Cutting the footprint of your own working practice
What a medical writer can change about the environmental impact of their own work — what they buy and throw away, how they run a desk, how lean their documents and studies are, how they travel, where they work from and how much they print — is the question this leaf answers. Putting a number on that impact is in measuring a practice's carbon footprint and setting a target, and the energy that software and digital content consume in the footprint of AI tools and digital content.
Do without before you substitute
Achim Schneider, introducing the subject at EMWA's October 2020 webinar "Sustainability Demystified", was asked what practical steps medical writers can take beyond flying less, and gave answers that apply to anyone but bear directly on how a desk-based professional works. Do only what is really necessary and avoid excessive use of anything. Beyond efficiency — getting more out of each unit consumed — there is sufficiency, which means taking only the minimum needed, built up from the bottom rather than trimmed from the top. The webinar's recording had no supplied captions, so its transcript was generated locally and quality-checked programmatically rather than proofread, and its figures and occasional clauses are approximate.
Buy fewer new things. A replacement costs twice: waste at one end and the carbon footprint of production at the other. The sequence he recommends is the familiar set of Rs — avoid the purchase where possible, then repair and fix, and only dispose when the thing genuinely cannot be kept in use, and then dispose properly. Where heating is within the writer's control, check that it does not originate from oil, gas or other fossil sources. The same double accounting applies to any equipment decision: count the energy and materials embodied in producing a thing, not only those consumed while operating it. The footprint definitions and calculators that support this are in the companion topic, and the office side of it — paper, plastic, food waste, general waste — was illustrated in the session from a published chart of what office workers throw away.
Catarina Leitão, a medical writer at Evidenze in Lisbon who volunteers with the Portuguese NGOs Ocean Alive and Circular Economy Portugal, came to the same view from the other end in EMWA's June 2024 Crofter column: many current solutions relieve one problem by aggravating another. Her examples come partly from her own early work covering medical congresses, where she watched plastic cups, plates and cutlery give way to paper and bamboo. Over 99% of plastic is produced from fossil-fuel chemicals, but large-scale production of the biodegradable substitutes often depends on monoculture, with loss of biodiversity, soil erosion and high water consumption. Digital alternatives to paper, such as e-billing, consume energy through devices, cloud storage and AI — telecom networks were expected to more than triple their energy use with Long-Term Evolution and fifth-generation mobile networks — and the shift to renewables and electric vehicles depends on mining: by 2030 the EU may need 18 times more lithium and five times more cobalt for vehicle batteries than in 2020, and 70–75% of cobalt reserves lie in the south-east of the Democratic Republic of the Congo, where extraction is bound up with human-rights violations and environmental destruction. E-waste is the fastest-growing domestic waste category, 53.6 million tonnes in 2019 of which 17.4% was recycled, much of it dismantled in low- and middle-income countries, and most plastics cannot be perpetually recycled, so she treats recycling as short-term mitigation. The June 2024 issue of Medical Writing (volume 33, number 2, on soft skills for medical writers) was admitted from an existing Markdown conversion without content repair; its known limitations are broken ligatures, mangled multi-column tables, interleaved page headers and footers, and figure text represented as marked text.
Her conclusion is that sustainability means changing behaviour rather than swapping one resource for another: reuse durable products — as EMWA did in asking the 2024 Valencia conference venue to use crockery and attendees to bring refillable cups and their own paper and pens — and apply refuse, reduce, reuse, repair and repurpose before recycle, against an Earth Overshoot Day that fell on 2 August in 2023. Choose devices designed to be upgraded or repaired, check that replacement parts will remain available and that there are enough repair specialists to make repair economical, since she has been forced into new purchases by parts no longer made, designs that block upgrades, cost and delay; EU measures on easier repair from 2023 and a common charger for phones by the end of 2024 and for laptops in 2026 were moving policy her way.
Cut the waste at the desk
EMWA's 2024 expert seminar on sustainability in healthcare, run by the association's sustainability special interest group, gave a more specific desk-level list. It came from an internal AstraZeneca campaign called Make It Sustainable, presented by Claudia Percivalle, a regulatory affairs director at AstraZeneca, as five things anyone can do, and Sarah Kabani's written report of the seminar in EMWA's March 2025 issue reproduces the five. Share documents as links rather than attachments, on the figure that an email with an attachment generates on average 50 grams of carbon dioxide, so four of them equate to driving a mile in a car. Shut the laptop down at the end of the day rather than leaving it asleep, since it continues to draw power in the background and the machine performs better for it. Cut how long meeting recordings are kept, on the finding that only 1% of them are watched after 60 days. Print less, and in black and white when you must. And reduce what you store, deleting unnecessary and duplicate files so that they no longer sit on a server. The seminar's record is Vimeo's uncorrected automatic captioning, so figures and organisation names in it are approximate. The March 2025 issue of Medical Writing (volume 34, number 1, on rare diseases) was admitted from an existing Markdown conversion without content repair; its known limitations are broken ligatures, mangled multi-column tables, interleaved page headers and footers, and figure text represented as marked text.
Kate Silverthorne of Silverthorne Communications wrote on doughnut economics for the healthcare industry in EMWA's September 2021 issue. Her list for writers and communicators as employees and freelancers is about keeping their own house in order: learning about, and where necessary challenging, their companies' carbon and social footprints, targets and strategy; applying the same principles to pensions, through environmental, social and governance schemes, and to resources, through renewable electricity, less wasted energy, and no single-use crockery or plastic packaging at business lunches; and supporting clients' own sustainability targets. Virtual meetings, which the pandemic showed can work well, are her largest example: attending one in-person congress, on the figures she cites, can account for around a third of a UK resident's annual carbon emissions against 0.2% for a virtual congress, so writers can advocate virtual meetings where they fit, while remembering people's need for the networking face-to-face meetings used to provide, and design physical materials such as exhibition booths to be reused, repurposed or at least recycled. The September 2021 issue of Medical Writing (volume 30, number 3) drawn on here was admitted from an existing Markdown conversion without content repair; its known limitations are broken ligatures, mangled multi-column tables, interleaved page headers and footers, and figure text represented as marked text.
The December 2022 issue's Crofter column, edited by Kimi Uegaki, is the practical end of the same argument. Its workplace contribution, from Viviana Neviani of Merus in Utrecht, collects eight tips — four winners of a competition run by the building where she works, in which anyone could post an idea on a green note in a jar in the lobby, and four from her employer's sustainability team: turn monitor brightness down to 60%; use the stairs more often; set the office one degree cooler in winter and one warmer in summer; brainstorm new ideas with colleagues; switch off the lights when leaving and make the most of natural light; use digital files instead of printing; organise a group activity such as a clean-up walk; and bring a reusable water bottle and coffee cup. For home, two writers shared plant-based recipes chosen to see a writer through busy working periods, and the column invites readers to send their own tips. The December 2022 issue of Medical Writing (volume 31, number 4, on open science and open pharma) drawn on here was admitted from an existing Markdown conversion without content repair; its known limitations are broken ligatures, mangled multi-column tables, interleaved page headers and footers, and figure text represented as marked text.
Write and design leaner documents and studies
The regulatory-writing version of the same instinct is a discipline the profession already has a name for. Raquel, a regulatory writer of fifteen years' standing who sat on the seminar's closing panel, argues that lean writing is a sustainability practice: minimising the size of a document, the number of documents, and the number of questions that come back from health authorities, and so getting medicines to patients faster by being efficient. Writers are stewards of documentation and communication, so the saving starts with how the document is written rather than with how it is stored.
The largest lever a regulatory or medical writer has, though, is not in the office at all but in the data a study is designed to collect. Claudia has a four-question test for every item in a schedule of assessments, which finds data collected and never analysed, and counting what the design costs in carbon works it through as protocol decisions.
Travel less, and get more from each journey
Travel is where a medical communications company's own footprint concentrates, and Gemma Rogers, who has spent more than fourteen years in medical communications and joined the seminar's closing panel, describes decisions rather than aspirations. Face-to-face contact with clients is a real part of the work and has traditionally meant flying; the substitutes she names are tying a meeting to a congress both parties are already attending rather than travelling for the meeting itself, taking trains and public transport where possible, and installing charging points and an electric car scheme at the offices. Beyond travel, her company had signed up to the Science Based Targets initiative, held an EcoVadis silver rating in the top 15% that year, and had partnered both with clients and with external consultants on sustainability research it then published at conferences and in journals. She adds an individual step that needs no organisational decision: choose an electricity supplier that uses renewable energy, at home and for the business.
Paul Tisdale, a communications director at Oxford PharmaGenesis, set out the same trade-off in EMWA's June 2023 freelancing issue of Medical Writing, and his version is a sequence rather than a list. Maintaining relationships with clients is critical to business development in healthcare communications, and even with a decade's improvement in virtual meetings, meeting in person allows the more expansive and relaxed conversations on which relationships thrive. His reconciliation is first to choose the activity with the lower environmental impact, such as a virtual check-in with a client, and, where emissions are unavoidable, to maximise what he calls the "return on carbon": plan a trip to meet as many clients as possible in one journey, or meet clients at the medical congresses both are attending rather than travelling to an office where many people may not be present because they work from home. Prefer lower-carbon transport such as trains, where working on the move is easier and fewer working hours are lost; where flying is the most appropriate option, take direct flights; and at company level, configure teams to support clients on the same continent, such as US-based teams working with US clients. Carbon offsetting, for a company or an individual, is to be seen as complementary to reducing primary emissions rather than as a replacement for it. The June 2023 issue of Medical Writing was admitted from an existing Markdown conversion without content repair; its known limitations are broken ligatures, mangled multi-column tables, interleaved page headers and footers, and figure text represented as marked text.
The rail half of that advice has one member's worked account behind it. Adam Jacobs, a senior director of biostatistical science at a contract research organisation, who had been to every in-person EMWA conference since 1999 and was the association's president in 2004–2005, described in the journal's December 2024 sustainability column how he moved almost all his business travel from planes to trains. The December 2024 issue of Medical Writing (volume 33, number 4, Medical Writing Around the World in 2024) was admitted from an existing Markdown conversion without content repair; its known limitations are broken ligatures, mangled multi-column tables, interleaved page headers and footers, and figure text represented as marked text. A frequent flyer until business travel stopped in March 2020, he used the pause to reflect on aviation's climate impact. His reasoning is that the destructive weather of 2024 — Storm Boris in Europe, Hurricanes Helene and Milton in the United States, Typhoon Yagi in south-east Asia, and deadly heat — arrived before the 1.5°C limit had even been breached, with projections pointing to about 2.7°C by the end of the century, so governments will not save us and individuals must take responsibility for their own emissions as well as voting for politicians who take climate change seriously.
His arithmetic comes with its own caution: reliable figures are hard to find, and the answer depends on how a train is powered, renewable electricity beating coal-fired power or diesel. On one carbon calculator a one-way London to Berlin trip emits about 260 kg of carbon dioxide by plane and 30 kg by train, and the overnight hotel stay in Brussels that the train journey needed, at about 12 kg for a typical Belgian hotel night, left the total far below flying. The time cost he found smaller than expected: long-distance trains have wifi and he works on them, so where a flight used to cost several hours of unproductive travel time on his timesheet, his train journeys have cost none. His record since 2022 is Berlin by train, Riga in November 2022 by air because there were then no cross-border trains between Poland and Lithuania, and Prague in 2023 and Valencia in 2024 by train with one overnight stop each way, with company trips to Brussels, Paris, Lausanne and Madrid in 2024 needing at most one; Riga in 2025 would be possible by rail now that Poland–Lithuania trains run, at the cost of three overnight stops.
The practical obstacle is ticketing. His Valencia journey needed four tickets from four operators — a local railway, Eurostar, the French national operator to an overnight stop in Girona, and the Spanish one onwards — and booking through a travel agent or a single website can still issue separate tickets. That matters when a train is late: a missed connection with one operator usually lets you take a later train, but not necessarily when the connecting train belongs to another operator and the ticket is not flexible. His mitigations are to put the overnight stop where the operator changes, to allow plenty of time for connections, or to buy a flexible ticket for the later legs, and he notes that an Interrail pass for European residents, now sold for periods shorter than a month, is flexible but does not help where a seat reservation is compulsory; he would welcome European coordination on passenger rights for such journeys. The column's editors add their own lesson, to check that an overnight train booking really includes a seat or a bed. His conclusion is that rail is more relaxing and often as fast door to door, since stations deliver you to the city centre: flying is a chore, and rail travel is an adventure.
Count the journey the work replaces, and the one it creates at home
Tisdale takes the office through the same test. Working from home avoids the emissions of travelling to the office, but for some people a shared workspace is the better choice, with face-to-face contact and the heating, cooling and lighting emissions divided among several occupants. How people get to an office matters a great deal — walking and cycling produce no emissions, public transport is better than the car, and where the car is the only option, carpooling schemes or electric vehicles help. The digital footprint of a company, its servers, websites and internet searches, is often overlooked and is a growing share of total emissions, so companies should ask their suppliers about low-carbon digital options such as net zero data centres; and reducing resource and water use and recycling all count alongside carbon and travel. His closing view is that many consultancies and individuals are only at the start of this, and that if the healthcare communications sector takes the initiative in reducing its own footprint and supporting clients to meet their targets, everyone benefits.
A desk-based job's largest single emission is often the commute to it, and a 2011 account of employee telecommuting works the arithmetic through. On the poll figures it used, the average American drove 16 miles to work each way, using about 1.45 gallons per round trip at 22.1 miles per gallon, and a typical car emitted 19.4 pounds of carbon dioxide per gallon — some 28 pounds a day, or about 6,600 pounds a year over a 235-day working year. The 2011 AMWA Journal issue (volume 26, number 4) drawn on here was admitted from an existing Markdown conversion without content repair, in which figure labels can be inlined into prose, cover and contents columns can interleave, and reference URLs can be malformed or truncated. The figures are of their date and their country, and the structure of the calculation is what transfers: distance, fuel economy, emissions per unit of fuel, and days worked.
The same account states the offsetting cost, which is the part such arithmetic usually omits. Any environmental benefit from taking the car off the road can be significantly diminished by heating or cooling a whole house through the working day, or by leaving lights on; and the electricity powering the computer, printer and peripherals is now the writer's own, and expensive if the equipment is not switched off when not in use. A home-working claim that counts only the avoided journey is answering the easier half of the question. Working from home as an employee covers the rest of that arrangement.
Interacting with colleagues, clients and employers online rather than in person is the same saving at a smaller scale, and the AMWA Journal's social media columnist made the argument explicitly in the same issue: using social networks to reach people makes sense as a green strategy because it reduces vehicle use and fuel consumption, and it connects a writer to people they would otherwise never meet. An electronic portfolio was presented on the same reasoning — responding to a job advertisement within minutes, reaching a client anywhere, and burdening neither party with paper. Showing an employer your writing carries how that portfolio is built.
Expect the paperless office to arrive as a less-paper office
Putting a number on office paper is what turns a paper-saving measure from a gesture into an arithmetic. A paper calculator cited in the same 2011 issue of the AMWA Journal put the effect of United States offices reducing virgin-fibre copy paper use by 10% from 2009 levels at 22.8 million trees saved, greenhouse gas emissions equivalent to taking 481,000 cars off the road, and more than 60,000 truckloads of solid waste kept out of landfills and incinerators. At the scale of one desk the same source gives about half a tree per case of ten reams of 100% virgin copier paper, which is the figure to reach for when the saving has to be made personal rather than national.
The profession's honest account of its own paper use is worth setting against the arithmetic, because it shows which reductions people actually make. Asked in 2011 what had happened to the paperless office, the AMWA Journal's freelance panel answered almost unanimously that it had not happened to them, and gave reasons that are about how the work is done rather than about intent. One panellist keeps paper because computer crashes take hours to recover from even with a backup, so phone numbers and calendar items on paper keep her working while the machine is being fixed; she prints references because she needs to highlight every one of them and loses track of her writing thoughts toggling between screens, and keeps a paper calendar because seeing every project due date in one block at a glance is what a visual person needs. Barbara Rinehart, the panel's most emphatic voice on the point, prints every PDF reference before starting, underscores and highlights them and spreads them across the desk, the floor and every flat surface until the project is finished, describing a physical bond with the paper and a memory of where things are that lets her find them again — she uses the search function in a PDF often, and brings what she finds back to the printed world. Brian Bass, answering the same question, shreds what is marked confidential and recycles everything else, and expects each succeeding generation of medical writers to be less addicted to paper than the last.
What the same panel does instead is the transferable part, because every measure on it is available to someone who has not given up printing. Clear the files two or three times a year and reprint on the reverse of any sheet that is not crinkled or bent — one panellist reports getting more than a month's supply that way, and another that tables print better on the back of text and text on the back of tables. Be selective about what is printed at all: save source documents to the hard drive and print only the page or section being used heavily, and copy a corrected phone number onto the email you already printed rather than printing the correction. Fact-check and highlight electronically for the clients where that works. And where confidential paper has to be destroyed, free shred days sponsored by local credit unions cover the ordinary case, with a paid service issuing a certificate of shredding where a client requires proof — a cost the panel treats as one the client should reimburse. The panel's own name for the result is a "less paper" office rather than a paperless one, adopted deliberately on the ground that it saves trees while leaving the writer working efficiently and without fear of losing key documents.
The cheapest measure in the issue costs a line of text. A sidebar suggested adding "Think before you print" to an email signature, set in green with a small graphic produced by typing a capital P in the Webdings font, and gave the HTML to reproduce it for anyone whose mail client needed the markup rather than the formatting. It asks nothing of the sender and moves the decision to the recipient, which is the only lever an email has over what happens to it.
Where the paper is a book rather than a document, the same issue pointed at the free digital library as the substitute. Project Gutenberg then carried over 30,000 titles in its own catalogue and more than 100,000 through its affiliates and partners, produced by thousands of volunteers, and had recorded over two million downloads in the preceding thirty days.
Three tools were recommended for anyone wanting to measure rather than estimate the paper side: a laboratory's Cutting Paper guidance on reducing paper use, a printing-management product for measuring and reducing what is printed, and an environmental organisation's Better Paper Project for choosing publication stock. All three are of 2011 and the addresses will have moved; what carries is that the paper decision has a measurement, a management and a sourcing side, and that they are separate.
Conference posters are one paper item with a reusable substitute. Gemma Rogers told the 2024 seminar, in Kabani's report, that her company had switched from paper posters to fabric-printed ones that can be washed and reused, with the added benefit that they fold and travel easily.