Oral vs parenteral drug administration: Quantifying the future health costs of routine prescribing choices through their environmental scope.
9 affiliations
- 1Department of Internal Medicine, Centre Hospitalier Universitaire de la Timone, Assistance Publique Hôpitaux de Marseille (AP-HM), France.
- 2Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and Statistics, F-75004 Paris, France.
- 3Emergency Department, Centre Hospitalier Universitaire Hôpital Nord, Marseille, France.
- 4Service central des Opérations Pharmaceutiques, Assistance Publique Hôpitaux de Marseille (AP-HM), France.
- 5Primum Non Nocere agency, Béziers, France.
- 6Emergency Department, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
- 7Laboratory "Research on Healthcare Performance" (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France.
- 8Centre Léon Bérard, Lyon, France.
- 9Aix Marseille University, ICR, UMR CNRS 7273, Marseille, France.
Abstract
Background
Climate 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
To quantify and compare the incremental environmental impacts and projected future health losses associated with oral, intravenous (IV), and intramuscular (IM) drug administration.Methods
We 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
GHG 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
When 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.
Related
- Quantifying the gap from scientific evidence to environmental policy and implementation across scales
- ECOCIDE: Quantifying War-Time Environmental Damage: A Difference-in-Differences Analysis of the Kakhovka Dam Destruction
- Efficient dual-mode liquid chromatography–tandem mass spectrometry methods for quantifying major cyanotoxins in natural water
- Quantifying nonlinear thresholds of grey-green space morphology on urban carbon metabolism across local climate zones: a machine learning study in Changchun city
- Quantifying metal transferability in soil and its relationship to metal-related health risks in the strawberry (Fragaria × ananassa)-human food chain
BibTeX
@article{marie2026oral,
title = {{Oral vs parenteral drug administration: Quantifying the future health costs of routine prescribing choices through their environmental scope.}},
author = {Benjamin de Sainte Marie and Baptiste Verhamme and Camille Carton and Zélie Charuel and Virginie-Eve Lvovschi and Max Piffoux and Manon Roche},
journal = {The journal of climate change and health},
year = {2026},
month = sep,
doi = {10.1016/j.joclim.2026.100757},
url = {https://europepmc.org/article/MED/42909402},
note = {CC BY},
}
RIS
TY - JOUR
TI - Oral vs parenteral drug administration: Quantifying the future health costs of routine prescribing choices through their environmental scope.
AU - Benjamin de Sainte Marie
AU - Baptiste Verhamme
AU - Camille Carton
AU - Zélie Charuel
AU - Virginie-Eve Lvovschi
AU - Max Piffoux
AU - Manon Roche
PY - 2026
DA - 2026/09/22
JO - The journal of climate change and health
DO - 10.1016/j.joclim.2026.100757
UR - https://europepmc.org/article/MED/42909402
AB - Background Climate 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 To quantify and compare the incremental environmental impacts and projected future health losses associated with oral, intravenous (IV), and intramuscular (IM) drug administration.Methods We 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 GHG 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 When 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.
SN - 2667-2782
ER -