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

A technical description of an acoustic Doppler based upper ocean profiling system

An acoustic Doppler profiler has been designed into a multi-sensor Acoustic Profiler of Ocean Currents system (APOC). All four major components of this data collecting ensemble are microprocessor based units, allowing programmatic flexibility. Various water column, meteorological, and navigation data are recorded in a raw and/or processed form. Plots and listings of processed data are generated and displayed in real-time for use by investigators. Once installed, the system requires only a periodic change of cartridge recording media. The equipment has collected data during five cruises, for a total of approximately 190 days at sea. A hardware and software description of the system is presented. Preliminary technical results are discussed and evaluated.Funding was provided by the National Science Foundation under grant Nos. OCE 84-16197 and OCE 84-00128

Seafloor borehole array seismic system (SEABASS)

The Seafloor Borehole Array Seismic System (SEABASS) has been developed to measure the pressure and three dimensional particle velocity of the VLF sound field (2-50HZ) below the seafloor in the deep ocean (water depths of up to 6km). The system consists off our three-component borehole seismometers (with an optional hydrophone), a borehole digitizing unit, and a seafloor control and recording package. The system can be deployed using a wire line re-entry capability from a conventional research vessel in Deep Sea Drilling Project (DSDP) and Ocean Drilling Project (ODP) boreholes. Data from below the seafloor are acquired either on-board the research vessel via coaxial tether or remotely on the seafloor in a self-contained package. If necessary the data module from the seafloor package can be released independently and recovered on the surface. This paper describes the engineering specifications of SEABASS, the tests that were carried out, and preliminary results from an actual deep sea deployment. Ambient noise levels beneath the seafloor acquired on the Low Frequency Acoustic-Seismic Experiment (LFASE) are within 20dB of levels from previous seafloor borehole seismic experiments and from land borehole measurements. The ambient noise observed on LFASE decreases by up to 12dB in the upper 100m of the seafloor in a sedimentary environment.This work was carried out under JHU Contract # 602809-0 and under ONR contracts #N00014-89-C-0018, #N00014-89-J-1012, and #N00014-90-C-0098