ArticlePloS one2025
Carbon footprint comparison of video intubation tools: Disposable laryngoscopes, reusable laryngoscopes, and stylets.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
purposeAs healthcare systems grapple with their 5% global carbon footprint contribution, sustainable medical device selection emerges as a critical decarbonization lever. This life cycle assessment (LCA) quantifies environmental disparities among three prevalent video intubation tools-Disposable video laryngoscopes (VLs), reusable VLs, and video Stylets-to guide evidence-based procurement.
methodsUsing International Organization for Standardization (ISO)14040 compliant life cycle assessment (LCA) methodology-the international standard defining LCA principles and framework-we quantified cradle-to-grave emissions for three video intubation devices manufactured by Zhejiang UE Medical Corp. The functional unit (one tracheal intubation) incorporated material extraction, manufacturing, low-temperature LTPS/ HLD, transportation, and disposal. SimaPro 9.4.0 with Ecoinvent 3.8 database calculated CO₂ equivalents (kg CO₂e), validated through sensitivity analyses of sterilization loading (10-80 devices/cycle) and regional grids.
resultsThe HLD-disinfected video stylet demonstrated superior environmental performance, emitting 98.24 kg CO₂e per 500 procedures-45.8% and 42.0% lower than reusable VLs (181.45 kg CO₂e) and disposable VLs (169.47 kg CO₂e), respectively. Sensitivity analyses identified sterilization loading as the dominant variable: half-load (50% chamber utilization) reduced emissions by 89-91% versus single-device processing, with full-load optimization yielding incremental 11-14% reductions. Process and regional variability further revealed that HLD decreased emissions by 19-24% compared to LTPS, while grid carbon intensity caused 24-33% variability (India vs. EU). Scenario comparisons confirmed the video stylet's environmental dominance across sterilization methods-even with LTPS (349.99 kg CO₂e/500 uses), it maintained a 45% reduction over reusable VL baselines, whereas HLD-treated video stylets (94.32 kg CO₂e) showed 6.7-fold lower emissions than disposable VLs and 59% below HLD-reprocessed reusable VLs.
conclusionsHLD-reprocessed video stylets are the environmentally optimal choice for high-volume, low-infection-risk settings. For low-throughput or high-risk scenarios, providers should balance environmental impacts with clinical requirements through frequency and resource assessment.
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