Portland-based anesthesiologist Dr. Brian B. Chesebro didn’t realize he would spark an industry revolution with his discovery. In his line of work, he uses various gases for pain management, the primary ones being sevoflurane and desflurane.
The two gases can be used together or interchangeably, since they are similar in application and effect. Either way, only about five percent of sevoflurane and desflurane get metabolized by the patient during an operation. The other 95 percent is emitted into the atmosphere from the hospital’s ventilation system.
Dr. Chesebro decided to do some digging and found that desflurane is much worse for the environment than sevoflurane—as in, twenty times worse. Not only is desflurane a more potent greenhouse gas, it’s also far more persistent in the atmosphere with a lifespan of 14 years, whereas sevoflurane lasts only one year.
After executing computational analyses of the greenhouse gas footprint in his field, Dr. Chesebro presented his research to his colleagues, explaining to one Dr. Michael Hartmeyer of the Oregon Anesthesiology Group and Providence Medical Center that his individual use of desflurane was “the greenhouse gas equivalent of driving a fleet of 12 Hummers.”
Word spread quickly, prompting all eight Providence hospitals in Oregon to make the switch to sevoflurane. An unexpected perk of this change was Providence saving approximately half a million dollars a year across its locations.
The millions that will be saved in healthcare costs over time certainly doesn’t hurt. But what makes this new trend so pertinent is that it’s the first major reform we’ve seen in the industry that directly combats climate change, which as the World Health Organization deemed, is the number one threat to global health of the 21st century.
Of course, in comparison to petroleum and other fossil fuel emissions, desflurane isn’t a main contributor to climate change. As gas manufacturer Baxter Global pointed out, inhaled anesthetics like desflurane “have a climate impact of .01 percent of fossil fuels.”
Dr. Chesebro understands these criticisms but maintains his stance:
Desflurane is not a major player in climate change. That argument holds a lot of weight with a lot of people. My counter-argument is, ‘Well, if it’s there, it’s bad. And if I can reduce my life’s footprint by a factor of six…why wouldn’t you do it?
Another Major Global Health Threat Spreads
Climate change was only one of many phenomena that made it on WHO’s list of the greatest threats to global health. Other entries on their list included antimicrobial resistance, noncommunicable diseases like diabetes and cancer, as well as vaccine hesitancy, which WHO defines as “the reluctance or refusal to vaccinate despite the availability of vaccines.”
Vaccine hesitancy has been a particularly insidious threat, as we are seeing a resurgence of diseases that were once nearly eliminated, case in point being the ongoing measles crisis. In the Pacific Northwest of the U.S., there have been 65 reported cases of the measles in Washington, which forced the governor to declare a state of emergency, and four cases in our home state of Oregon.
We’ve also seen a 30 percent increase in cases around the world. In 2017, there were 110,000 people who died of measles worldwide. This year, the epidemic has killed over 900 people in Madagascar alone. Even a five-year-old tourist can inflict a plague if not vaccinated.
With increasing populations and globalization, the world has become a much smaller place, which means disease will spread further and faster than ever.That’s why providers must implore their patients to get themselves and their children vaccinated.
This isn’t a matter of personal politics and beliefs—but a matter of life and death.
