What's in the Bin? A Waste Audit of an Australian Tertiary Ear, Nose and Throat Outpatient Clinic

Background

Healthcare contributes 4.4% of global emissions. Climate change contributes to vector-borne diseases, food insecurity and morbidity and mortality associated with extreme weather. Ear, nose and throat (ENT) outpatient clinics are particularly resource intensive, yet their environmental impact has not been quantified. The aim of this study was to quantify waste generation in an ENT outpatient clinic and estimate associated carbon equivalent emissions produced.

Methods

Disposable waste from 20 consecutive ENT outpatient clinics at a tertiary Australian hospital was collected, counted and weighed in November 2024. Plastic packaging was also collected from 10 of these clinics and weighed. Published lifecycle assessments (LCA) were used to calculate global warming potential (GWP).

Results

Across 20 clinics, 292 patients were seen and 128 nasendoscopes used. Annually, 244.56 kg of clinical waste was estimated to be generated, associated with 10 606 pieces of plastic packaging (19.54 kg). The GWP associated with this was 996.154 kg of carbon dioxide equivalent emissions (kgCO2-e). In the clinic, re-usable rhinolaryngoscopes generated 477.26 kgCO2-e annually. In total, the clinical waste, plastic packaging and use of re-usable scopes equated to 1015.75 kgCO2-e annually, or 0.26 kgCO2-e per patient.

Conclusion

ENT outpatient clinics generate considerable waste and emissions from disposables and packaging. Sustainable practice requires collaboration between clinicians, manufacturers and infection control, with transparent LCA data and local assessments to inform procurement and align healthcare with sustainability goals. A potential saving equivalent of up to 1 t of carbon dioxide CO2-e was identified from a single tertiary ENT unit.