Carbon footprint of a chemotherapy production unit within a hospital pharmacy: Time for green pharmacy.

BackgroundIn the last decade, environmental impact assessment has become a major concern for human activities, which is particularly true for health. The french healthcare sector emits approximately 49 million tons of CO2 equivalent (CO2eq) per year, approximately 8% of the total national Green House Gas (GHG) emissions. In this context, assessing the carbon footprint of a resource-consuming unit like the cytotoxic drug production unit (CPU) is essential. The study aimed to assess the carbon footprint of a CPU.MethodsA retrospective study was conducted in a french CPU producing more than 51,000 preparations per year in 2022. Global warming impact of CO2eq emissions were determined for medicines (using the French monetary Emission Factor), single-use material (using the Base Empreinte® database), energy of electrical devices, staff transportation and waste.ResultsThe carbon footprint of the CPU was equal to 18'230.7 tons of CO2eq. Antineoplastic drugs accounted for more than 18'179 tons of CO2eq emissions. Excluding the medication part, it was equal to 51.7 tons of CO2eq. More precisely the distribution of CO2eq emission sources were staff transportation (35.9%), waste (21.1%), single-use sterile medical devices (18.1%), energy consumption (9.3%), disposable personal protective equipment (8.5%), and solvent bags and bottles (7.1%).ConclusionThis study prompts us to identify the main sources of GHG emissions within a CPU. Areas for improvement to reduce global warming impact might be deprescribing of antineoplastic drugs, staff transport reduction using telecommuting or carpooling and rethinking our production process to reduce waste production.