Life Cycle Analysis of Delivering an Infant in the US · Life Cycle Analysis of Delivering an...

April 30–May 2, 2012 • Denver, ColoradoColorado Convention Center & The Hyatt Regency Denver

Life Cycle Analysis of Delivering an Infant in the US

Noe C Woods, MD

Assistant Professor of Obgyn,

U of Pittsburgh School of Medicine

Melissa Bilec, PhD, LEED APDepartment of Civil and Environmental Engineering

Mascaro Center for Sustainable InnovationUniversity of Pittsburgh

April 30–May 2, 2012 | Denver, Colorado | www.cleannmed.org

Waste produced from one NSVD

Sustainable Healthcare: a collaboration


Magee-Womens Hospital University of Pittsburgh School of Medicine

Ranked #7 for Gynecologic Care by US News & World Report

Deliver 10,000 babies/year

Over 15,000 operations/year


MASCARO CENTER FOR SUSTAINABLE INNOVATION (MCSI)42,000 ft2 green building (LEED gold)2nd floor addition and tower

• How can LCA determine environmental sustainability of the healthcare industry? (external)

• What aspects of hospital operating procedures contribute the most to a procedure’s environmental impacts? (external)

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Life Cycle Thinking in Healthcare Literature

– Ecological footprint of NHS in England and Whales (2004) and Lions Gate Hospital in Canada (2002)

– Carbon footprint of Swedish health center (2005)

– EIO‐LCA of US healthcare sector (2007)

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LCA MethodsISO 14040 & 14044Guidelines

Goal and Scope Definition

Interpretation and Analysis

Inventory Analysis (LCI)

Impact Assessment (LCIA)

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Campion, N., Thiel, C.L., DeBlois, J., Woods, N.C., Landis, A.E., Bilec, M.M. “Life Cycle Perspectives of Delivering an Infant in the US.” 2012, Science of the Total Environment.


Functional Unit


Energy– Lighting and machine loading ‐ visual survey

– HVAC – bin energy model

Materials– Disposable materials – custom packs (20% RMW, 80% MSW)

– Surgical instruments – reusable custom packs

Waste disposal contribution analysis

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• Life Cycle Inventory (LCI)– USLCI

– Ecoinvent– Other database

• Life Cycle Impact Assessment (LCIA)– TRACI 2 version 3.01, Tool for

the Reduction and Assessment of Chemical and other environmental Impacts (USEPA)

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Vaginal Births vs. Cesarean Section

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At Magee Women’s Hospital, Pittsburgh, PA.

C‐Section

Vaginal

Disposable Kits Reusable Kits

Cesarean Section Disposable Kit

Of the disposable materials, cotton, LDPE (low density polyethylene), and PVC were the three highest materials. Specifically, blue OR towels represented 90% of the cotton, gowns and drapes represent 92% of the LDPE, and suction tubing represented 69% of the PVC.

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Energy consumption (HVAC, machines, and lighting) contributed the highest percentage for both modes of delivery in the categories of global warming potential, acidification, and respiratory effects categories.

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Campion, N., Thiel, C.L., DeBlois, J., Woods, N.C., Landis, A.E., Bilec, M.M. “Life Cycle Perspectives of Delivering an Infant in the US.” Science of the Total Environment.

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The increasing reliance on disposable materials is contributing to higher levels of hospital waste and associated environmental impacts.

Where to next?

• Advance life cycle thinking within healthcare

• Need for impact data for hospital facilities

• Interdisciplinary discussions of problems and solutions

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LCA of HysterectomiesWhat aspects of hospital operating procedures contribute the most to a procedure’s

environmental impacts?

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• Four types or modes– Laparoscopic

– Robotic

– Vaginal

– Abdominal

• Variable patient outcomes

National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Researchand Grant Number ULI RR024153


LCA of Hysterectomies

IRB approval and patient consentProper medical safetytraining and PPEProcedure

– Remove all waste from OR

– Collect MSW and Recycling

– Sort by material type

– Weigh

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Waste Audit Procedure

• Recorded after surgery– Patient ID– Date of procedure– Type of hyst– No. ppl in room– Which reusable trays were

opened– No. linens used

• Weighed Materials• Counted Materials

– Mixed materials– Wet and soiled materials

• Peel packs (to capture RMW)

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LCA of HysterectomiesEstimate OR energy consumption specific to hysterectomy mode

• Lighting and machine loading ‐ Power consumption monitoring of variable‐draw machines

• HVAC – bin energy model

• 90 WASTE AUDITS DONE!

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