{
  "abstract": "Background\n\nClimate change is a major threat to global health, and healthcare is itself a substantial contributor. Choosing the route of drug administration may represent a simple opportunity to reduce environmental impact without compromising care.Objective\n\nTo quantify and compare the incremental environmental impacts and projected future health losses associated with oral, intravenous (IV), and intramuscular (IM) drug administration.Methods\n\nWe performed a life cycle assessment of route-specific materials and packaging associated with oral and parenteral administration scenarios in the emergency departments of the public hospitals of Marseille, France. The functional unit was administration of 100 mg ketoprofen. The active pharmaceutical ingredient was excluded to isolate the environmental impact attributable to the administration route. Environmental impacts were assessed using ReCiPe 2016 and converted into disability-adjusted life minutes (DALMs).Results\n\nGHG emissions were: 19 g CO₂e for oral administration, 279 g CO₂e for IM injection, 440 and 521 g CO₂e for IV flash and IV syringe pump administration with a pre-existing catheter respectively, and 776 g CO₂e for IV administration requiring catheter placement. Oral administration also had the lowest impact across all 18 midpoint environmental indicators. Projected health losses ranged from 0.13 to 5.59 DALMs, with climate change accounting for 88-92% of the total impact.Conclusions\n\nWhen clinically appropriate, prioritizing oral administration and reducing unnecessary IV use may substantially decrease healthcare-related emissions while maintaining quality of care, representing a simple step toward more sustainable healthcare and contributing to health for future generations.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Medicine, Centre Hospitalier Universitaire de la Timone, Assistance Publique Hôpitaux de Marseille (AP-HM), France.",
    "Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and Statistics, F-75004 Paris, France.",
    "Emergency Department, Centre Hospitalier Universitaire Hôpital Nord, Marseille, France.",
    "Service central des Opérations Pharmaceutiques, Assistance Publique Hôpitaux de Marseille (AP-HM), France.",
    "Primum Non Nocere agency, Béziers, France.",
    "Emergency Department, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.",
    "Laboratory \"Research on Healthcare Performance\" (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France.",
    "Centre Léon Bérard, Lyon, France.",
    "Aix Marseille University, ICR, UMR CNRS 7273, Marseille, France."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Benjamin de Sainte Marie"
    },
    {
      "affs": [
        2
      ],
      "name": "Baptiste Verhamme"
    },
    {
      "affs": [
        3
      ],
      "name": "Camille Carton"
    },
    {
      "affs": [
        4
      ],
      "name": "Zélie Charuel"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Virginie-Eve Lvovschi"
    },
    {
      "affs": [
        7
      ],
      "name": "Max Piffoux"
    },
    {
      "affs": [
        3,
        8
      ],
      "name": "Manon Roche"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6rnj8kwwqkpxt.bib",
  "cited_by": 0,
  "doi": "10.1016/j.joclim.2026.100757",
  "fulltext_url": "https://europepmc.org/articles/PMC13685454",
  "id": "6rnj8kwwqkpxt",
  "issns": [
    "2667-2782"
  ],
  "landing_url": "https://europepmc.org/article/MED/42909402",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2305|Environmental Impact and Sustainability"
    ]
  ],
  "openalex": "W7214037759",
  "pdf_url": "https://europepmc.org/articles/PMC13685454?pdf=render",
  "pmcid": "PMC13685454",
  "pmid": "42909402",
  "published": "2026-09-22",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/6rnj8kwwqkpxt.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:14Z",
      "native_id": "MED:42909402",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42909402"
    }
  ],
  "subjects": [
    {
      "field": "earth",
      "origin": "openalex:2305|Environmental Impact and Sustainability",
      "subfield": "environmental-science"
    }
  ],
  "title": "Oral vs parenteral drug administration: Quantifying the future health costs of routine prescribing choices through their environmental scope.",
  "title_text": "Oral vs parenteral drug administration: Quantifying the future health costs of routine prescribing choices through their environmental scope.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:14Z",
  "url": "https://research.draconitic.com/paper/6rnj8kwwqkpxt",
  "venue": "The journal of climate change and health",
  "versions": []
}