A Process-Based Framework to Calculate the Carbon Footprint of Sterile Processing in Central Sterile Supply Departments

Abstract

Background and Purpose: Central sterile supply departments are essential to surgical and procedural services using reusable medical devices. Their workflows consume energy, water, and packaging materials, continuously generating waste. However, practical frameworks for calculating carbon footprints from routine sterile processing activities and translating them into decision-ready indicators remain limited. This article proposes a process-based framework for calculating the carbon footprint of sterile processing in central sterile supply departments, integrating quality management, occupational safety, and sustainability. Methods: This methodological academic article synthesized relevant evidence and developed a seven-step framework based on process-based carbon accounting and life-cycle thinking. The steps include defining system boundaries and functional units; developing an instrument set database; collecting daily activity data for washer-disinfectors and steam sterilizers; calculating per-cycle emissions from activity data and emission factors; allocating emissions to instrument sets and individual instruments; incorporating sterile barrier systems and waste-management pathways; and linking the results to surgical case-level indicators. Results: The proposed framework establishes per-cycle emissions as an auditable starting point and converts them into per-set, per-instrument, and per-case indicators. These indicators reflect machine capacity utilization, quality-related reprocessing, packaging choices, and waste-management pathways. Quality control points are embedded in each step to support carbon reduction without compromising patient safety, infection prevention, or occupational safety. Conclusions: The framework provides a transparent and repeatable management tool for central sterile supply departments. It can support integrated decision-making on quality, safety, and sustainability, and can serve as a basis for field testing and the development of hospital-specific carbon reference values.