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

Removal of cadmium from aqueous solution using marine green algae, Ulva lactuca

The present study aimed to evaluate the efficiency of marine algae for removal of metals from the aqueous solution. The green alga, Ulva lactuca, collected from the intertidal zone of the Suez Bay, northern part of the Red Sea was used to reduce cadmium levels from the aqueous solutions. The biosorption mechanisms of Cd2+ ions onto the algal tissues were examined using various analytical techniques: Fourier-transform infrared spectroscopy (FT-IR) and Scanning electron microscopy (SEM). Results indicated that at the optimum pH value of 5.5; about 0.1 g of U. lactuca was enough to remove 99.2% of 10 mg L−1 Cd2+ at 30 °C in the aqueous solutions. The equilibrium data were well fitted with the Langmuir and Freundlich isotherms. The monolayer adsorption capacity was 29.1 mg g−1. The calculated RL and ‘n’ values have proved the favorability of cadmium adsorption onto U. lactuca. The desorption test revealed that HCl was the best for the elution of metals from the tested alga. In conclusion, the seaweed U. lactuca was the favorable alternative of cadmium removal from water