• Stephen J Lightfoot, Tim Grant, Anna Boyden, and Scott McAlister.
• Department of Anaesthetics, St George Private Hospital, Sydney, NSW, Australia. Electronic address: stephenlightfoot@gmail.com.
• Br J Anaesth. 2024 Dec 1; 133 (6): 146514771465-1477.

BackgroundSingle-use anaesthetic drug trays are used widely in Australia, but their environmental impact is unclear.MethodsA life cycle assessment was completed for 10 different types of single-use anaesthetic drug trays made of four materials: the synthetic plastics polypropylene and polystyrene, and the natural fibres bagasse (sugarcane pulp) and cellulose pulp.ResultsCarbon emissions per tray from total life cycle with landfill disposal were 33-454 g CO2-eq, which equates to 152-2066 tonnes CO2-eq annually. Recycling mitigates this impact, reducing emissions per tray to 16-294 g CO2-eq. The tray with the least emissions for landfill and recycling was the small polystyrene injection tray. There was a significant linear relationship between the mass of a tray and its carbon emissions. For landfill, recycling, and incineration disposal, Pearson's r value was 0.98, 0.99, and 0.95, respectively. Composting natural fibres can give a carbon benefit over some synthetic plastics under specific disposal scenarios, but this benefit was not seen under all circumstances. There was a strong positive correlation between the increasing mass of a tray and its increasing environmental impacts for water consumption, particulate matter formation, and mineral depletion.ConclusionsSingle-use trays with the lowest mass should be preferentially chosen. Recycling and composting will reduce environmental impacts. Natural fibre does not automatically confer any environmental benefit over plastic and sustainability claims should be carefully examined for accuracy. The practice of using a single-use drug tray for every procedure should be reconsidered.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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