There are increasing concerns regarding the environmental costs of healthcare. However, there is a paucity of literature examining the associated environmental impact of common bedside procedures, such as catheterisation. This study aims to assess the environmental impact of catheterisation in a specialist spinal cord injury unit at a tertiary metropolitan hospital.

A retrospective chart review was performed of spinal cord injured patients who underwent urinary catheter changes over the course of 1 representative week. These results were extrapolated to determine the number of new catheters utilised over the course of 1 year. The primary outcome of this study was to identify the carbon footprint and waste generation (kg) of regular catheterisation over 1 year. The carbon footprint (estimated kg of CO2 produced [CO2e]) was estimated using the following formula: weight of raw material*emission factors of the corresponding raw material (kg CO2e/kg). The secondary outcome was to identify the cost and environmental impact of available catheters at our institution. Raw material data was obtained from manufacturer details and emission factors of the raw materials were obtained from technical reports compliant with the principles set forth by the ISO (international organization for standardization) 14064 standard. Commercial catheter samples were weighed manually.

There were 26 total catheter changes over the course of 1 week at the Royal North Shore Hospital spinal cord injury unit. Extrapolated over 1 year, this amounts to 1352 catheter changes required. All catheters stocked in our institution (both indwelling and suprapubic) were made with 100% silicone. Silicone was identified to have an approximate emission factor of 5 kg CO2e/kg. Table 1 details the catheter brands available at our institution and accompanying product specifications. The average yearly carbon footprint of catheterisation in the spinal cord injury unit is 98.02 kg of CO2, which is just over the CO2 produced from a round trip from Sydney to Orange in the average car. The total waste generation of catheters used is 19.60 kg. The total length of catheters used annually placed end-to-end is 561.08m. The cost of catheters used ranged from AUD 3.10–22.50. The catheter from Mdevices was the least expensive with the second lowest carbon footprint. The catheter from Coloplast was the most expensive with the lowest carbon footprint.

The average yearly carbon footprint of catheterisation in one unit alone is 98.02 kg of CO2. Clinical care providers and hospital administrators who look after patients who require regular catheterisation and recatheterisation should be cognizant of the associated environmental impacts. Further research is required to develop policies to reduce the carbon footprint of basic urological procedures.