Abstract
Healthcare institutions contribute significantly to global greenhouse gas (GHG) emissions due to their energy consumption, material use, and waste generation. The COVID-19 pandemic altered hospital activities, affecting their carbon footprint through changes in patient visits, medical procedures, and resource consumption. This study examines the GHG emissions of two university hospitals in Istanbul, one with 85 beds and another with 95 beds, between the years of 2018 and 2022. Emissions were categorized as direct (Category 1), energy indirect (Category 2), and other indirect (Categories 3 and 4), following ISO 14064-1, IPCC, and GHG Protocol standards. Results indicate that the highest emissions per patient occurred in 2020 (10.6 and 8.2 kgCO2e/person) when the pandemic was at its peak. By 2022, with a nearly twofold increase in patient numbers, per capita emissions decreased by up to 36%. Indirect emissions surged in 2020 due to increased use of single-use medical materials and waste production. These findings highlight the pandemic’s dual impact on hospital carbon footprints and emphasize the need for sustainable healthcare strategies.
Keywords
Climate change Greenhouse gas emissions Healthcare sector carbon footprint Pandemic impact.
Ethical Statement
Etik beyan gerekmemektedir.
Supporting Institution
Destekleyen kuruluş bulunmamaktadır.
References
- Čuček, L., Klemeš, J. J., & Kravanja, Z. (2012). A review of footprint analysis tools for monitoring impacts on sustainability. Journal of Cleaner Production, 34, 9-20.
- Walsh, S.J., O’Leary, A., Bergin, C., Lee, S., Varley, A., Lynch, B (2024). Primary healthcare’s carbon footprint and sustainable strategies to mitigate its contribution: a scoping review. BMC Health Serv Res (24), 1630.
- Nicolet, J., Mueller, Y., Paruta, P., Boucher, J., Senn, N. (2022) What is the carbon footprint of primary care practices? A retrospective life-cycle analysis in Switzerland. Environ Health (21), 3.
- Pichler, P.P., Jaccard, I.S., Weisz, U., Weisz, H. (2019). International comparison of health care carbon footprints. Environ. Res. Lett. (14) 064004. review. J Adv Nurs. 2023 Aug;79(8):2830-2844. doi: 10.1111/jan.15671. Epub 2023 May 17. PMID: 37198974.
- Kouwenberg, L.H.J.A, Cohen, E.S, Hehenkamp W.J.K., Snijder, L.E., Kampman, J.M., Küçükkeles, B., Kourula, A., Meijers, M.H.C., Smit, E.S., Sperna Weiland, N.H., Kringos, D.S. (2024). The Carbon Footprint of Hospital Services and Care Pathways: A State-of-the-Science Review. Environ Health Perspect. 132 (12), 126002, 2024.
- Yongkui Li, Yong Zha, Minhao Li, Lili Qian (2025). Evaluating the carbon footprint of a hospital from the dynamic life cycle perspective: A case study in Shanghai, Building and Environment, 277, 112950.
- Lau, I., Burdorf, A., Hesseling, S., Wijk, L., Tauber, M., & Hunfeld, N. (2024). The carbon footprint of a Dutch academic hospital—using a hybrid assessment method to identify driving activities and departments, Frontiers in Public Health, 12, 1380400.
- Baş, S., Sur, K. (2023). The Impact of COVID-19 on Healthcare Systems: Challenges and Sustainability Measures, Journal of Public Health Research, 14 (2), 198-213.
- Morooka, H., Yamamoto, T., Tanaka, A., Furuhashi, K., Miyagawa Y., Maruyama, S. (2022) Influence of COVID-19 on the 10-year carbon footprint of the Nagoya University Hospital and medical research centre, Globalization and Health 18, 92.
- ISO 14064-1, "Greenhouse Gases – Part 1: Specification with Guidance at the Organization Level for Quantification and Reporting of Greenhouse Gas Emissions and Removals," International Organization for Standardization (ISO), 2018.
- IPCC 2006, 2006 IPCC Guidelines for National Greenhouse Gas Inventories, Prepared by the National Greenhouse Gas Inventories Programme, Eggleston H.S., Buendia L., Miwa K., Ngara T. and Tanabe K. (eds). Published: IGES, Japan.
- GHG Protocol, "Corporate Standard: A Guide to Measuring and Managing Greenhouse Gas Emissions," World Resources Institute (WRI) & World Business Council for Sustainable Development (WBCSD), 2023.
- Ministry of Environment, Urbanization and Climate Change. (2018-2022). National Inventory Report (NIR): Greenhouse Gas Emissions of Türkiye Submitted to UNFCCC. Retrieved from https://unfccc.int/documents/
- Ministry of Energy and Natural Resources. (2018-2022). Grid Emission Factor Information Forms. Retrieved from https://enerji.gov.tr/evced-cevre-ve-iklim-turkiye-ulusal-elektrik-sebekesi-emisyon-faktoru
- IPCC, "Assessment Reports on Global Warming Potential and Emission Factors," Intergovernmental Panel on Climate Change (IPCC) Reports, 2018-2022.
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- Tennison I, Roschnik S, Ashby B, Boyd, R., Hamilton, I., Oreszczyn, T., Owen, A., Romanello, M., Ruyssevelt, P., Sherman, J.D., Smith, A.Z.P., Steele, K., Watts, N., Eckelman, M.J. (2021). Health care’s response to climate change: a carbon footprint assessment of the NHS in England. Lancet Planet Health, 5, 84–92.
- Yaman, C., "Emission Factors for Hospital Waste Management in Turkey," Turkish Journal of Environmental Studies, vol. 45, pp. 213-227, 2020.
- Rizan, C., Bhutta, M.F., Reed, M., Lillywhiteet, R. (2021). Waste and Carbon Footprint of Healthcare Operations in the UK,BMJ Global Health, 6 (7), 987-999.
- American Petroleum Institute (API). (2023). API TR 1533: Lubricants Life Cycle Assessment and Carbon Footprinting - Methodology and Best Practice [PDF dosyası]. American Petroleum Institute. Retrieved from: https://www.api.org/-/media/files/certification/engine-oil-diesel/publications/api%20tr%201533.pdf
- Turkish Standards Institution (TSE). (2014). Measuring Instruments Regulation (2014/32/EU). Official Gazette, 21 June 2014.
- Prasad, P.A., Joshi, D., Lighter, J., Agins, J., Allen R., Collins, M. (2022). Environmental footprint of regular and intensive inpatient care in a large US hospital. Int J Life Cycle Assess, 27(1), 38–49.
- Wu, R. (2019). The carbon footprint of the Chinese health-care system: an environmentally extended input–output and structural path analysis study, The Lancet Planetary Health 3 (10), e413 - e419.
- Sanz-Calcedo, J. (2019). Study of CO2 emissions from energy consumption in Spanish hospitals. Vibroengineering PROCEDIA 26, 20965.
Abstract
Sağlık kurumları, enerji tüketimi, malzeme kullanımı ve atık üretimi nedeniyle küresel sera gazı (GHG) emisyonlarına önemli ölçüde katkıda bulunmaktadır. COVID-19 pandemisi, hasta ziyaretleri, tıbbi prosedürler ve kaynak tüketimindeki değişiklikler yoluyla hastane faaliyetlerini değiştirmiş ve karbon ayak izlerini etkilemiştir. Bu çalışma, İstanbul’daki biri 85 yataklı, diğeri 95 yataklı iki üniversite hastanesinin 2018-2022 yılları arasındaki sera gazı emisyonlarını incelemektedir. Emisyonlar, doğrudan (Kategori 1), enerji dolaylı (Kategori 2) ve diğer dolaylı (Kategori 3 ve 4) olarak ISO 14064-1, IPCC ve GHG Protokolü standartlarına göre sınıflandırılmıştır. Sonuçlar, en yüksek hasta başına emisyonların 2020 yılında (27,8 ve 23,9 kgCO₂e/kişi) görüldüğünü ve bu dönemin pandeminin en yoğun yaşandığı zaman dilimi olduğunu göstermektedir. 2022 yılına gelindiğinde, hasta sayısının neredeyse iki katına çıkmasıyla birlikte kişi başına emisyonlarda %36’ya varan bir azalma tespit edilmiştir. Pandemi döneminde tek kullanımlık tıbbi malzemelerin ve atık üretiminin artması nedeniyle dolaylı emisyonlarda önemli bir yükseliş gözlemlenmiştir. Bu bulgular, pandeminin hastane karbon ayak izi üzerindeki çift yönlü etkisini ortaya koymakta ve sürdürülebilir sağlık hizmetleri stratejilerinin önemini vurgulamaktadır.
References
- Čuček, L., Klemeš, J. J., & Kravanja, Z. (2012). A review of footprint analysis tools for monitoring impacts on sustainability. Journal of Cleaner Production, 34, 9-20.
- Walsh, S.J., O’Leary, A., Bergin, C., Lee, S., Varley, A., Lynch, B (2024). Primary healthcare’s carbon footprint and sustainable strategies to mitigate its contribution: a scoping review. BMC Health Serv Res (24), 1630.
- Nicolet, J., Mueller, Y., Paruta, P., Boucher, J., Senn, N. (2022) What is the carbon footprint of primary care practices? A retrospective life-cycle analysis in Switzerland. Environ Health (21), 3.
- Pichler, P.P., Jaccard, I.S., Weisz, U., Weisz, H. (2019). International comparison of health care carbon footprints. Environ. Res. Lett. (14) 064004. review. J Adv Nurs. 2023 Aug;79(8):2830-2844. doi: 10.1111/jan.15671. Epub 2023 May 17. PMID: 37198974.
- Kouwenberg, L.H.J.A, Cohen, E.S, Hehenkamp W.J.K., Snijder, L.E., Kampman, J.M., Küçükkeles, B., Kourula, A., Meijers, M.H.C., Smit, E.S., Sperna Weiland, N.H., Kringos, D.S. (2024). The Carbon Footprint of Hospital Services and Care Pathways: A State-of-the-Science Review. Environ Health Perspect. 132 (12), 126002, 2024.
- Yongkui Li, Yong Zha, Minhao Li, Lili Qian (2025). Evaluating the carbon footprint of a hospital from the dynamic life cycle perspective: A case study in Shanghai, Building and Environment, 277, 112950.
- Lau, I., Burdorf, A., Hesseling, S., Wijk, L., Tauber, M., & Hunfeld, N. (2024). The carbon footprint of a Dutch academic hospital—using a hybrid assessment method to identify driving activities and departments, Frontiers in Public Health, 12, 1380400.
- Baş, S., Sur, K. (2023). The Impact of COVID-19 on Healthcare Systems: Challenges and Sustainability Measures, Journal of Public Health Research, 14 (2), 198-213.
- Morooka, H., Yamamoto, T., Tanaka, A., Furuhashi, K., Miyagawa Y., Maruyama, S. (2022) Influence of COVID-19 on the 10-year carbon footprint of the Nagoya University Hospital and medical research centre, Globalization and Health 18, 92.
- ISO 14064-1, "Greenhouse Gases – Part 1: Specification with Guidance at the Organization Level for Quantification and Reporting of Greenhouse Gas Emissions and Removals," International Organization for Standardization (ISO), 2018.
- IPCC 2006, 2006 IPCC Guidelines for National Greenhouse Gas Inventories, Prepared by the National Greenhouse Gas Inventories Programme, Eggleston H.S., Buendia L., Miwa K., Ngara T. and Tanabe K. (eds). Published: IGES, Japan.
- GHG Protocol, "Corporate Standard: A Guide to Measuring and Managing Greenhouse Gas Emissions," World Resources Institute (WRI) & World Business Council for Sustainable Development (WBCSD), 2023.
- Ministry of Environment, Urbanization and Climate Change. (2018-2022). National Inventory Report (NIR): Greenhouse Gas Emissions of Türkiye Submitted to UNFCCC. Retrieved from https://unfccc.int/documents/
- Ministry of Energy and Natural Resources. (2018-2022). Grid Emission Factor Information Forms. Retrieved from https://enerji.gov.tr/evced-cevre-ve-iklim-turkiye-ulusal-elektrik-sebekesi-emisyon-faktoru
- IPCC, "Assessment Reports on Global Warming Potential and Emission Factors," Intergovernmental Panel on Climate Change (IPCC) Reports, 2018-2022.
- Department for Environment, Food & Rural Affairs (DEFRA). (2018-2022). UK government GHG conversion factors for company reporting: 2018-2022 datasets. Retrieved from https://www.gov.uk/government/collections/government-conversion-factors-for-company-reporting
- International Energy Agency (IEA). (2019). GHG intensity of passenger transport modes. Retrieved from https://www.iea.org/data-and-statistics/charts/ghg-intensity-of-passenger-transport-modes-2019
- Villota-Paz, J.M., Osorio-Tejada, J.L., Morales-Pinzón, T. (2023). Comparative life cycle assessment for the manufacture of bio-detergents Environ Sci Pollut Res 30, 34243–34254.
- Tennison I, Roschnik S, Ashby B, Boyd, R., Hamilton, I., Oreszczyn, T., Owen, A., Romanello, M., Ruyssevelt, P., Sherman, J.D., Smith, A.Z.P., Steele, K., Watts, N., Eckelman, M.J. (2021). Health care’s response to climate change: a carbon footprint assessment of the NHS in England. Lancet Planet Health, 5, 84–92.
- Yaman, C., "Emission Factors for Hospital Waste Management in Turkey," Turkish Journal of Environmental Studies, vol. 45, pp. 213-227, 2020.
- Rizan, C., Bhutta, M.F., Reed, M., Lillywhiteet, R. (2021). Waste and Carbon Footprint of Healthcare Operations in the UK,BMJ Global Health, 6 (7), 987-999.
- American Petroleum Institute (API). (2023). API TR 1533: Lubricants Life Cycle Assessment and Carbon Footprinting - Methodology and Best Practice [PDF dosyası]. American Petroleum Institute. Retrieved from: https://www.api.org/-/media/files/certification/engine-oil-diesel/publications/api%20tr%201533.pdf
- Turkish Standards Institution (TSE). (2014). Measuring Instruments Regulation (2014/32/EU). Official Gazette, 21 June 2014.
- Prasad, P.A., Joshi, D., Lighter, J., Agins, J., Allen R., Collins, M. (2022). Environmental footprint of regular and intensive inpatient care in a large US hospital. Int J Life Cycle Assess, 27(1), 38–49.
- Wu, R. (2019). The carbon footprint of the Chinese health-care system: an environmentally extended input–output and structural path analysis study, The Lancet Planetary Health 3 (10), e413 - e419.
- Sanz-Calcedo, J. (2019). Study of CO2 emissions from energy consumption in Spanish hospitals. Vibroengineering PROCEDIA 26, 20965.
Details
| Primary Language | English |
|---|---|
| Subjects | Environmental Assessment and Monitoring, Natural Resource Management, Environmental Management (Other) |
| Journal Section | Research Articles |
| Authors | |
| Early Pub Date | June 16, 2025 |
| Publication Date | |
| Submission Date | February 13, 2025 |
| Acceptance Date | June 4, 2025 |
| Published in Issue | Year 2025 Volume: 37 Issue: 2 |
