The healthcare industry's own footprint
Healthcare has an environmental footprint of its own, described by the waste it generates, its share of global emissions and materials, the activities and products that make up a health system's total, and its emissions per unit of revenue.
The waste healthcare generates
By the World Medical Association's figures, about 80% of the waste that healthcare activities generate is general waste, and the remaining 20% is material that may be infectious, toxic or radioactive. An estimated 16,000 million injections are given worldwide each year, and not all of the needles and syringes are properly disposed of. Healthcare waste contains potentially harmful microorganisms, which can affect hospital patients, healthcare workers and the general public.
The sector's share of global emissions
A 2020 BMJ analysis of healthcare's pathway to net zero emissions held that healthcare's greenhouse gas emissions are substantial and that the health sector has generally lagged behind most other industries in reducing its carbon footprint. The same analysis held that healthcare leaders and organisations have both the responsibility and the opportunity to chart a path to net zero emissions.
By one 2024 account, the health system is responsible for 4.6% of annual global greenhouse gas emissions and uses 10% of all materials each year, and so presents a potential risk of soil, water and air pollution. On that account, healthcare services have a carbon footprint just as mining and transportation do, and it has to be dealt with in a very aggressive and powerful way. On the same account, dealing with it includes addressing the health system's massive environmental impact, from its use of energy and water to the proper management of toxic chemicals and hazardous waste.
Another 2024 estimate put healthcare at around 2.4 gigatonnes of carbon dioxide equivalent a year, roughly 4 to 5% of global greenhouse gas emissions, which makes healthcare equivalent to the fifth highest emitting country in the world, after China, the United States, India and Russia.
By a 2022 account, healthcare systems in the world's largest economies are responsible, on average, for nearly 5% of a nation's greenhouse gas emissions, and if the global healthcare sector were a country it would be the fifth largest polluter on earth.
Where the emissions sit inside a health system
Research has broken healthcare's carbon footprint down by sector, in carbon dioxide equivalents per year, and across medical procedures and treatments. Anaesthetics are among the procedures shown, which is no surprise, since they involve gases, some of which have a global heating potential.
In health systems' carbon footprint models, pharmaceuticals make up a considerable proportion of the overall footprint. By a 2024 account, about 19% of total US health-system emissions came from pharmaceuticals, while in the National Health Service (NHS) 20% came from medicines and chemicals and another 5% from anaesthetic gases and metered-dose inhalers.
By a 2022 account, 25% of the NHS's emissions come from medicines, with anaesthetic gases and metered-dose inhalers making up one fifth of that share. An NHS document places the remaining 20% primarily in the manufacturing and freight inherent in the supply chain.
By a 2024 account, much is known about the carbon footprint of anaesthetic gases and metered-dose inhalers. Research on anaesthetic gases repeatedly identifies desflurane as the most polluting. Metered-dose inhalers contain hydrofluoroalkane propellants that, in some estimates, are more than 3,800 times more polluting than carbon dioxide. In 2024, policy and regulation around both products were shifting: the NHS had banned desflurane except in exceptional circumstances, and there was a drive to switch from metered-dose inhalers to dry-powder inhalers.
On the same account, for other pharmaceutical products there was a large gap in data on their impacts. Research on products such as ibuprofen, penicillin and morphine was very sparse and quite context-dependent. Granular data on pharmaceuticals' emissions at the level of individual products was lacking.
Emissions against revenue
Emissions can be put in a financial context by relating them to annual revenue. By a 2020 account, corporations in the global stock market index emitted on average about 160 tonnes of carbon dioxide equivalent per million US dollars of annual revenue, which comes to 160 kilotonnes for a company with a billion dollars in revenue and to megatonnes for one with a thousand billion. Pharmaceutical companies' figures seemed to be lower than that average, which the same account put down to the industry's not being in mining, energy generation, coal burning or concrete production, industries with higher than average footprints. Between 2012 and 2015, some of the companies' figures went down and some went up.
By a 2023 account, the pharmaceutical sector emits on average approximately 48.6 tonnes of carbon dioxide equivalent per million US dollars of revenue a year.