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

Workshop on the production of abundance estimates for sensitive species (WKABSENS). ICES Scientific Reports, 3:96.

The Workshop on the production of annual estimates of abundance of sensitive species (WKABSENS) met to define sensitive species, collate ICES assessments of abundance where these are available, and estimate indices of their abundance per swept-area where not, for the OSPAR area. The analyses identified 140 potentially sensitive species or species complexes, among which 10 are diadromous and three are coastal, 20 have uncertain species ID and nine were identified as sensitive in only one of the sources examined. Among the sensitive species and species complexes, there was sufficient data to provide abundance indices for 50 species, of which 16 had existing stock assessments whereas the workshop derived abundance estimates for the remaining 34 species from survey data. Three statistical modelling approaches (binomial, General Additive Models (GAMs) and VAST) and were explored and the final abundance indices were calculated using GAMs. The species were divided into stocks before estimating abundance indices where these could be identified from the spatial distribution of the species in the survey. The group considered that a similar analysis using data from additional surveys, commercial indices or data from bycatch observers can potentially provide improved abundance estimates for species with variable or low catchability, such as deep-water and pelagic species