6 things you can do to reduce the environmental impact of clinical research trials

1. Understand the impact of your trial and make a plan

The first step to reducing the environment impact of your research trial is to understand and measure its potential impact. This process could seem daunting at first, but start with a simple audit. Map out areas where your trial might be impacting the environment, whether that’s patient travel to appointments, the energy used by equipment, or consumables and waste, and consider alternative options. 

There are resources to help you with this. A Clinical Trial Carbon Calculator has been produced by the Sustainable Healthcare Coalition. Calculators like these allow you to estimate the environmental impacts of different parts of the research trial and test out alternative options to see what actions can deliver the biggest environmental benefits. They can be used at all stages of the process – when developing the protocol for the trial, for decision-making while the trial is ongoing, or for retrospective analysis. 

Some of the terms used in this space may be unfamiliar at first and you’ll probably hear about different ‘scopes’ of emissions – scope 1, 2 and 3. We’ll describe these briefly here as they come up quite a lot. These scopes refer to where greenhouse gas emissions come from:

• Scope 1 are direct emissions that you/your organisation emit directly (e.g. petrol in a work vehicle, burning gas to provide heat or the use of anaesthetic gases).
• Scope 2 are indirect emissions from purchased electricity, steam, heating, and cooling – the emissions that were caused offsite to generate electricity that you use onsite.
• Scope 3 emissions relate to all other indirect emissions that occur in an organisation’s supply chain (e.g. purchased goods, employee and patient commuting, waste disposal, sample transport).

In clinical research trials, scope 3 emissions from the supply chain can be a significant contributor and, in commercial trials, has been estimated at up to five times greater than emissions from scope 1 and 2. This illustrates why it’s so important to work with your suppliers to encourage them to make changes at their end to help reduce the environmental impact of your trial, as well as addressing your own scope 1 and 2 emissions.

It is impossible to achieve perfection but the environmental benefit of small changes can soon add up to significant carbon reductions across a whole trial – whether that’s optimising operational efficiency, choosing lower-carbon products or reducing travel. What’s key is that you integrate sustainability into protocol design and operational planning. That’s where you have the most influence to minimise wasted steps, procedures or travel, and where you have the greatest opportunity to plan for any digital or decentralised approaches.

3. Use more environmentally friendly medical products and procedures

Medical products all have an environmental footprint. While clinical need must always come first, when possible choose materials that have a lower environmental impact. As an example, the carbon footprint of a vial is typically around 25 times greater than that of an equivalent tablet – so where practical to do so, choosing a tablet could considerably reduce the emissions of this aspect of a trial.

Look into options for leasing devices, or buying reconditioned equipment. Where possible, use equipment that is energy efficient. It can reduce the emissions of your trial and save money on operational energy costs at the same time.

Ask your suppliers about the environmental impact of the products and devices they sell. It will encourage them to increase the availability of products that are more environmentally friendly and encourages innovation in product design.

To help make these decisions easier, the Lancet MedZero provides a great platform to access emissions data for a range of products and devices.

When it comes to clinical procedures, not all options have the same environmental impact. An MRI scan uses twice as much energy as a CT scan, 20 times as much as an X-ray and 35 times as much as an ultrasound scan. Again, clinical need must come first, but consider if a lower-carbon imaging option, like an X-ray or ultrasound, could provide the insights you need.

5. Improve the environmental performance of your trial site

There are a range of ways to improve sustainability at trial sites, from the physical infrastructure of the buildings to the way in which patients, staff and students use those buildings and the equipment in them.

Solar panels on roofs, buying energy from renewable sources, better insulated buildings and more energy efficient products can all have a big impact. While you may not be able to directly control changes to the infrastructure, you can request and suggest improvements. It will elevate the issue and help estate managers to make the case for investment in greener facilities.

Take part in behaviour change programmes like the Laboratory Efficiency Assessment Framework (LEAF). Such programmes raise awareness of individual actions amongst staff and student teams, and encourage a sense of competition to help improve environmental performance. Actions include things like sharing equipment and materials between labs, making sure freezer temperatures are not set unnecessarily low, sharing freezer space and ensuring that procedures are in place to switch off equipment when not in use. While these actions are comparatively small, the aim is to encourage lots of teams to adopt these behaviours – so the impact soon adds up.