An LCA of hospital pathology testing

There is increasing interest within the healthcare sector about the environmental impacts associated with the provision of health services, with the sector being responsible for approximately 4.4% of global greenhouse gas emissions. The aim of this study is to develop an LCA of six commonly used pathology tests in hospitals in Australia, as testing is ubiquitous within healthcare. The study is a cradle-to-grave assessment of pathology testing, from raw material acquisition for collection equipment and reagents, the collection of the sample from the patient, sample transport to the pathology lab and its subsequent analysis, and the disposal of clinical waste. The study has been performed in accordance with ISO 14,040 and ISO 14,044. The data were modelled using SimaPro® software, version 9.0.0.27, using the Australian National Life Cycle Inventory Database (AusLCI) for Australian specific data, and from Ecoinvent 3.5® for all other data. Impact assessment was performed using the ReCiPe 2016 V1.02 (H). We focused on midpoint indicators that damage human health, as well as reporting in disability adjusted life years (DALYs). Focussing on climate change, the impact of a single blood test given in a hospital ranges from 74 g CO2e through to 274 g CO2e, whilst for a urinalysis in a hospital the impact is greater at 538 g CO2e. Expressed in DALYs, blood tests ranged from impacts range from 0.146 µDALYs through to 0.383 µDALYs, whilst urinalysis was 0.701 µDALYs. For the majority of the tests, the major source of impacts was the collection tubes and jars, and the electricity use of the analysers. Test reagents had only a minimal impact. Urinalysis had additional impacts due to test consumables (agar plate), and compressed air required for the automated analyser and incubator. Globally, tens of billions of pathology tests are performed annually, with each individual test having a low environmental impact. Not all testing, however, is necessary, and reducing this unnecessary testing will reduce environmental and economic impacts and potential adverse health outcomes. Increasing laboratory utilisation (efficiency) will additionally reduce environmental impacts per test.