Examining the influence of sample rejection rates on the carbon footprint of clinical laboratories: a retrospective analysis
Abstract
Aims: Clinical laboratories play a vital role in healthcare, yet their operations contribute to resource consumption, waste generation, and greenhouse gas emissions. The need for sustainable practices in laboratories has led to guidelines for reducing their carbon footprint. This study aims to assess the impact of sample rejection rates (SRRs) on laboratory sustainability by calculating the carbon footprint and medical waste generated due to rejected samples.
Methods: This retrospective, single-center study obtained data from the Hospital Information Management System for two years (2021 and 2022). SRRs were calculated for different sample tube types. The carbon footprint caused by rejected samples was calculated using CO2 emission (CO2e) conversion factors. The weight of medical waste generated due to rejected samples was evaluated. Statistical analysis was performed using appropriate tests.
Results: In 2021 and 2022, SRRs for different sample tubes were calculated, with statistically significant differences observed. The total CO2e value resulting from rejected samples over two years was 12.3 tons, and the medical waste generated was 3.7 tons. The highest SRR was observed in Blue top tubes, while yellow top tubes showed a significant reduction in SRR in 2022.
Conclusion: This study highlights the impact of SRRs on laboratory sustainability. The calculated CO2e and medical waste values underscore the need to minimize sample rejections. While these values seem minor compared to global emissions, they reflect only a portion of the potential environmental impact. Reducing sample rejections not only improves patient safety and laboratory efficiency but also aligns with the larger goal of creating environmentally conscious and sustainable healthcare practices.
Keywords
Clinical laboratories sustainability environmental impact waste reduction preanalytical errors sustainable healthcare
References
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- EFLM. EFLM guidelines for green and sustainable laboratories, 1st ed. Belgium: The European Federation of Clinical Chemistry and Laboratory Medicine; 2022. Accessed April 4, 2023. https://www.eflm.eu/upload/docs/eflm-greenlab-booklet.pdf.
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- Carraro P, Servidio G, Plebani M. Hemolyzed specimens: a reason for rejection or a clinical challenge? Clin Chem. 2000;46(2):306-307. doi:10.1093/clinchem/46.2.306
- Gunnur Dikmen Z, Pinar A, Akbiyik F. Specimen rejection in laboratory medicine: necessary for patient safety? Biochem Med (Zagreb). 2015;25(3):377-385. doi:10.11613/BM.2015.037
- ISO 14001:2015. Environmental management systems - Requirements with guidance for use. Geneva: International Organization for Standardization (ISO); 2015.
- Carraro P, Plebani M. Errors in a stat laboratory: types and frequencies 10 years later. Clin Chem. 2007;53(7):1338-1342. doi:10.1373/clinchem.2007.088344
- Atay A, Demir L, Cuhadar S, et al. Clinical biochemistry laboratory rejection rates due to various types of preanalytical errors. Biochem Med (Zagreb). 2014;24(3):376-382. doi:10.11613/BM.2014.040
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- McAlister S, Barratt AL, Bell KJ, McGain F. The carbon footprint of pathology testing. Med J Aust. 2020;212(8):377-382. doi:10.5694/mja2.50583
- McAlister S, Grant T, McGain F. An LCA of hospital pathology testing. Int J Life Cycle Assess. 2021;26(9):1753-1763. doi:10.1007/s11367-021-01959-1
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- Nicolet J, Mueller Y, Paruta P, Boucher J, Senn N. What is the carbon footprint of primary care practices? A retrospective life-cycle analysis in Switzerland. Environ Health. 2022;21(1):1-10. doi:10.1186/s12940-021-00814-y
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- Lopez JB, Jackson D, Gammie A, Badrick T. Reducing the environmental impact of clinical laboratories. Clin Biochem Rev. 2017;38(1):3-11.
- Gammie AJ, Lopez JB, Scott S. Imperative: reducing the environmental impact of clinical laboratories. Clin Chem Lab Med. 2023;61(4):634-637. doi:10.1515/cclm-2022-1052
- Rin GD. Pre-analytical workstations: a tool for reducing laboratory errors. Clin Chim Acta. 2009;404(1):68-74. doi: 10.1016/j.cca.2009.03.024
- Aykal G, Keşapli M, Aydin Ö, et al. Pre-test and post-test applications to shape the education of phlebotomists in a quality management program: an experience in a training hospital. J Med Biochem. 2016;35(3):347-353. doi:10.1515/jomb-2016-0011
- Shrank WH, Rogstad TL, Parekh N. Waste in the US health care system: estimated costs and potential for savings. JAMA. 2019;322(15):1501-1509. doi:10.1001/jama.2019.13978
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- Bindraban RS, Berg MJ, Naaktgeboren CA, Kramer MHH, Solinge WW, Nanayakkara PWB. Reducing test utilization in hospital settings: a narrative review. Ann Lab Med. 2018;38(5):402-412. doi:10.3343/alm.2018.38.5.402
- Pennestrì F, Banfi G. Value-based healthcare: the role of laboratory medicine. Clin Chem Lab Med. 2019;57(6):798-801. doi:10.1515/cclm-2018-1245
Abstract
References
- Plebani M, Laposata M, Lippi G. Driving the route of laboratory medicine: a manifesto for the future. Intern Emerg Med. 2019;14(3):337-340. doi:10.1007/s11739-019-02053-z
- EFLM. EFLM guidelines for green and sustainable laboratories, 1st ed. Belgium: The European Federation of Clinical Chemistry and Laboratory Medicine; 2022. Accessed April 4, 2023. https://www.eflm.eu/upload/docs/eflm-greenlab-booklet.pdf.
- Plebani M. Errors in clinical laboratories or errors in laboratory medicine? Clin Chem Lab Med. 2006;44(6):750-759. doi:10.1515/CCLM.2006.123
- Carraro P, Servidio G, Plebani M. Hemolyzed specimens: a reason for rejection or a clinical challenge? Clin Chem. 2000;46(2):306-307. doi:10.1093/clinchem/46.2.306
- Gunnur Dikmen Z, Pinar A, Akbiyik F. Specimen rejection in laboratory medicine: necessary for patient safety? Biochem Med (Zagreb). 2015;25(3):377-385. doi:10.11613/BM.2015.037
- ISO 14001:2015. Environmental management systems - Requirements with guidance for use. Geneva: International Organization for Standardization (ISO); 2015.
- Carraro P, Plebani M. Errors in a stat laboratory: types and frequencies 10 years later. Clin Chem. 2007;53(7):1338-1342. doi:10.1373/clinchem.2007.088344
- Atay A, Demir L, Cuhadar S, et al. Clinical biochemistry laboratory rejection rates due to various types of preanalytical errors. Biochem Med (Zagreb). 2014;24(3):376-382. doi:10.11613/BM.2014.040
- Endris S, Tamir Z, Sisay A. Medical laboratory waste generation rate, management practices and associated factors in Addis Ababa, Ethiopia. PLoS One. 2022;17(4):e0266888. doi:10.1371/journal.pone.0266888
- McAlister S, Barratt AL, Bell KJ, McGain F. The carbon footprint of pathology testing. Med J Aust. 2020;212(8):377-382. doi:10.5694/mja2.50583
- McAlister S, Grant T, McGain F. An LCA of hospital pathology testing. Int J Life Cycle Assess. 2021;26(9):1753-1763. doi:10.1007/s11367-021-01959-1
- TURKSTAT Greenhouse gas emissions statistics. Accessed April 5, 2023. https://data.tuik.gov.tr/Bulten/Index?p=Greenhouse-Gas-Emissions-Statistics-1990-2021-49672&dil=2#:~:text=TURKSTAT%20Corporate&text=The%20greenhouse%20gas%20inventory%20results,4%20tonnes%20CO2%20eq.
- Crippa M, Guizzardi D, Banja M, et al. CO2 emissions of all world countries - JRC/IEA/PBL 2022 report, EUR 31182 EN, Publications Office of the European Union, Luxembourg, 2022, doi:10.2760/730164
- Nicolet J, Mueller Y, Paruta P, Boucher J, Senn N. What is the carbon footprint of primary care practices? A retrospective life-cycle analysis in Switzerland. Environ Health. 2022;21(1):1-10. doi:10.1186/s12940-021-00814-y
- World Health Organization. Healthcare waste. Accessed April 5, 2023. https://www.who.int/news-room/fact-sheets/detail/health-care-waste.
- Lopez JB, Jackson D, Gammie A, Badrick T. Reducing the environmental impact of clinical laboratories. Clin Biochem Rev. 2017;38(1):3-11.
- Gammie AJ, Lopez JB, Scott S. Imperative: reducing the environmental impact of clinical laboratories. Clin Chem Lab Med. 2023;61(4):634-637. doi:10.1515/cclm-2022-1052
- Rin GD. Pre-analytical workstations: a tool for reducing laboratory errors. Clin Chim Acta. 2009;404(1):68-74. doi: 10.1016/j.cca.2009.03.024
- Aykal G, Keşapli M, Aydin Ö, et al. Pre-test and post-test applications to shape the education of phlebotomists in a quality management program: an experience in a training hospital. J Med Biochem. 2016;35(3):347-353. doi:10.1515/jomb-2016-0011
- Shrank WH, Rogstad TL, Parekh N. Waste in the US health care system: estimated costs and potential for savings. JAMA. 2019;322(15):1501-1509. doi:10.1001/jama.2019.13978
- Molero A, Calabrò M, Vignes M, Gouget B, Gruson D. Sustainability in healthcare: perspectives and reflections regarding laboratory medicine. Ann Lab Med. 2021;41(2):139-144. doi:10.3343/alm.2021.41.2.139
- Bindraban RS, Berg MJ, Naaktgeboren CA, Kramer MHH, Solinge WW, Nanayakkara PWB. Reducing test utilization in hospital settings: a narrative review. Ann Lab Med. 2018;38(5):402-412. doi:10.3343/alm.2018.38.5.402
- Pennestrì F, Banfi G. Value-based healthcare: the role of laboratory medicine. Clin Chem Lab Med. 2019;57(6):798-801. doi:10.1515/cclm-2018-1245
Details
| Primary Language | English |
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| Subjects | Clinical Chemistry |
| Journal Section | Original Article |
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| Early Pub Date | September 26, 2023 |
| Publication Date | September 28, 2023 |
| Published in Issue | Year 2023 Volume: 6 Issue: 5 |
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