Choosing Wisely & Climate Action
Reducing unnecessary tests, treatments and procedures is an opportunity to benefit both patients and the planet.
The health care sector is responsible for nearly 5% of global greenhouse gas emissions. This occurs through a variety of routes, ranging from the material waste produced in the course of health care delivery to the harmful gases released in certain procedures, to the carbon-intensive processes involved in the manufacturing of pharmaceuticals and other health care products.
Every unnecessary test, treatment, and procedure is therefore an opportunity to make a positive contribution towards the health of our patients and the planet. By eliminating practices that do not add value to patient care, you’re not only avoiding potential harms associated with overuse, but also netting benefit to the environment.
This is the co-benefit of doing Choosing Wisely.
Reducing unnecessary tests, treatments and procedure can benefit our planet in a variety of ways, including:
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Medications impact the environment across their lifecycle, spanning production, transportation, use, and disposal. Pharmaceutical manufacturing often involves the use of chemicals, energy, and water. A significant concern is the presence of pharmaceuticals in water bodies from human and animal waste or improper disposal. Wastewater treatment plants may not be equipped to remove these compounds, leaving the presence of pharmaceutical residues in rivers, lakes, and groundwater.
Antibiotics, which are one of the highest dispensed medications, are often prescribed for viral infections despite evidence that these drugs are ineffective against viruses. Unnecessary use coupled with the accumulation of antibiotics and other antimicrobial agents in the environment contributes to antimicrobial resistance. This can lead to the emergence of superbugs—bacteria that have developed resistance to antibiotics—making future bacterial infections harder or sometimes impossible to treat.
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Unnecessary testing can contribute to greenhouse gas emissions through equipment operation, energy use, water consumption, manufacturing, and material waste.
With over 1.2 million lab tests performed each day in Canada, laboratories represent a sizable part of the health care system. Lab testing involves single-use materials like tubes, syringes, and pipettes, while laboratories are energy-intensive operations due to specialized equipment, ventilation, and temperature control systems. While many lab tests are needed, some are not and often done routinely or automatically. Unnecessary lab testing can also result in false positives and drive further testing, procedures, referrals, and treatments — all of which produce additional carbon emissions.
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Unnecessary procedures impact the environment by creating excess greenhouse gas emissions, consuming resources, energy, and generating waste.
Procedures require patients to travel to their appointments, and this can include travelling by car, bus, train as well as air travel for those in northern and remote communities. These modes of transportation generate greenhouse gas emissions. These emissions could be reduced by foregoing unnecessary tests and procedures and, where available and appropriate, utilizing telemedicine/virtual medicine. Overuse of procedures also creates excess waste. This can include single-use items like needles, syringes, test kits, gloves, gowns and masks, as well as pharmaceutical waste.
Choosing Wisely and the Climate Crisis: A Role for Clinicians
An article in BMJ Quality and Safety on reducing low-value care to tackle the climate crisis.
Choosing Wisely for Patients, and the Planet
An article on how reducing overuse avoids harm to patients and the planet.
Choosing Wisely and Climate Action
A webinar on the environmental impact of unnecessary tests, treatments, and procedures.
Environmental Co-Benefits of Reducing Low-Value Care
A webinar discussing the co-benefits of reducing low-value care.