Life Cycle Greenhouse Gas Emissions of Gastrointestinal Biopsies in a Surgical Pathology Laboratory

Ilyssa O. Gordon, Jodi D. Sherman, Michael Leapman, Michael Overcash, Cassandra L. Thiel

Research output: Contribution to journalArticlepeer-review


Objectives: Given adverse health effects of climate change and contributions of the US health care sector to greenhouse gas (GHG) emissions, environmentally sustainable delivery of care is needed. We applied life cycle assessment to quantify GHGs associated with processing a gastrointestinal biopsy in order to identify emissions hotspots and guide mitigation strategies. Methods: The biopsy process at a large academic pathology laboratory was grouped into steps. Each supply and reagent was catalogued and postuse treatment noted. Energy consumption was estimated for capital equipment. Two common scenarios were considered: 1 case with 1 specimen jar (scenario 1) and 1 case with 3 specimen jars (scenario 2). Results: Scenario 1 generated 0.29 kg of carbon dioxide equivalents (kg CO2e), whereas scenario 2 resulted in 0.79 kg CO2e - equivalent to 0.7 and 2.0 miles driven, respectively. The largest proportion of GHGs (36%) in either scenario came from the tissue processor step. The second largest contributor (19%) was case accessioning, mostly attributable to production of single-use disposable jars. Conclusions: Applied to more than 20 million biopsies performed in the US annually, emissions from biopsy processing is equivalent to yearly GHG emissions from 1,200 passenger cars. Mitigation strategies may include modification of surveillance guidelines to include the number of specimen jars.

Original languageEnglish (US)
Pages (from-to)540-549
Number of pages10
JournalAmerican Journal of Clinical Pathology
Issue number4
StatePublished - Oct 1 2021


  • Biopsy
  • Gastrointestinal
  • Greenhouse gas emissions
  • Life cycle assessment
  • Surgical pathology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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