The health sector is a major producer of greenhouse gases on a global scale. Some institutions are trying to change practices, medical or not, to reduce their carbon footprint, such as the hospital in the city of Laval, near Montreal, in Canada.
From our correspondent in Montreal,
In front of the Cité-de-la-Santé hospital in Laval, two elements strike a foreign visitor. First, the huge car parks to accommodate cars, which arrive directly from the bordering motorway slip road. Then, the two sets of buildings: one aging, the other brand new, covered with black solar panels to heat the indoor air. Inside one complex, as in the other, the staff is gradually mobilizing to change practices and reduce the center’s environmental impact.
For the first time in the health sector in Quebec, the Laval integrated health and social services center (CISSS) drew up a report on its greenhouse gas (GHG) emissions in June 2022, to target priority projects. The hospital complex, of which the Cité-de-la-Santé hospital is part, emits 90,000 tonnes of CO2 equivalent each year, equivalent to the emissions of 10 container ships over one year, mainly produced by travel by staff vehicles and the purchase of equipment. These figures are in line with a global trend: the health sector is responsible for 4.4% of global GHG emissions.
Health before all
” I was really surprised by this result. We expected to have a large carbon impact from home-work staff travel, almost 40% of emissions, but not that the vast majority of the rest was due to the purchase of care supplies. says Benoît Lalonde, deputy director of technical services at the CISSS and head of the sustainable development committee. The plastic of the gloves, the packaging of sterilized tools, the syringes, the fabric, the trays or even the meals are all aggravating factors of this assessment.
But the result could have been worse. The center had already made efforts to reduce its carbon footprint, by changing certain practices. In 2019, doctors like Stéphanie Burelle, an emergency physician, decided to found the Éco-CPDP, the ecological focus of the Council of Physicians, Dentists and Pharmacists at the centre, an important body of the CISSSs. Today president of this eco-council, Stéphanie, who defines herself as eco-anxious and concerned about the future of her child, summarizes the raison d’être of the Éco-CPDP: ” take care as a whole, also taking into account their environmental impact “. From the very first meetings, a major question then arises: how to reduce the environmental impact of practices without losing quality of care?
Any change in sanitary protocols, ecological or not, must be approved by the infection prevention and control officer. At the CISSS de Laval, Olivier Haeck is in charge, and the infectious disease specialist is as committed to patient safety as he is to listening to the demands of the eco-CPDP. When the pandemic Covid-19 arrived, at the beginning of 2020, it authorized the use of washable blouses, contrary to Quebec guidelines. ” I had reread the scientific literature on the subject and systematically throwing away the gowns was not necessary. In addition, the supply was not assured and we therefore launched the production of reusable gowns in partnership with local companies. “, explains the infectiologist. A decision still in application today and which has made it possible to avoid the use of millions of disposable gowns each year.
Ideas are blooming
The initiatives supported by the eco-CPDP are far from being limited to overalls. Head to the hemodialysis department, where patients’ blood is filtered to replace their kidneys. In early 2023, Dominique Boudreau, nursing care advisor, and Louis Prud’homme, the doctor in charge of the service, reduced the use of plastic bags filled with purified water. ” To supply our dialysis machines, we need ultrapure water. We therefore invested in a water system so efficient that it produces water without pyrogen, without bacteria: it’s like a water treatment plant, but internal “, proudly explains the caregiver. If the system fails, an emergency call is made to request rapid intervention and another pump takes over. 40,000 bags are thus saved each year, not to mention other adjustments in the service which further reduce the use of disposable materials.
Another challenge for the eco-CPDP is to reduce the use of anesthetic gas, and to favor one rather than another. Indeed, anesthetic gases emit a lot of greenhouse gases, but things are progressing, notes Stéphanie Burelle. ” The word was quickly transmitted in the services concerned. Sevoflurane is much less polluting than desflurane, and we have seen a drop in the use of the latter. Whenever possible, the anesthetic is delivered intravenously rather than by aerosol, which helps to avoid leakage into the air.
Other avenues are still under study. It would be a question of returning to the wooden splint instead of plastic for the injured, of replacing single-use pads with washable pads. ” A company is offering to sterilize single-use instruments again, this is something we are studying, because sterilizing them ourselves is impossible”agrees microbiologist Olivier Haeck.
Holistic prescription
Apart from medical practices, buildings are also changing. Three of the 33 CISSS buildings have been equipped with air pumps to recover the constant temperature of the ground and inject it into the network. “ It’s geothermal. With all the investments we have made in terms of insulation, we have achieved a saving of 40%, which is equivalent to approximately 330,000 Canadian dollars saved per year. proudly details Fanny Steben, head of the sustainable building sub-committee. Three large biodigesters will be set up to reduce the amount of organic matter thrown into the canteens and trees are planted each year.
There remains a major impact from the carbon footprint which is struggling to reduce: the use of private cars. The CISSS is in discussion with the city of Laval to improve public transport service, but habits die hard and carpooling is not yet popular enough.
The benefits of the initiatives already in place are multiple. Money savings in a sector where every penny is counted, time savings, by mobilizing less hands, less space, by reducing the quantity of material to be stored, and of course, carbon savings, without wasting given the main objective of a health establishment: to care for its patients.