Environmental impact

An investigation of the environmental impact of using reusable versus single-use endoscopes

Environmental impact of using endoscopes

We often hear the question “Isn’t it better for the environment to use a reusable endoscope?” we decided to put it to a test. Leading environmental professors from the University of Southern Denmark have investigated the impact of single-use bronchoscopes compared to the complex and lenghty cleaning process of reusable bronchoscopes.2-5


Reprocessing of reusable endoscopes

The amount of disposable equipment and detergents used for reprocessing one reusable endoscope is surprising. This picture illustrates of how much material is actually needed for cleaning one reusable endoscope.1

Complexity has a high cost

Recently in the US, The Centers for Disease Control and Prevention (CDC) published a new and more extensive guidance for the reprocessing of reusable endoscopes.2 The CDC is not alone; more and more national agencies and local institutions are introducing stricter guidelines to minimize the risk of cross contamination and improve patient safety.3-5  

These guidelines call for extensive use of personal protection equipment and detergents, resulting not only increased reprocessing costs but also a higher environmental burden. This trend enables us to more confidently say, from an environmental impact, there is little difference between a reusable and a single-use bronchoscope – perhaps it may even be less impactful to choose the single-use.

“The use of cleaning materials and personal protective equipment illustrates that reusable bronchoscopes have comparable or higher material and energy consumption as well as emissions of CO2-equivalents and value of resource consumption to Ambu® aScope™ 4 Broncho single-use scopes.6 

The value of resouces

Value of scarce resources in aScope™ 4 Broncho and materials used to reprocess reusable bronchoscopes.4

Materials used

Embodied energy in the materials of aScope™ 4 Broncho and materials used to reprocess reusable bronchoscopes.4


CO2-emission related to aScope™ 4 Broncho and materials used to reprocess reusable bronchoscopes.6


CO2 emissions, scarce resources, materials, etc. can be difficult to measure. We have put the numbers into perspective by tying them to activities we all know and understand.

Disposal of one aScope is equivalent to the disposal of 349 g of household waste7

One aScope


349g household waste

CO2 emmission equals

Everyday thousands of passengers fly from NYC to LA making it one of the busiest air routes in the US.

The combined CO2 emission of 271 aScope 4 Broncho*s equals one passenger flying one-way from NYC to LA**.

Or you can say that 271 bronchoscopies using aScope 4 Broncho have the same CO2 impact as the one passenger on the flight from NYC to LA.

* Both production and disposal
** According to Simapro version one person flying one km corresponds to 0.11 kg CO2

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  1. Ofstead CL, Quick MR, Eiland JE, Adams SJ. A Glimpse At The True Cost Of Reprocessing Endoscopes: Results Of A Pilot Project. www.bostonscientific.com [Internet]. 2017; Available from: https://www.bostonscientific.com/content/dam/bostonscientific/uro-wh/portfolio-group/LithoVue/pdfs/Sterilization-Resource-Handout.pdf

  2. Center for Disease Control and Prevention. Essential Elements of a Reprocessing Program for Flexible Endoscopes – Recommendations of the Healthcare Infection Control Practices Advisory Committee. 2016;1–12.

  3. AAMI. American National Standard - Flexible and semi-rigid endoscope processing in healthcare facilities. 2015; Available from: https://my.aami.org/aamiresources/previewfiles/ST91_1504_preview.pdf

  4. SGNA. SGNA Standards: standards of infection control in reprocessing of flexible gastrointestinal endoscopes. Gastroenterol Nurs [Internet]. 2012;33(1):70–80. Available from: https://www.sgna.org/Portals/0/Education/PDF/Standards-Guidelines/sgna_stand_of_infection_control_0812_FINAL.pdf

  5. AORN. Guidelines and Tools for the Sterile Processing Team. 2018; Available from: https://www.aorn.org/guidelines/clinical-resources/publications/ebooks/guidelines-tools-sterile-processing-team

  6. Sørensen B. L. and Grüttner H. 2017; Comparative study on environmental impact of reusable and single-use bronchoscopes. Data on file.

  7. Nielsen, Thyge M. et al. 2016; Affalds-sortering på Gentofte Hospital. Available from: https://www.herlevhospital.dk/