A consortium of passionate researchers from TU Delft, Erasmus University Rotterdam, and Erasmus MC, have embarked on a mission to radically transform endoscopy practices, paving the way for a sustainable healthcare future. The Zero Emission Endoscopy (ZEE) program aims to drastically reduce the ecological footprint of endoscopy departments, tackling this critical societal challenge head-on.

Why is this important?

The healthcare sector, paradoxically contributes significantly to environmental degradation. While dedicated to restoring and protecting our health, hospitals generate substantial waste, pollution, and carbon emissions, fueling the very climate change that threatens our well-being. In the Netherlands alone, healthcare accounts for a staggering 7% of the national CO2 footprint. Within this sector, the Endoscopy Department stands out as a major contributor to hazardous waste, ranking third highest in hospitals.

Revolutionize endoscopy

The ZEE program aims to revolutionize endoscopy by implementing sustainable practices, reducing healthcare’s environmental impact. Through collaboration with Dutch institutions and industry partners, we’ll develop evidence-based models for eco-friendly hospitals, publishing in leading journals and presenting at conferences. We’ll engage stakeholders via meetings, our website, and media, fostering a national and international shift towards sustainable healthcare by 2030. Regional gastroenterologists will form a focus group, ensuring practical implementation.

Our aim 

1. To make a direct impact on the ecological footprint of the Endoscopy department, with a focus on CO2 footprint and waste reduction.
2. To build a strong research community to create an evidence-based transition model for an environmentally sustainable Endoscopy Department, using the expertise of three Dutch research institutions and our partners.

Research focus

Workpackages

This program will consist of four work packages:

• WP1 will focus on Procurement and the Value Chain
• WP2 will focus on the Healthcare System itself (the endoscopy care pathway)
• WP3 will focus on the Human and Technology perspective of the product system
• WP4 will focus on Collaboration and Dissemination

Consortium expertise

Our program aligns with the Environment, Social, and Governance (ESG) framework, Sustainable Development Goals (SDGs), and the Green Deal Duurzame Zorg 3.0, demonstrating our commitment to global sustainability efforts. We recognize the urgency of addressing climate change and are determined to play a leading role in creating a greener and healthier future.

Who will benefit?

A wide range of stakeholders will benefit from a lower environmental impact of GI Endoscopy in the Netherlands:

1. Patients and healthcare professionals within the hospital
2. Other hospitals and medical societies
3. Insurance companies, suppliers, waste companies, ministry of health (VWS)
4. The society as a whole, also on the long term via reduced environmental damage

Impact and outcome

This program will be considered successful if all objectives and aims are achieved, resulting in 4-6 cocreated endoscopy cases and at least 20% reduction of the CO2 footprint and 20% waste reduction of the Endoscopy departments in participating hospitals, as compared to a baseline measured at the start of the program and corrected for a comparable patient mix. Additional impact is achieved by implementing stricter triage procedures to determine when scoping of a patient is necessary and when not.

Currently, the main challenge (and the biggest opportunity for impact) in reducing the environmental impact of endoscopy lies in defining how care pathways and the ecosystems in which they operate can be changed. This program will develop evidence-based and scalable interventions to answer that call.