A sustainable health care system is achieved by delivering high quality care and improved public health without exhausting natural resources or causing ecological damage. Like all sectors of the economy, the healthcare sector in Australia and New Zealand needs to move to a more sustainable model by actively reducing its environmental impact and carbon emissions. Subsequently, there are a multitude of processes and clinical pathways in healthcare that require environmental assessment.
The investigators will conduct a Life Cycle Assessment (LCA) (cradle to grave) to determine the environmental footprint of a producing a unit of Packed Red Blood Cells (PRBC). The study is purely observational, with no changes to patient activity.
The scope of the LCA will include all significant material and energy inputs from the time of blood donation to the administration of blood to a patient. Inputs will include raw material production, manufacturing, packaging, transport, use, and end-of-life (clinical waste, landfill, and recycling). The production of a unit of RBC will be subdivided into donor travel, donation, separation/fractionation, transportation, storage, laboratory testing, and delivery to the patient.
This study will provide valuable information regarding the environmental impact of PRBCs. Understanding the environmental footprint of PRBCs will provide further motivation to improve the appropriate use of blood products and reduce any associated waste. Further, this study will provide a detailed analysis of both the location and extent of environmental impacts, such as greenhouse gas, particulate matter emissions, and water use, meaning any mitigation strategies can be focused on those processes that have the highest environmental burden.
Professor Bernd Froessler, Lyell McEwin Hospital, South Australia
Associate Professor Forbes McGain, Western Health, Melbourne
Dr Owen Tomasek, Northeast Health, Wangaratta Victoria.
Technical lead: Dr Scott McAlister, University of Melbourne, University of Sydney.
The project was awarded $A45,610 through the ANZCA research grants program for 2023.
Blood products like Red Blood Cells are used every day in health care. To get one unit of red blood cells to a patient, a lot must happen:
The donor travels to a centre or a mobile collection unit goes out. Staff work there, equipment is used, plastic bags and test tubes are made, machines run to process and store the blood, fridges and freezers keep it cold, and vehicles transport it to hospitals.
All of this uses energy and materials and produces greenhouse gases. When we add it up for just one unit of blood, the number might seem small, but across millions of units a year, the impact becomes large.
Therefore, understanding the carbon footprint of a unit of red blood cells matters because it tells us how much climate impact. This can be done with a Life Cycle Assessment.
We undertook a prospective, single-centre Life Cycle Assessment (LCA) to determine the CO2 eq emissions for producing one unit of packed RBCs in Auckland, NZ.
The total CO2 eq emissions for one unit of packed RBCs from collection to ready-for-use storage in the hospital was 5.51 kg CO2 eq emissions (equivalent to burning 2.5 litres of petrol). Transport dominated emissions (60%), followed by the plastic RBC collection bag (23%).
The knowledge we gained should encourage the health care sector to consider three important things:
- We can look for smarter ways to provide blood that use less energy and create less waste, without ever compromising patient care. That might mean more efficient fridges, better transport routes, or using less single‑use plastic where it is safe to do so.
- We can see where blood is being used unnecessarily and reduce avoidable transfusions. This is where Patient Blood Management is powerful: by treating iron deficiency and anaemia more effectively, reducing blood loss as much as possible, we protect patients and avoid using blood when it is not truly needed, which also reduces the environmental impact.
- We can compare blood transfusion to alternative treatments, like iron therapy, and make more informed decisions about what offers better outcomes for patients and leads to careful use of money.
We are now in a better position to improve the system. We can contribute to protect so that we keep the potentially the life‑saving benefits of blood transfusion while lowering the impact on the planet and making our health care more sustainable for future generations.
Abstract/ poster presentation at the ASM 2025.
Manuscript in preparation for journal submission.