Introduction

Sustainability is a major issue that doesn’t spare the field of digestive endoscopy. Bearing that in mind, the French Society of Digestive Endoscopy (SFED) created the Eco-responsibility and Sustainability Commission in 2021 and conducted a survey on green endoscopy practices throughout France.

Aims & Methods

Two digital forms (Google® Mountain View California, USA) were created and sent via the SFED mailing list (doctors and nurses). Data collection took place from January to April 2022.
The first questionnaire included 32 questions, regarding participants, their sensitivity to the ecological cause (using a numerical scale up to 10, the highest sensitivity) their use of small devices, the type of water used, their knowledge of biomedical waste (BMW), the clothing worn in the endoscopy room (ER) and recycling loops. The second questionnaire consisted of 31 questions, concerning the participants, whether they had already taken ecological action on a personal level, their data storage systems and their means of transportation.

Results

First questionnaire : 707 people from all over France responded out of 9911 recipients of the SFED mailing list. Average environmental sensitivity was 7.5/10.
- Regarding the use of small devices : 88.4% of the participants use reusable valves. 49.5% use reusable bite blocks. 94.3% use single use hemostatic clips.
- Regarding the type of water used according to the endoscope use : for the aspiration tests, 32.6% use filtered tap water; for the insufflation and endoscope lens wash jar, 24.9% use filtered tap water; and for the irrigation pump, 71.9% % use filtered tap water.
- 96.5% of participants knew that BMW should be incinerated, but only 5.4% knew that for every ton of BMW incinerated, approximately 1 ton of CO2 is produced.
- Regarding he clothing worn in the endoscopy room : 71.2% of the participants wear fabric scrubs washed within the hospital, most of the surgical cap (87.6%) are use single use, but theatre clogs are mainly reusable (88.7%). When the participants are cold in the ER, in 63.4% they wear single use over shirt.
- Regarding recycling loops : there is a glass recycling loop in 73.1% ER, a plastic recycling loop in 59.3% and a paper recycling loop in 38.3%.
Second questionnaire: 385 people from all over France responded out of 9969 recipients of the SFED mailing list. Average environmental sensitivity was 7.7/10. 90% of the participants have personally undertaken ecological actions, such as sorting waste, recycling, composting, buying less, cycling. Storage : 24.6% of pictures are stored on a server, 35.1% are stored and printed, 30.1% are printed only. Transportation : 21.6% of the participants go to work by bike, 60.3% by car, 8.1% by foot, 3.9% use public transportation.

Conclusion

To conclude, this practice survey is a global reflection of green endoscopy in France and allows us to have concrete results to base our efforts on to reduce the carbon impact of digestive endoscopy. To help us, the ESGE recently published its recommendations, and we can use the 3Rs rule: Reduce, Reuse, Recycle.