From the individual to the community and beyond: water quality, stress indicators and key species in coastal waters

This review examines water quality and stress indicators at levels of organisation from the individual to the community and beyond by means of three case studies concentrating on rocky shores within the north-east Atlantic. Responses of dogwhelks (Nucella) to tributyltin pollution from antifouling paints is examined as the main case study. There are effects at the individual level (development of male sexual characteristics in the female leading to effective sterility) and population level (reduction in juveniles, few females and eventual population disappearance of dogwhelks in badly contaminated areas) but information on community level effects of dogwhelk demise is sparse. Such effects were simulated by dogwhelk removal experiments on well studied, moderately exposed ledges on shores on the Isle of Man. The removal of dogwhelks reduced the size and longevity of newly established Fucus clumps that had escaped grazing. Removal of dogwhelks also increased the likelihood of algal escapes. In a factorial experiment dogwhelks were shown to be less important than limpets \{Patella) in structuring communities but still had a significant modifying effect by increasing the probability of algal escapes. Community level responses to stress on rocky shores are then explored by reference to catastrophic impacts such as oil spills, using the Torrey Canyon as a case study. Recovery of the system in response to this major perturbation took between 10-15 years through a series of damped oscillations. The final case study is that of indicators of ecosystem level change in response to climate fluctuations, using ratios of northern \{Semibalanus balanoides) and southern (Chthamalus spp.) barnacles. Indices derived from counts on the shore show good correlations with inshore sea-water temperatures after a 2-year lag phase. The use of barnacles to measure offshore changes is reviewed. The discussion considers the use of bioindicators at various levels of organisation

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

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

Recovery of polluted ecosystems: the case for long-term studies

Recovery of marine ecosystems from pollution has tended to receive less attention than the study of new or continuing impacts, but such studies are important in charting recovery from acute incidents and following legislation to deal with chronic contamination. Recovery is inevitably a long-term process, and where such studies have been made they are often too short-lived. Interest quickly wanes following an acute incident and governmental bodies rapidly switch to new legislative priorities for chronic inputs. We review three case studies: recovery of dogwhelk populations after local extinction by tributyl tin leachates from antifouling paints; recovery of rocky shore communities from oil spills; and recovery of estuarine ecosystems from industrial and urban development. We then make some generalisations about recovery processes before making a plea for long-term studies of polluted areas