LAUSR

Endoscopies have a significant environmental impact, and their use in the UK’s National Health Service (NHS) is increasing. In the context of the NHS’ 2040 net zero targets, we calculated emissions for colon capsule endoscopy (CCE) and compared these with traditional endoscopy, in a district general hospital. We used local data to map the proportion of patients undergoing CCE who also require endoscopy. Given there is no existing carbon footprint for CCE, we gathered primary data on travel, materials, waste, and estimated energy use, and matched them with the UK government's conversion factors database. We then identified existing carbon footprint calculations for endoscopy, chose the most similar context, and added local travel data. Of 283 patients undergoing CCE, 50.6% required further investigations. For procedures alone, endoscopy generated 22.8kg carbon dioxide (CO2e), with 14.2kgCO2e for CCE. For CCE the largest contributor to emissions was patient travel, and for endoscopy it was medical equipment. However, given 50% of CCE patients required endoscopies, total average emissions for the CCE pathway per patient increases to 25.6kgCO2e. While emissions per procedure are lower, the greener potential of CCE can only be realised if patient travel is also made lower carbon, or if this service is hosted closer to patients’ homes. In addition, completion of CCE reduced the need for further investigations, so improving completion rates would also reduce emissions. Overall, this work highlights the need to consider patient travel and overall pathways in carbon emissions calculations.