Economic and environmental benefits of greening a Mohs surgery clinic: A comprehensive intervention and analysis.

Abstract

Cutaneous cancer represents the most common worldwide malignancy and Mohs micrographic surgery (MMS) is performed more than 876,000 times/year in the United States. A more complete understanding of downstream (waste and electrical) greenhouse gas (GHG) emissions from MMS is needed. To determine the waste produced, electricity used, and downstream GHG emissions emitted by MMS and to implement interventions that reduce these. The carbon footprint of an academic Mohs surgery clinic was quantified and interventions were implemented to reduce it. The clinic's electrical consumption and wastes sorted by type were measured before and after the interventions and converted to GHG emissions. The preintervention and postintervention downstream GHG emissions were 319.58 and 271.65 t per year, respectively, decreasing by 15%. Waste decreased by 33% from 2.97 t to 1.99 t per year, with a shift away from regulated toward unregulated and recyclable waste. Preintervention, electricity usage accounted for 5% of downstream GHG emissions, whereas waste production accounted for the remaining 95%. Electrical consumption decreased by 71% from 39,012 to 11,228 kWh/year, yielding a cost saving of $2706 per year. Limitations include parameters of the M + WasteCare calculator. There are many opportunities for optimizing MMS to conserve resources.