Research Articles
Mostly harmless? A survey of South African anaesthetists’ knowledge and attitudes regarding environmental sustainability in the operating theatre
Submitted: 18 November 2025 | Published: 01 January 2022
About the author(s)
L. Frewen, Department of Anaesthesiology, Port Elizabeth Hospital Complex, South AfricaE.S. Grossman, Port Elizabeth and East London Health Research Centres, Faculty of Health Sciences, Walter Sisulu University, South Africa
C. Basson, Department of Anaesthesiology, Port Elizabeth Hospital Complex, South Africa
Full Text:
PDF (88KB)Abstract
Background: The healthcare industry has been shown to have a large negative environmental impact – producing vast amounts of waste and CO2 emissions. Operating theatres demonstrate a disproportionately high waste production to floor space ratio, producing up to 33% of hospital waste. Furthermore, anaesthesia is responsible for 25% of operating theatre waste production.
Methods: This study assesses the opinions and knowledge of South African anaesthetists regarding the environmental impact of anaesthetic practice. A validated questionnaire was developed using an online survey tool, SurveyMonkey. The survey link requesting participation was published once in the South African Society of Anaesthetists’ weekly newsletter, and thereafter snowballing was used to increase sample size.
Results: The survey was completed by 222 South African anaesthesia providers. Ninety-two per cent of respondents (189/205; CI 87.4–95.3%) agreed that environmental impact is an important factor to be taken into account when conducting anaesthesia practice. However, only 35.0% of South African anaesthetists felt that their knowledge was sufficient to guide such practice (72/206; CI 28.5–41.9). Although 65.2% of South African anaesthetists recycled at home (133/204; CI 58.2–71.6%), and 90.7% were keen to recycle at work (185/204; CI 85.6–94.1%); a mere 11.8% of respondents reported recycling at work (24/204; CI 7.8–17.2%). The greatest perceived barriers to recycling in South African operating theatres were lack of information, lack of recycling facilities and staff attitudes.
Conclusion: South African anaesthetists appear keen to adopt environmentally friendly practices in the operating theatre. However, there are several barriers that prevent implementation. Further, anaesthetists lack the knowledge and education necessary to guide sustainable practice. This requires redress in national curricula.
Keywords
Metrics
Total abstract views: 472Total article views: 237
Crossref Citations
1. Barriers and facilitators to sustainable operating theatres: a systematic review using the Theoretical Domains Framework
Aws Almukhtar, Carys Batcup, Miranda Bowman, Jasmine Winter-Beatty, Daniel Leff, Pelin Demirel, Talya Porat, Gaby Judah
International Journal of Surgery vol: 110 issue: 1 first page: 554 year: 2024
doi: 10.1097/JS9.0000000000000829
2. A Survey on Environmental Sustainability Among Anesthesiologists: An Opportunity for Changing Behaviors
Patrícia Santos, Beatriz Oliveira, Cristina Romão, Nuno Leiria
Cureus year: 2024
doi: 10.7759/cureus.53367
3. Patients’ Perspectives on Climate Change, Health, and Sustainability in Ophthalmology
Denise Yang-Seeger, Annkathrin Schellstede, Laurenz J.B. Pauleikhoff, Martin S. Spitzer, Johannes Birtel
Ophthalmologica vol: 249 issue: 1 first page: 1 year: 2025
doi: 10.1159/000549175
4. Integrating Sustainability Practices and Governance Capabilities in South Africa’s Private Healthcare System for Improved Performance
Nombuyiselo Nzimande, Blessing Takawira
Sustainability vol: 18 issue: 6 first page: 2857 year: 2026
doi: 10.3390/su18062857
5. Environmentally sustainable anaesthesia in Africa: A scoping review of current knowledge, practices and challenges
Alessio P. Giuricich, Mithasha Gayaparsad, Lionel Green-Thompson, Munira Guzgay
Southern African Journal of Anaesthesia and Analgesia vol: 32 issue: 1 year: 2026
doi: 10.4102/SAJAA.v32i1.1506
6. An evaluation of anaesthetic waste generation at a Johannesburg academic hospital
J Meintjes, L Gilliland
Southern African Journal of Anaesthesia and Analgesia vol: 30 issue: 4 first page: 118 year: 2024
doi: 10.36303/SAJAA.3119
7. Environmental sustainability in anesthesia and operating room practice: a national multicenter survey of knowledge, attitudes, and behaviors
Semin Turhan, Sibel Önen Özdemir, Mehmet Berksun Tutan, Güvenç Doğan, Selçuk Kayır, Arzu Akdağlı Ekici, Özgür Yağan
BMC Anesthesiology vol: 26 issue: 1 year: 2026
doi: 10.1186/s12871-026-03858-0
8. Anaesthetists’ knowledge and practice of environmentally sustainable anaesthesia in an academic department of anaesthesiology
AP Giuricich, T Jeggo, T Kleyenstuber
Southern African Journal of Anaesthesia and Analgesia vol: 30 issue: 5 first page: 158 year: 2024
doi: 10.36303/SAJAA.3144
9. Improving Environmental Sustainability of Operating Theatres
Siya Lodhia, Victoria Pegna, Ruth Abrams, Daniel Jackson, Timothy A. Rockall, Chantelle Rizan
Annals of Surgery vol: 280 issue: 6 first page: 954 year: 2024
doi: 10.1097/SLA.0000000000006337
10. Sustainability in anaesthesia: are South African anaesthesia providers doing their part?
FC Vorster, BJS Diedericks
Southern African Journal of Anaesthesia and Analgesia vol: 30 issue: 6 first page: 173 year: 2024
doi: 10.36303/SAJAA.3157
11. Environmentally sustainable anaesthesia in a developing country – a narrative review
AP Giuricich, T Kleyenstuber, T Jeggo
Southern African Journal of Anaesthesia and Analgesia vol: 30 issue: 4 first page: 123 year: 2024
doi: 10.36303/SAJAA.3141
12. Environmental sustainability in pediatric otolaryngology: An international survey of operating room practice patterns
Nick Teller, Kalpesh Hathi, Claire A. Wilson, Jacob Davidson, Anthony De Luca, Neil K. Chadha, Sohit Kanotra, Eric Levi, Mat Daniel, Scott M. Rickert, Thomas Schrepfer, Niall Jefferson, Julie Strychowsky
International Journal of Pediatric Otorhinolaryngology vol: 197 first page: 112532 year: 2025
doi: 10.1016/j.ijporl.2025.112532
13. Environmental Sustainability Initiatives in the Operating Room: A Scoping Review
Emre Gorgun, Sumudu Dehipawala, Matthew O’Hara, Elena Naoumtchik, Gaurav Gangoli, Crystal Ricketts, Giovanni A. Tommaselli
Annals of Surgery Open vol: 5 issue: 3 first page: e451 year: 2024
doi: 10.1097/AS9.0000000000000451
