The document discusses the National Green Theatres Programme in Scotland, which aims to reduce carbon emissions from healthcare, particularly in surgical theatres and anaesthetics. It notes that NHS Scotland emissions are 577,700 tonnes of CO2e annually, with theatres and anaesthetics being high contributors. It outlines over 40 proposed sustainability actions and an approach using quality improvement methods to implement emission mitigation efforts across structures, equipment, practices and culture. Examples provided show significant emission reductions achieved from switching anaesthetic agents and capturing waste gases. The programme aims to establish sustainable procurement, evaluate impacts, and develop a framework allowing for circular economy practices in healthcare.
Novo Nordisk introducing the Coalition for Sustainable Pharmaceuticals and Me...UN SPHS
Anne Gadegaard, Global Senior Advisor of Novo Nordisk has delivered a presentation on 11 May 2016 at the dialogue on “Fostering Sustainable Procurement: How Procurers Can Change the Global Health Sector” in UN City, Copenhagen.
Green Procurement for Global Health Aid Presentation, at the GOA Meeting, India, in 1st of October, 2015.
Presented by Dr. Christoph Hamelmann, Regional Team Leader (Europe and Central Asia) and Senior Advisor (Arab States), HIV, Health and Development. Coordinator of the Secretariat of the UN informal Interagency Task Team on Sustainable Procurement in the Health Sector (iIATT-SPHS).
This presentation was given at the EPA’s National Water Event 2019, which took place on 29 and 30 May 2019 in Galway. This presentation by Sean Mc Gee from Irish Water is on dealing with lead in drinking water and balancing the environment and health.
Presenters: Juna Shrestha and Benjamin Huber
Title: Carbon offsetting to sustainably finance the System of Rice Intensification (SRI) in Nepal
Date: October 4, 2016
Venue: Mann Library 160, Cornell University, Ithaca, NY
Sponsors: SRI-Rice, International Programs, CALS, Cornell University
Novo Nordisk introducing the Coalition for Sustainable Pharmaceuticals and Me...UN SPHS
Anne Gadegaard, Global Senior Advisor of Novo Nordisk has delivered a presentation on 11 May 2016 at the dialogue on “Fostering Sustainable Procurement: How Procurers Can Change the Global Health Sector” in UN City, Copenhagen.
Green Procurement for Global Health Aid Presentation, at the GOA Meeting, India, in 1st of October, 2015.
Presented by Dr. Christoph Hamelmann, Regional Team Leader (Europe and Central Asia) and Senior Advisor (Arab States), HIV, Health and Development. Coordinator of the Secretariat of the UN informal Interagency Task Team on Sustainable Procurement in the Health Sector (iIATT-SPHS).
This presentation was given at the EPA’s National Water Event 2019, which took place on 29 and 30 May 2019 in Galway. This presentation by Sean Mc Gee from Irish Water is on dealing with lead in drinking water and balancing the environment and health.
Presenters: Juna Shrestha and Benjamin Huber
Title: Carbon offsetting to sustainably finance the System of Rice Intensification (SRI) in Nepal
Date: October 4, 2016
Venue: Mann Library 160, Cornell University, Ithaca, NY
Sponsors: SRI-Rice, International Programs, CALS, Cornell University
SPHS Webinar Series: Human Rights, Water and Antimicrobial Resistance: A New ...UN SPHS
In light of the discussions held at the Asia Forum 2018 Campfire Session led by Stockholm International Water Institute (SIWI), the SPHS webinar "Human Rights, Water and Antimicrobial Resistance: A New Nexus-Approach To Address a Complex Challenge?" focuses on the relationship between a healthy environment and human rights, with a special focus on water and antibiotics. Experts explain how this approach can stimulate virtuous developments within the health sector, and how health care providers ensure simultaneous access to affordable medicines while safeguarding human rights of people living nearby production sites, who share the same water resources. The objective is to share information with the audience about the activities of pharmaceutical companies and relevant stakeholders from the health sector, including leading practices and gaps, to trigger a conversation on how purchasers can influence sustainable procurement of pharmaceuticals.
In addition, Active Pharmaceutical Ingredients (APIs & Formulations) or chemicals that are discharged in the wastewater from the production of pharmaceuticals, impact the human health and the environment through water contamination. The webinar also discusses strategies to effectively measure and monitor the APIs in the wastewater discharged resulting from production, development and related activities involving pharmaceuticals manufacturing.
Introduction
The clean Tech Revolution
Objectives
Main Characteristics of Clean Technology
Cleaner Technology principles
Cleaner Technology practices
Top 10 clean technology breakthroughs
Challenges or disadvantages of Green Technology
Conclusion
Ecological factor is considered among the top most parameters for development of pharma company. And the Pharma company are booming due to their focus on this parameters.
SPHS Webinar Series: Effective Communication for Innovation in Sustainable Pr...UN SPHS
The second SPHS webinar, Effective Communication for Innovation in Sustainable Procurement in the Health Sector was held on 7 December 2017.
This webinar presents concrete case studies and expert knowledge in applying sustainable environmental criteria/methods in public procurement in the health sector. Presenters speak to their experiences of communicating across teams of procurers, requisitioners, and suppliers to bring sustainable procurement to the health sector as well as promote transparency and accountability mechanisms in the procurement system.
An ecological assessment of food waste composting using a hybrid life cycle a...Ramy Salemdeeb
A conference paper published at the 8th Conference of the International Society for Industrial Ecology, At University of Surrey, Guildford, UK, At Surrey
Green Talks LIVE webinar: Pharmaceutical Residues in FreshwaterOECD Environment
On Thursday 14 November, Hannah Leckie and Bob Diderich (OECD Environment Directorate) presented the key findings of the report "Pharmaceutical Residues in Freshwater: Hazards and Policy Responses", which warns of the risks from increased pharmaceutical residues in the environment, and how policy makers and other stakeholders can take action to reduce the risks.
Helen Clayton: EU and National Actions to Protect Citizens from Water PollutionTHL
Helen Clayton, Policy Officer, Unit Clean Water, European Commission, DG Environment, at Europe That Protects - Safeguarding Our Planet, Safeguarding Our Health EU side event, 3-4 Dec 2019, THL, Helsinki
Presentation by Alex De Pinto, International Food Policy Research Institute (IFPRI)
International conference on agricultural emissions and food security: Connecting research to policy and practice
10-13 September 2018
Berlin, Germany
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
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SPHS Webinar Series: Human Rights, Water and Antimicrobial Resistance: A New ...UN SPHS
In light of the discussions held at the Asia Forum 2018 Campfire Session led by Stockholm International Water Institute (SIWI), the SPHS webinar "Human Rights, Water and Antimicrobial Resistance: A New Nexus-Approach To Address a Complex Challenge?" focuses on the relationship between a healthy environment and human rights, with a special focus on water and antibiotics. Experts explain how this approach can stimulate virtuous developments within the health sector, and how health care providers ensure simultaneous access to affordable medicines while safeguarding human rights of people living nearby production sites, who share the same water resources. The objective is to share information with the audience about the activities of pharmaceutical companies and relevant stakeholders from the health sector, including leading practices and gaps, to trigger a conversation on how purchasers can influence sustainable procurement of pharmaceuticals.
In addition, Active Pharmaceutical Ingredients (APIs & Formulations) or chemicals that are discharged in the wastewater from the production of pharmaceuticals, impact the human health and the environment through water contamination. The webinar also discusses strategies to effectively measure and monitor the APIs in the wastewater discharged resulting from production, development and related activities involving pharmaceuticals manufacturing.
Introduction
The clean Tech Revolution
Objectives
Main Characteristics of Clean Technology
Cleaner Technology principles
Cleaner Technology practices
Top 10 clean technology breakthroughs
Challenges or disadvantages of Green Technology
Conclusion
Ecological factor is considered among the top most parameters for development of pharma company. And the Pharma company are booming due to their focus on this parameters.
SPHS Webinar Series: Effective Communication for Innovation in Sustainable Pr...UN SPHS
The second SPHS webinar, Effective Communication for Innovation in Sustainable Procurement in the Health Sector was held on 7 December 2017.
This webinar presents concrete case studies and expert knowledge in applying sustainable environmental criteria/methods in public procurement in the health sector. Presenters speak to their experiences of communicating across teams of procurers, requisitioners, and suppliers to bring sustainable procurement to the health sector as well as promote transparency and accountability mechanisms in the procurement system.
An ecological assessment of food waste composting using a hybrid life cycle a...Ramy Salemdeeb
A conference paper published at the 8th Conference of the International Society for Industrial Ecology, At University of Surrey, Guildford, UK, At Surrey
Green Talks LIVE webinar: Pharmaceutical Residues in FreshwaterOECD Environment
On Thursday 14 November, Hannah Leckie and Bob Diderich (OECD Environment Directorate) presented the key findings of the report "Pharmaceutical Residues in Freshwater: Hazards and Policy Responses", which warns of the risks from increased pharmaceutical residues in the environment, and how policy makers and other stakeholders can take action to reduce the risks.
Helen Clayton: EU and National Actions to Protect Citizens from Water PollutionTHL
Helen Clayton, Policy Officer, Unit Clean Water, European Commission, DG Environment, at Europe That Protects - Safeguarding Our Planet, Safeguarding Our Health EU side event, 3-4 Dec 2019, THL, Helsinki
Presentation by Alex De Pinto, International Food Policy Research Institute (IFPRI)
International conference on agricultural emissions and food security: Connecting research to policy and practice
10-13 September 2018
Berlin, Germany
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
2. NHS SCOTLAND EMISSIONS 577,700 tCO2e
THIS IS 5% OF SCOTLAND’S CARBON FOOTPRINT
High emission clinical care pathways
Renal Medicine
Respiratory Medicine
Theatres & Anaesthetics
4. >42 sustainability actions towards
Ideal green theatres
• Structures
• Systems & equipment
• Clinical practices & team culture
4
5. Approach
Apply quality Improvement and implementation science
methodologies & frameworks to scale up mitigation efforts
Evaluate impact of changes on policy & opportunities for
further emission savings
Develop infrastructure and ethos that allows for circular
economy of goods.
Procurement decisions include sustainability metrics
Interventions are assessed using a health climate economic
model to assess full anthropogenic effect.
5
6. Ken B in 2016
• 8 hours of N2O/O2/Desflurane at 2l/min @ 1
MAC
= 4672km
in an average car
Anaesthetic Impact Calculator on the
App Store (apple.com)
6
Dr Kenneth Barker, Principal Environmental Anaesthetist SG
7. Ken B Today
• 8 hours of O2/sevoflurane at 0.5l/min @ 1
MAC
= 20km
in an average car
7
Dr Kenneth Barker, Principal Environmental Anaesthetist SG
9. • Proved annual system waste:
792,000, 723,528 and 358,268 litres at three NHS Lothian sites
respectively
• ~ 1039 tCO2e ANNUAL EMISSIONS
• Averted unnecessary capital expenditure
9
N2O mitigation at NHS Lothian
NHS LOTHIAN RESULTS:
Alifia Chakera, Founder the Nitrous Oxide Project
10. Developing a local
Nitrous Oxide Project
10
Lean Six Sigma
DMAIC Cycle
Incorporate lean tools:
Decision Tree Analysis
Process Mapping
Alifia Chakera, founder the Nitrous Oxide Project
11. • By 31 March 2021 16 sites reported piped N2O waste
• Annual volume waste 13.7million litres 95% of total
turnover
• Mitigation report developed for the Greener NHS
• Scottish N2O mitigation implementation plan released
UK & ROI RESULTS
National N2O mitigation waste reporting
Alifia Chakera Founder the Nitrous Oxide Project 11
12. Improvement & implementation
Anaesthetic Gases Mitigation
tCO2e 2018/19 2019/20 2020/21* 2021/22
Piped N2O 9,586 9,385 7,764 6,717
Volatiles 7,423 3,684 1,502 1,088
12
*Depressed levels due to Covid 19 & reduction in through put.
13. 13 |
Validate the need for AGSS given 20-30 air exchanges/hr
• Absence of nitrous oxide
• Low gas flow volatile anaesthesia
• Presence of Volatile Capture technologies
Impact of changes & National Policy
14. Sustainable Procurement
• Environmental
Sustainability 30%
• User convenience 30%
• Security of Supply 20%
• Cost 20%
Norway
• Environment &
Sustainability 20%
• Capacity 25%
• Access to product 25%
• Price 30%
14
UN
Bengt Mattson, Chairman of the European Trade Associations Joint Task Force on
Pharmaceuticals in the Environment (IAI PIETF)
15. NSS Procurement
• 5-8% discretionary environmental weighting if
deemed relevant by clinical advisory panel
• Cost is still primary driver
• Sustainability procurement tools under
revision
• BUT SUSTAINABILTY IS A BARGAIN
15
18. Health Climate Economics
• Health Technology Assessment organisations
do not include a sustainability variable in
assessing treatment or intervention.
• A sustainability variable includes the harm
caused by the agent on the environment
paradoxically harming health
A.Chakera https://doi.org/10.1136/bmj.n2922
18
19. Ecotoxicity:
How do medicines get into the environment?
• Consumption / use of medicines (90%)
Between 30-100% of an oral dose can be excreted as
an active substance in urine into waste water system
• Improper disposal (~5%)
Many unused or unwanted medicines get
flushed down toilets
• Production processes in pharmaceutical
industry (~5%)
19
20. Ecotoxicity of agents
Propofol
• Growth inhibition & death of
algae
• Acute toxicity in small
crustaceans and freshwater
fish
• Chronic exposure - it impacts
the survival, growth and
reproduction of Daphnia
magna
• Overall impact could be 60
times greater than
manufacturer assessment
estimate
Sugammadex
• Excreted in urine unchanged
• Highly likely to have significant
impact due to its ability to
bind to oestrogen and
progesterone.
• Potential as an endocrine
disruptor and the widespread
detection of EE2 in water
research is needed on whether
sugammadex is a source of
environmental harm from the
practice anaesthesia.
20
Mankes, R. Anesthesia & Analgesia: May 2012 - Volume 114 - Issue 5 - p 1091-1092
AstraZeneca (2017) Environmental Risk Assessment Data: Propofol.
21. A “non-toxic
environment”
Vision
To improve healthcare & the environment,
inform legislation, drive research &
innovation
Mission
Steering Group
One Health Breakthrough Partnership
https://ohbp.org/ 21
22. THANK YOU FOR YOUR TIME
@AlifiaChakera
@pharmdeclares
#nixthenitrous
www.linkedin.com/in/alifia-chakera
Email: Alifia.chakera.gov.scot
22
