead author of the survey and ASCRS board member, David F. Chang, M.D. believes cataract surgery is an area in which ophthalmologists can contribute significantly to the cause.

“The problem of operating room waste is not an easy one to fix, but one we can all agree is an ideal area in which to target carbon reduction strategies,” Dr. Chang said. “Because cataract surgery is one of the most commonly performed operations, we have an opportunity to collaborate with industry and regulatory agencies to make an impact.”

A recent study comparing the materials, waste, and costs associated with cataract surgery, as it’s performed in India and the United States found a dramatic difference in the carbon footprint. In India, a single cataract surgery produced an average of 0.25 kg of waste, two-thirds of which is recycled. In the US, each surgery generated 2.3 to 3.9 kg of waste per case, all of it landfill or biohazardous material. Much of the difference between the two countries comes down to single versus multi-usage of surgical pharmaceuticals, devices, and supplies.  

It’s because of studies like these that the Ophthalmic Instrument Cleaning and Sterilization Task Force –a group of experts from ASCRS, the Academy and the Outpatient Ophthalmic Surgery Society, and the Canadian Ophthalmological Society – undertook the online survey published today in the Journal of Cataract & Refractive Surgery. The Task Force wanted to find out what their members thought about operating room waste, the factors that drive excessive waste, and their willingness to consider economic and environmental sustainability initiatives.

They found that 91 percent are concerned about global warming, 93 percent believed that operating room waste is excessive and should be reduced; and 78 percent believed that we should reuse more supplies. They believe waste is driven by overly rigid regulation, product liability concerns, and manufacturers’ profit incentive. Most surgeons and nurses want more reusable options, more discretion on when to reuse products, and greater manufacturer consideration of carbon footprint, such as with product packaging.

About the American Academy of Ophthalmology

The Academy is the world’s largest association of eye physicians and surgeons. A global community of 32,000 medical doctors, it protects sight and empowers lives by setting the standards for ophthalmic education and advocating for its patients and the public. The Academy innovates to advance the profession and to ensure the delivery of the highest-quality eye care. Through its EyeSmart® articles on AAO.org, the Academy provides the public with the most trusted information about eye health. For more information, visit aao.org. 

About ASCRS

ASCRS is an international educational society with nearly 8,000 ophthalmic surgeons at every career stage. Its mission is to empower anterior segment surgeons to improve the vision, outcomes and quality of life for their patients through innovative approaches to education, advocacy and philanthropy. For more information, visit ascrs.org.

1. Chang DF, Thiel CL. Survey of cataract surgeons' and nurses' attitudes toward operating room waste J Cataract Refract Surg 2020; 46:933–940
2. New England Journal of Medicine: Climate Change – A Health Emergency https://www.nejm.org/doi/full/10.1056/NEJMp1817067