Climate change, sustainability and anesthesiology practice: A national survey among anesthesiologists and nurse anesthetists in Norway

Abstract

Background: In the face of climate change the health sector will need to tackle both the increasing consequen- ces for health worldwide and to reduce its own carbon footprint, which is estimated at 4.4% of global emis- sions. Raising the voice of health professionals has been identified as paramount to achieving the wide-scale and urgent response required to limit the consequences of climate change for health. Among health profes- sionals, anesthetic practitioners are ideally placed to lead the way given that they make daily decisions regarding anesthetic gasses with a considerable footprint on climate and the environment. Methods: Here, we describe a cross-sectional nationwide survey among 3,300 anesthesiologists and nurse anesthetists in Norway, focusing on climate change, health, and sustainable anesthetic care. Responses were tabulated and characterized using descriptive statistics. Results: A large majority of the responding anesthesiologists and nurse anesthetists (n = 697, response rate 21.1%) agreed or strongly agreed that the world is facing a climate crisis; that nurses and doctors have a par- ticular responsibility to warn about health threats; and that health organizations should limit their impact on climate and the environment. We found that desflurane is still widely used in Norway, despite its high cli- mate footprint. We also identified several barriers to development of sustainable anesthetic care, including a lack of easy access to waste management systems, an absence of guidelines which promote sustainable care, and inadequate means for disposal of drug residues. Conclusions: Alongside other surveys, the present survey identifies safe and feasible adjustments to anes- thetic practice which can give substantial emission reductions, pave the way for a wider health sector response, and yield considerable benefits to planetary health.