Clinical trials are also carbon intensive and can be made more efficient to reduce the carbon footprint. An audit by The Sustainable Trials Study Group provides insights into how to reduce the carbon intensity of clinical trials.
A significant portion of clinical trials’ emissions are greenhouse gases. The two main sources are air travel and energy use in research facilities. Emissions from buildings would be decreased via the use of renewable energy sources and more efficient energy consumption. Air travel could be decreased by videoconferencing, streamlined trial designs, and decreased red tape.
The London School of Hygiene & Tropical Medicine organised the Sustainable Trials Study Group to investigate methods of lowering greenhouse gas emissions from clinical trials. This international Centre for Health Research offers a robust research agenda on the connections between the environment and health. To lessen the institution’s carbon footprint, a sustainability group was formed, and this report is the result of their efforts.
The CRASH trial case study
Together with the Edinburgh Centre for Carbon Management, the research team performed a carbon audit of the Medical Research Council’s (MRC) CRASH trial. The CRASH trial is a multicentre, multinational study that looked at how corticosteroids affected 10,008 persons who had suffered head injuries in terms of death and disability. Patients were enrolled in the trial over a five-year period (1999-2004), with the help of the London School of Hygiene & Tropical Medicine, and they came from 49 different countries. The medicine was produced in the United States by Pfizer, while the placebo was created in France. In Wales, medication and a placebo were packed. To be distributed to hospitals worldwide, treatment kits were delivered to London.
For the 12-month period (August 2003 to July 2004), emissions were estimated. We gathered information on operational operations in accordance with the World Business Council for Sustainable Development’s protocol for reporting greenhouse gas emissions.
We calculated the fuel used for all transportation—including site visits, data audits, and staff commuting—delivery—of drugs and placebo to the packaging company, treatment packs and trial materials to hospitals, and waste disposal. We also calculated the fuel used off-site to generate the electricity used by the trial coordinating centre. The energy used to create the trial materials and treatments was not included.
The total emission of greenhouse gases related to the trial was 126 tonnes
The trial’s overall greenhouse gas emissions during the year-long audit period totalled 126 tonnes (in carbon dioxide equivalents). According to estimates of global per capita production, this is comparable to 32 persons producing it in a year, or six individuals producing it in the US. The entire trial produced around 630 tonnes of carbon dioxide equivalents if the audit year is indicative. This translates to approximately 525 round-trip flights for one person from London to New York. The recruitment of 10 008 patients resulted in 1945 primary end-point events and 63 kg of greenhouse gas emissions per participant or 324 kg per primary end-point event.
The highest portion of emissions—39%, or 50 tonnes—came from the coordination centre, followed by the distribution of pharmaceuticals and paperwork (28%, or 35 tonnes), and transport (23%, or 29 tonnes). The usage of energy accounted for just over 45 of the 50 tonnes of carbon dioxide equivalent emissions linked to the coordination centre, with the remaining emissions coming from the disposal of office trash.
It was fascinating to note that hotel stays and air travel for site visits, on-site data verification, and meetings with partners accounted for the majority (94%) of the emissions associated with travel. Even though just 22% of air travel mileage was short haul, it accounted for 31% of emissions since it emits more greenhouse gases than long-range travel. The air freight of medication kits and paperwork to hospitals was responsible for the majority (97%) of emissions from the distribution of pharmaceuticals and documentation.
Clinical trials are energy-intensive and produce substantial greenhouse gas emissions
Clinical studies utilise a lot of energy and emit a lot of greenhouse gases. When compared to other service sectors, which average about 4-6 tonnes per employee per year, the figure of 14 tonnes per employee per year is excessive.
How to reduce the carbon footprint of clinical trials
- Saving electricity
Even though this was an international trial, the trial coordination centre’s usage of electricity was the main contributor to emissions. By installing on-site renewable energy sources or purchasing power from renewable energy firms, organizations might reduce such emissions to zero. Additionally, by installing voltage optimization devices to the incoming electricity supply, which reduce power consumption by about 10%, as well as by using energy-efficient lighting, such as low-energy light bulbs with motion sensors and light-sensitive dimming as well as timers to turn off appliances at night, reductions may be made.
- Making trials simpler and more efficient
By using fewer workers, experiments could consume less energy. It would be beneficial to reduce bureaucracy and use straightforward designs without pointless data collection. Many trialists have emphasised how the bureaucracy involved with applications to ethical committees and other regulatory authorities significantly increases the carbon footprint of trials. Although the energy consumption of such systems must be considered, electronic remote data collection may result in lower workforce numbers.
The necessity for on-site data verification and trial-related travel can both be decreased by using straightforward designs with statistical checks for data abnormalities. Building local trial experts and may be more energy efficient than bringing in outside experts, and conducting trials inside networks of trialists may result in less training being required. Travel could be cut by setting up the teleconferencing and videoconferencing infrastructure.
- Raising awareness and commitment
For long-lasting change, funding agencies and research institutions must remain dedicated. Additionally, it may lead to more pragmatic trial designs, better research topic selection, and a higher possibility that studies will yield crucial findings for global health.