@article{AJO5200,
author = {Madison Boot and Isabella Ludbrooke and Joe Jabbour and Richard Fox and Murray Thompson and Ryan Winters and Robert Eisenberg and Daron Cope and Niall Jefferson},
title = {Environmental impact of single-use plastics in common ENT procedures: a prospective analysis of waste generation and carbon emissions in an Australian hospital},
journal = {Australian Journal of Otolaryngology},
volume = {9},
number = {0},
year = {2026},
keywords = {},
abstract = {Background: Healthcare contributes 7% of Australia’s total carbon emissions, with operating theatres being disproportionately resource-intensive environments. Despite growing sustainability awareness, no Australian data exist quantifying plastic waste generated during ear, nose and throat (ENT) procedures. This prospective audit quantified single-use plastic waste (kg) and estimated carbon dioxide emissions (kg CO2) from paediatric tonsillectomy, adenoidectomy, and grommet insertion procedures at an Australian district hospital.Methods: A prospective audit of consecutive paediatric ENT procedures was conducted between July-December 2024 at a district hospital site. An audit of plastic waste generated during tonsillectomy, adenoidectomy, and grommet surgeries was recorded, with all single-use plastics being catalogued by item type, polymer composition, and weight (kg). Carbon emissions were calculated using published emission factors for polypropylene (3 kg CO2/kg plastic).Results: Analysis of 115 procedures revealed a mean plastic waste of 1.5 kg [standard deviation (SD) 0.23] for combined procedures, tonsillectomy + adenoidectomy + grommets (TAG) (n=58), 1.2 kg (SD 0.15) for tonsillectomy/adenoidectomy procedures (n=36), and 1.1 kg (SD 0.11) for grommet insertion alone (n=21). This equated to estimated CO2 emissions of 4.5, 3.6, and 3.3 kg per procedure respectively, totalling 459.9 kg CO2 over six months. This is equivalent to manufacturing approximately 1,480 1-litre plastic water bottles.Conclusions: This first Australian audit demonstrates that paediatric ENT procedures generate substantial plastic waste and CO2 emissions. Given that tonsillectomy, adenoidectomy, and grommet insertion occur in bacterially colonised fields, rigorous evaluation of whether sterile barriers improve outcomes is urgently needed. Eliminating single-use items could reduce the impact of plastic waste and lower surgical costs.},
issn = {2616-2792}, url = {https://www.theajo.com/article/view/5200}
}