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

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

Low silica synthetic faujasite X and synthetic zeolite A formation from sodium-aluminosilicate gels

Synthetic zeolites A and X were prepared from sodium-aluminosilicate gels by crystallization under hydrothermal conditions and at water bath temperature. The process of crystallization and physico-chemical studies on the synthetic zeolites and amorphous aluminosilicate hydrates, from which formed, have been examined by X-ray diffraction measurements, chemical analyses and differential analyses. The structures of synthetic zeolites A and X have been determined in their hydrated form. Zeolite A is represented by the oxide formula : Na2O. Al2O3 . 2 SiO2 . 0.16 NaAlO2 . 4.30 H2O. and the zeolite has the composition (unit cell composition) Na12 [12 AlO2 . 12 SlO2] . NaAlO2 . 29 H2O. The synthetic zeolite X is represented by the oxide formula Na2O . Al2O3 . 2.1 SiO2 (5.63 7.02 ) H2O and the simple zeolite has the composition (unit cell composition) Na94 [94 AlO2 . 94 SiO2] . (260 264) H2O.Des zéolites synthétiques A et X ont été préparées à partir de gels aluminosilicatés sodiques par cristallisation dans des conditions hydrothermales et au bain-marie. Le mécanisme de cristallisation a été examiné et des études physico-chimiques des zéolites de synthèse et des hydrates d'alumino silicates amorphes qui leur ont donné naissance ont été menées par diffraction des rayons X, analyses chimiques et analyses thermiques différentielles. Les structures des zéolites synthétiques A et X ont été déterminées sous leur forme hydratée. La zéolite A est représentée par la formule en oxydes : Na2O. Al2O3 . 2 SiO2 . 0.16 NaAlO2 . 4.30 H2O. et a la composition suivante (en cellule-unité) : Na12 [12 AlO2 . 12 SlO2] . NaAlO2 . 29 H2O. La zéolite de synthèse X est représentée par la formule en oxydes : Na2O . Al2O3 . 2.1 SiO2 (5.63 7.02 ) H2O et à la composition (en cellule-unité) : Na2O. Al2O3 . 2 SiO2 . 0.16 NaAlO2 . 4.30 H2O. and the zeolite has the composition (unit cell composition) Na94 [94 AlO2 . 94 SiO2] . (260 264) H2O.Grba V., Soljic Z. Low silica synthetic faujasite X and synthetic zeolite A formation from sodium-aluminosilicate gels. In: Bulletin du Groupe français des argiles. Tome 27, fascicule 2, 1975. pp. 167-175

Study on the properties of synthetic zeolites A and X and amorphous aluminosilicate hydrates in relation to their application as adsorbents and as thin-layers in the acid medium

Studies on the adsorptive properties of crystalline zeolites and Na-aluminosilicate gels, from which they are formed , show that crystalline zeolites can adsorb molecules of a certain size and shape, but gels cannot. That characteristic of zeolites as adsorbents is unique in orders of adsorbents on the basis of silicates and aluminosilicates. Investigations on the reaction of the amorphous alumino silicate hydrates and crystalline zeolites with diluted acids show that at the beginning an exchange of sodium with H-ions takes place, giving crystalline or amorphous alumino silica te acids. By further treatment a simultaneous transformation of crystalline structure into an amorphous state and decomposition of aluminosilicate acids take place, and finally a complete destruction of aluminosilicate systems occurs.Des études sur les propriétés d'adsorption de zéolites cristallisées et de gels alumino-silicatés sodiques à partir desquels elles se néoforment, montrent que les zéolites cristallisées peuvent adsorber des molécules d'une certaine taille et forme, mais que les gels ne le peuvent pas. Des recherches sur la réaction d'hydrates d'aluminosilicates amorphes et de zéolites cristallisées avec des acides dilués montrent qu'en début de réaction, un échange entre sodium et ions-H se produit, qui donne naissance à des acides d'aluminosilicate cristallisés ou amorphes. Par un traitement plus poussé, on observe une transformation simultanée de la structure cristallisée en une forme amorphe, et la décomposition des acides d'aluminosilicate ; finalement, une destruction complète du système aluminosilicaté se produit.Soljic Z., Grba V. Study on the properties of synthetic zeolites A and X and amorphous aluminosilicate hydrates in relation to their application as adsorbents and as thin-layers in the acid medium. In: Bulletin du Groupe français des argiles. Tome 27, fascicule 2, 1975. pp. 177-183

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 coprioritized 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