Environmental Sustainability of Clinical Laboratories: A Scoping Review

Abstract

Introduction: Climate crisis presents a complex and growing challenge for healthcare systems, contributing to substantial global emissions. The NHS is responsible for 4–5% of the country’s total carbon footprint. Many disciplines are assessing and designing interventions to tackle this issue, however clinical laboratories remain underexplored. Methods: Using multi-database searches, all primary studies assessing environmental outcomes of laboratories were included, screened and data extracted based upon publication year, geography, interconnectivity and area and type of laboratory or test. Findings: There has been longstanding interest in the environmental impact of laboratories, gaining popularity in the last decade. There is a limited number of intervention studies aimed at improving sustainability. Most research originates from the USA, UK and Australia. There is limited interconnectivity of studies included in this review. Studies have primarily been conducted at laboratory level, focusing on quantifying waste in kilograms, measuring carbon dioxide equivalent emissions, and categorising by type and to a lesser degree assessed for specific clinical tests. Across both laboratory and specific test assessments there is notable heterogeneity in methods used and areas explored. Discussion: This review highlights a growing interest and awareness in this important field, the diversity of reported outcomes and the limited interconnectivity of studies suggest it remains a developing area. Lack of consensus in methodologies and outcome measures suggests that establishing a baseline analysis remains a distant goal. Ideally, future efforts should prioritize improving the assessment of individual tests, fostering greater standardization, and enhancing repeatability to strengthen the reliability of environmental impact evaluations.