A general review of the environmental impact of health care, hospitals, operating rooms, and anesthetic care.

The environmental impact of humanity has been steadily increasing with a growing world population. Since the industrial revolution, both the growth inworld population and the environmental impact per capita have been increasing exponentially and have reached levels that already have negative consequences for large parts of the world population. This will potentially negatively influence life on planet earth to an unimaginable degree. Global annually averaged surface air temperature has increased by about 1°C over the last 115 years and it is widely recognized that this time period is the warmest in the history of modern civilization. There is overwhelming evidence that human activities, such as emission of greenhouse gases (GHG), are the dominant cause for the observed global warming. A large number of scientific studies have documented the consequences of rising temperatures such as rising oceanic temperatures, rising sea levels, melting glaciers, diminishing snow cover, shrinking sea ice, ocean acidification, increasing atmospheric water vapor, and direct and indirect effects on human health and well-being. The global atmospheric carbon dioxide (CO2) concentration has now passed 400 parts per million, a level that last occurred about 3 million years ago, when both global average temperature and global sea level were significantly higher than today. In the very optimistic scenario under which global GHG emissions are reduced to zero by the year 2100, there would still be an increase in global temperature by 1°C. If emission of GHG continues at the current level, global temperatures will rise by 2.8 to 5.7°C by the year 2100. Reduction of emission of GHG, reduction of current CO2 levels in the atmosphere, andmitigation of the effects of elevated levels of GHG in the atmosphere are arguably the greatest challenges faced by humanity in the coming years. Similarly, pollution by accumulation of discarded plastic products has emerged as a threat to environmental health, mainly affecting marine eco-systems, with additional significant potential harm to human health. The cumulative production of plastic exceeds 8000 millionmetric tons, ofwhich~9%has been recycled, 12% incinerated, and 79% accumulated in landfills or the natural environment. Currently, it is estimated that 6 to 8millionmetric tons of plastic enter the Earth’s oceans every year, with devastating impacts onmarine life and human health. The 2014 report by the National Oceanic and Atmospheric Administration estimates that this amount is even higher and puts it at 38 million metric tons for 2015 alone (noaa.gov). The main effects of this pollutionarephysical, suchas lacerations, blockage, and retention, and toxicological. Via direct ingestion or ingestion of contaminated prey in high enough doses, these plastics can cause problems such as cancer, endocrine disruption, immune impairment, neurological damage, reproductive failure, developmental delays, and muscle damage (noaa.gov). Although the numbers are already staggering, current trends of production, consumer use, and demographics point to further increases in plastic use and contamination in the future. In fact, without waste management infrastructure improvements, the cumulative quantity of plastic waste available to enter the ocean from land is predicted to increase by an order of magnitude by 2025.