P275 Endoscope energy use – endoscopy decontamination unit: benchmarking in sustainable endoscopy. (19th June 2022) - Siddhi, Sandeep
Abstract : Introduction: Maurice et.al. [1] have highlighted the need for gastroenterologists to change endoscopy practice, highlighting the lack of evidence to accurately define the scope of the environmental impact of endoscopy services. Endoscope decontamination is a critical part of a safe endoscopy service. Previous studies were mostly based on the waste produced (Sathvik et al [2], Eckelman et al [3]). There is a need to establish a baseline of the energy, water and waste generated by this activity. This study attempts to set a theoretical baseline for the Environmental operational impact of an Endoscope Decontamination Unit (EDU) per endoscope processed to enable a quantitative comparing the best environmental option when designing or refurbishing EDUs or purchasing EDU equipment. This paper proposes an energy assessment tool to allow sensitivity analysis of different scenarios and equipment options to be compared to establish optimum energy efficiency by cost and CO2 produced, per year in a typical unit. Methods: Basic operational procedures were established and combined with quantified data where available and justified assumptions otherwise. A construction industry standard computer model (Integrated Environmental Solutions: Virtual Environment (IESVE)) was used to create a computer simulation of a typical facility to allow the energy consumption and CO2 output of various scenarios to be compared. The model includes industry standard factors like local climate, heat gains from staff, lighting, computers, room occupancy and shifts, etc. and directly specified devices unique to an EDU such as Reverse Osmosis plant. Results: There are several potentially significant opportunities for energy reduction as modelled in IESVE. For example, one of the biggest factors is the energy-intensive reverse osmosis (RO) water provision. RO water rejects 25 to 50% of input water but electrodialysis could recycle the "waste" water back into the RO input resulting in a net saving of 9% of the total water used, or 10% of the energy budget. Other more straightforward strategies, with lower capital cost and faster payback, could reasonably be expected to save a further 10%. Conclusions: Assuming that the EDU layout used is typical of such facilities, practitioners could use IESVE to predict which working practices would give the best energy reductions, without impacting patient care or staff work patterns. One approach would be to identify the activity that uses the greatest resource and focus small reductions in it, giving maximum impact. Energy budget reductions of around 10% are very plausible, and could then be shared as best practice. The IESVE modelling technique is suggested as a suitable method to develop a benchmarking procedure.