Carbon footprint evaluation of routine anatomic pathology practices using eco-audit: Current status and mitigation strategies

Because of global warming, integrating an ecological dimension to the practice of pathology is crucial, as already performed in other medical specialties. The aim of the study was to estimate the greenhouse gas emissions (GHE) of one biopsy/surgical specimen hematoxylin-phloxine-saffron (HPS) slide, one frozen section examination, and one immunohistochemistry (IHC) slide, and to propose environmentally friendly recommendations. The different steps of the pathological procedures, from sample transport to slide/block destruction, were considered for the GHE evaluation. Consumables and reagents used at each step were noted, as well as the electricity consumption of the premises/equipment, specific wastes, and staff travel. The GHE analyses were performed according to the eco-audit method. The GHE attributable to one HPS slide of a biopsy, one HPS slide of a surgical specimen, one frozen section examination, and one IHC slide were 0.589 kgCO_2e (CO₂ equivalent), 0.618 kgCO_2e, 1.481 kgCO_2e, and 0.363 kgCO_2e, respectively. For a one-year activity in the pathology department, the GHE for HPS was estimated at 91,897 kgCO_2e, equivalent to 422,321 km of thermal car ride. The main GHE sources were staff travel for one biopsy HPS slide (34.2 %) and one surgical specimen HPS slide (32.6 %), materials (39.1 %) and staff travel (27.2 %) for one frozen section examination, and staff travel (28.2 %) and reagents and their packaging (44.9 %) for one IHC slide. The present study highlighted the most significant sources of GHE for routine practices in a pathology department, underlining that, from pathologists to policy makers, each actor has a responsibility to implement sustainable changes.