Climate change is killing Americans in surprising ways, and the waste created by health care itself is part of the problem, according to a report in one of the world’s most prestigious medical journals.

The report, published this week in the British medical journal The Lancet, is part of a global study looking at how climate change is affecting the world’s health.

Climate change has created a health crisis that continues to worsen, one that threatens to undermine the past 50 years of public health gains, it says.

Lancet Countdown Report on Health and Climate Change has been issued every year since 2016. This year’s report calls on the nations of the world and the United States to rapidly reduce the amount of fossil fuels burned while increasing the transition to clean energy.

The health damage created by climate change stacks up to “the same order of magnitude as the damage associated with medical errors,” said Jonathan Buonocore, a professor in the Department of Environmental Health at Boston University’s School of Public Health and one of the authors the work.

(Preventable medical errors kill 250,000 Americans each yearaccording to a study by researchers at the Johns Hopkins University School of Medicine.)

Climate change affects the health of Americans in several ways. The report cites air pollution related to fossil fuelstropical cyclones exacerbated by climate change, links of heat waves to preterm births and the future effects of climate change.

On the bright side, U.S. adoption of wind and solar power has led to about 1,200 to 1,600 fewer premature deaths in the US in 2022 due to better air quality.

Health care waste is part of the problem, researchers say

The report highlights the link between the health care sector and climate change, with 8.5% of US greenhouse gas emissions coming from industry. The researchers note that there is no national program requiring them to measure, manage or disclose their data.

The number includes not only the energy used by hospitals and clinics, but also the huge amounts of medical waste, often single-use plastic devices, that are thrown away every day, Buonocore said.

All single-use plastic is designed to keep hospitals and operating rooms sterile, but researchers say there are ways to reduce waste without putting patients at risk.

Heating and cooling costs are also an issue. Operating room HVAC systems run 24/7, whether or not a patient is in them, said Dr. Shaneeta Johnson, professor of surgery at Morehouse School of Medicine in Atlanta, Georgia.

Operating rooms create a lot of waste

Operating rooms contribute to this in ways patients don’t think about, Johnson said.

“The operating room is responsible for about 30 percent of medical waste in the United States,” she said. These include disposable instruments, plastic drapes, syringes, tubing, bandages, and anything that could be contaminated with body fluids. The disposal of medical waste is regulated and in many cases it must be cremated.

One thing that hospitals have been working on is creating what are known as “lean” surgical trays, meaning only sterilizing and putting the instruments on the surgical trays that the surgeon might need, rather than anything they might could want. This is done by working with surgeons so that they can select the tools they actually use, discarding those that are not needed.

“There are significant opportunities to ’tilt’ surgical trays so that we don’t autoclave as many instruments as possible,” Johnson said. Studies show that such efforts can reduce a healthcare facility’s carbon footprint.

An autoclave is a machine that exposes surgical materials to hot, pressurized steam to sterilize them.

“We need to work harder to reduce waste. Both physical waste and wasted resources from overdiagnosis and overtreatment. All of this would save the country a lot of money and dramatically reduce the carbon footprint of our industry,” said Dr. Vivian Lee, author of the book, “The long fix“, and an Executive Fellow at Harvard Business School, who wrote on the topic.

She points out that for every patient in a hospital, over 30 kilograms of waste is produced per day in the US, largely due to the rise of single-use consumables. Some of the waste is for procedures that are essentially unnecessary. “Many professional societies have drawn up long lists of unnecessary treatments, such as antibiotics for the common cold or x-rays for back pain. All of these waste resources, lead to an excess carbon footprint and very rarely help patients,” said Lee.

This article originally appeared on USA TODAY: The report raises the alarm about the deadly health effects of climate change