Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Monitoring turbidity and sediment re-suspension induced by channel dredging and subaqueous disposal in a deficit lagoon

In order to test a procedure for sustainable management of sediment in Marano and Grado Lagoon, consisting of dredging the Coron channel and sediment disposal in a deeper part of the same channel, an impact assessment of turbidity and sediment re- suspension has been carried out, by means of Acoustic Doppler Current Profiler surveys, suspended particulate matter collection and placement of sediment traps. Dredging and disposal operations cause an alteration of water turbidity, generating plumes that are driven by tidal currents within the channel and persist in water column for hours. Tidal flats next to the channel are involved in an anomalous sedimentation rate, temporally and spatially restricted. Background concentration during dredging and disposal operations is consistent with those caused by the wind waves. Peak values of concentration in channel and maximum rates of sedimentation on tidal flat are consistent with those caused by clam fishing with mechanical dredges, permitted on the same areas. Results indicate the possibility to adopt this type of sediment management practice as a good low-impact provisional procedure in this part of the lagoon

The Ligosullo (UD, Italy) Landslide, Revisiting of Past Data and Prospects from Monitoring Activities

The paper focuses on the analysis of a landslide, located in the northern sector of the Friuli Venezia-Giulia Region (North-Eastern Italy) affecting the village of Ligosullo. Field surveys, geophysical investigations and interferometric analyses, financed by the Geological Survey of Friuli Venezia-Giulia Region in the last 15 years let to recognize a sliding surface up to 70 m deep, causing the mobilization of 7 millions m3 of material. A new phase of studies including geological and geomechanical surveys and monitoring activities has been recently undertaken by the University of Padua (Department of Geoscience) and NHAZCA S.r.l. (Spin-off of \u201cSapienza University of Rome\u201d). The first results we obtained and the future goals are discussed in this paper