Quantification of Medical Waste and Incineration-Related CO₂ Emissions Associated With Gastrointestinal Endoscopy at Two Facilities in Japan: A Preliminary Observational Study.
- 1Department of Gastroenterology and Neurology, Faculty of Medicine Kagawa University Kagawa Japan.
- 2Department of Gastroenterology Imagawa Medical Clinic Kagawa Japan.
- 3Faculty of Engineering and Design Kagawa University Kagawa Japan.
Abstract
Objectives
Sustainable development oals in gastrointestinal endoscopy (GIE), referred to as "green endoscopy," have been a research focus in Western countries. However, the environmental burden of GIE in Japan is poorly understood. We quantify medical waste and estimate GIE-derived incineration-related CO₂ emissions in Japan.Methods
In a dual-center observational study, we report waste from esophagogastroduodenoscopy (EGD), colonoscopy (CS), endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic submucosal dissection (ESD) from June 2024 to January 2025. We classify waste as infectious/non-infectious, combustible/non-combustible, liquid, or sharps. We record the per-procedure waste and the procedure time, estimate CO₂ emissions from the combustion of the measured waste mass using combustion equations for cellulose and polyethylene, and calculate per-minute emissions and annual totals. Sensitivity analyses are performed for changes in the anticipated waste composition.Results
Estimated per-procedure CO₂ emissions are 949, 1178, 5834, and 4780 g for EGD, CS, ESD, and ERCP, respectively. Aggregate per-minute emissions are 168, 165, 89, and 75 g/min for ERCP, EGD, CS, and ESD, respectively. Annual institutional emissions total approximately 5800 kg. Estimated emissions are 64%-69% and 123%-134% of the base composition scenario values in the lower- and higher-emission composition scenarios, respectively.Conclusions
ESD had the highest per-procedure emissions, and ERCP and EGD had the highest per-minute emissions. These results provide preliminary baseline data on incineration-derived CO₂ emissions as a foundation for promoting "green endoscopy."
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BibTeX
@article{kawanishi2026quantification,
title = {{Quantification of Medical Waste and Incineration-Related CO₂ Emissions Associated With Gastrointestinal Endoscopy at Two Facilities in Japan: A Preliminary Observational Study.}},
author = {Ryosuke Kawanishi and Atsushi Imagawa and Naoya Tada and Noriko Nishiyama and Haruo Oba and Hideki Kobara},
journal = {DEN open},
year = {2026},
month = oct,
doi = {10.1002/deo2.70455},
url = {https://europepmc.org/article/MED/42923600},
note = {CC BY},
}
RIS
TY - JOUR
TI - Quantification of Medical Waste and Incineration-Related CO₂ Emissions Associated With Gastrointestinal Endoscopy at Two Facilities in Japan: A Preliminary Observational Study.
AU - Ryosuke Kawanishi
AU - Atsushi Imagawa
AU - Naoya Tada
AU - Noriko Nishiyama
AU - Haruo Oba
AU - Hideki Kobara
PY - 2026
DA - 2026/10/22
JO - DEN open
DO - 10.1002/deo2.70455
UR - https://europepmc.org/article/MED/42923600
AB - Objectives Sustainable development oals in gastrointestinal endoscopy (GIE), referred to as "green endoscopy," have been a research focus in Western countries. However, the environmental burden of GIE in Japan is poorly understood. We quantify medical waste and estimate GIE-derived incineration-related CO₂ emissions in Japan.Methods In a dual-center observational study, we report waste from esophagogastroduodenoscopy (EGD), colonoscopy (CS), endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic submucosal dissection (ESD) from June 2024 to January 2025. We classify waste as infectious/non-infectious, combustible/non-combustible, liquid, or sharps. We record the per-procedure waste and the procedure time, estimate CO₂ emissions from the combustion of the measured waste mass using combustion equations for cellulose and polyethylene, and calculate per-minute emissions and annual totals. Sensitivity analyses are performed for changes in the anticipated waste composition.Results Estimated per-procedure CO₂ emissions are 949, 1178, 5834, and 4780 g for EGD, CS, ESD, and ERCP, respectively. Aggregate per-minute emissions are 168, 165, 89, and 75 g/min for ERCP, EGD, CS, and ESD, respectively. Annual institutional emissions total approximately 5800 kg. Estimated emissions are 64%-69% and 123%-134% of the base composition scenario values in the lower- and higher-emission composition scenarios, respectively.Conclusions ESD had the highest per-procedure emissions, and ERCP and EGD had the highest per-minute emissions. These results provide preliminary baseline data on incineration-derived CO₂ emissions as a foundation for promoting "green endoscopy."
SN - 2692-4609
ER -