Mostly harmless? A survey of South African anaesthetists’ knowledge and attitudes regarding environmental sustainability in the operating theatre



environmental sustainability, operating theatre, recycling


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.

Author Biographies

L Frewen, Walter Sisulu University

Department of Anaesthesiology, Port Elizabeth Hospital Complex, South Africa

E S Grossman, Walter Sisulu University

Port Elizabeth and East London Health Research Centres, Faculty of Health Sciences, Walter Sisulu University, South Africa

C Basson, Port Elizabeth Hospital Complex

Department of Anaesthesiology, Port Elizabeth Hospital Complex, South Africa






Original Research