A process-based life cycle assessment of the climate impact of a Swedish intensive care unit

About 4.4% of the global emissions of greenhouse gases can be ascribed to healthcare. Intensive care is among the most resource intensive specialties and the purpose of this study was to quantify the total climate impact of a Swedish intensive care unit (ICU) and identify modifiable elements that can lower the intensive care unit's climate impact. A process-based life cycle assessment was conducted to estimate the climate impact per inpatient day in Sweden using the ReCiPe2016 impact assessment method. The analysis included single-use items; reusable instruments and textiles; pharmaceuticals and fluids; medical gases; and energy consumption for electronics equipment, lighting, and heating, ventilation, and air conditioning (HVAC). Input data were collected in 2022 at a mixed surgical and medical ICU in Sweden. Swedish low-climate-impact energy mix were used in the primary analysis. Results are reported as the global warming potential of carbon dioxide equivalents for 100 years (CO2eq). The median climate impact of one inpatient day was 30 kg CO2eq (95%-reference interval: [27-31]). Approximately 63% (19 kg CO2eq [18-20] could be attributed to single-use items, 19% (5.5 kg CO2eq [4.3-7.9]) was attributed to the unit's energy consumption, pharmaceuticals and fluids contributed 7% (1.9 kg CO2eq [1.7-2.2]), and 5% (1.5 kg CO2eq [1.2-1.9]) was attributed to medical gases. A sensitivity analysis, using a high-climate-impact energy mix increased the total climate impact to 126.5 kg CO2eq (103-154). In countries with low-climate-impact energy mixes, such as Sweden, the opportunity to reduce the climate impact of intensive case lies primarily in the reduced use of single-use items. For countries that depend on high-climate-impact energy mixes, the foremost opportunity to reduce the climate impact of intensive care is to transition to renewable energy.