**5. HCW and carbon emissions**

It is estimated that in the USA alone, 8–9% of the total annual carbon dioxide emissions (33.34 MT) is contributed by the healthcare industry (HCI) [15, 16]. Just to understand the contribution of HCI in CO2 emission, if we consider that the average value of 5% of total carbon dioxide emission is by HCI the amount of carbon dioxide emission by the top 10 carbon dioxide emitting countries in the year 2020 can be of large quantum as is given in the following **Table 7** [17].

The research shows that three groups of countries i.e. North America (29%), East Asia/Pacific (30%), and Europe/Central Asia regions (19%) contribute about 78% of health care emissions. The remaining 22% of global health care emissions is shared by Latin America (6%), South Asia (2%), and the remaining 14% is shared by


#### **Table 7.** *Top ten countries with CO2 emission rates and contribution of HCS*


#### **Table 8.**

*Impact of environmental pollution on human health [21].*

the combined health sectors of Sub-Saharan Africa, Middle East, and North African countries [18].

If we consider HCI a country, it would be at least the fifth-largest emitter of greenhouse gases on the planet. The HCI's carbon footprint can be the same as the emissions of 514 coal-fired power plants [19].

Studies have reported that greenhouse gas emissions from the health sector in various countries range from 3 to 10% of the national emissions. The energy consumption and other waste generation make it a significant factor in changing climatic conditions due to various pollutions. US Environmental agency has reported that HCW is the third major cause of dioxin pollution and 10% of overall mercury emission. The burning of medical waste such as plastic materials, which are generated from polyvinyl chloride (PVC) products is the major producer of dioxin [20]. The effect of climate change has a multifaceted effect on human health which is summarized in **Table 8**.
