Percutaneous coronary interventions (PCI) and transcatheter-based valve therapies are performed with increasing frequency. However, the amount and composition of waste generated and the associated environmental burden is largely unknown. Today, Doctor Michael Kunz (University Hospital Basel - Basel, Switzerland) presents data on the waste burden and the environmental impact of different disposal strategies following interventional cardiology procedures.
This lifecycle assessment and modelling study was conducted at a Swiss tertiary centre and assessed waste generated during 50 cases of the most common cardiac procedures: diagnostic coronary angiography, PCI, complex PCI, transcatheter aortic valve implantation (TAVI) and transcatheter edge-to-edge repair (TEER). The environmental footprint of the waste disposal of each procedure was quantified by integrating 16 environmental impact categories into a single normalised score in micropoints (μPt). Three possible disposal models were compared: waste separation, municipal incineration and full hazardous incineration.
The median waste per case was 7.68 kg, 77.6% of which was incinerable, with diagnostic coronary angiography producing the least (3.54 kg) and TEER the most (17.51 kg). This equated to around 15.24 tons of waste annually from this one centre alone. The environmental burden ranged from 246 μPt for diagnostic angiography to 724 μPt for TEER.
A strong association between disposal strategy and environmental burden was noted. The environmental footprint per average procedure was least for waste separation (477.95 μPt, equivalent to 15.85 kg CO2) and greatest for full hazardous incineration (1,272.11 μPt; 22.98 kg CO2). Associated costs for hazardous-only disposal were over four times those for waste separation. Extrapolating these findings to all procedures in Germany using various assumptions indicated production of 4,022 tons of waste annually and an environmental burden equivalent to driving approximately 22 million km/year with waste separation and 58 million km/year with full hazardous incineration.
The authors conclude that the substantial environmental footprint and costs associated with waste generation of interventional cardiology procedures can be considerably reduced using simple waste separation strategies and minimisation of unnecessary packaging, where possible.