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To identify the main environmental hotspots of cataract surgery and evaluates strategies to reduce its environmental impact and to compare process-based and monetary value-based methodologies for environmental assessment. Radboud University Medical Center, Nijmegen, the Netherlands. Cradle-to-grave life cycle assessment (LCA) following ISO 14040/44 guidelines. The environmental impact of phacoemulsification cataract surgery was assessed, including all processes, products, and equipment used in the operating room. Key contributors to human health and ecosystem damage were identified. A monetary value-based analysis was performed using the same inventory data to compare methodological approaches. Disposables (35%) and patient travel (31%) were the largest contributors to the environmental impact. Immediate sequential bilateral cataract surgery (ISBCS) reduced the impact by 19%, and simplifying surgical kits achieved a 10% reduction. Additional reductions were observed with renewable energy (-12%) and sustainable transportation (-8%). The monetary value-based approach yielded a fourfold higher carbon footprint than the process-based LCA, while identifying similar hotspots. The main environmental hotspots of cataract surgery were patient travel and disposable products. The most effective mitigation strategy to reduce the carbon footprint is implementing ISBCS. Additional mitigation strategies include reducing the use of disposable products, encouraging sustainable travel options, and switching to renewable energy. These findings highlight opportunities for ophthalmologists to contribute to more sustainable surgical care.

Life cycle impact assessment (LCIA) is a lively field of research, and data and models are continuously improved in terms of impact pathways covered, reliability, and spatial detail. However, many of these advancements are scattered throughout the scientific literature, making it difficult for practitioners to apply the new models. Here, we present the LC-IMPACT method that provides characterization factors at the damage level for 11 impact categories related to three areas of protection (human health, ecosystem quality, natural resources). Human health damage is quantified as disability adjusted life years, damage to ecosystem quality as global species extinction equivalents (based on potentially disappeared fraction of species), and damage to mineral resources as kilogram of extra ore extracted. Seven of the impact categories include spatial differentiation at various levels of spatial scale. The influence of value choices related to the time horizon and the level of scientific evidence of the impacts considered is quantified with four distinct sets of characterization factors. We demonstrate the applicability of the proposed method with an illustrative life cycle assessment example of different fuel options in Europe (petrol or biofuel). Differences between generic and regionalized impacts vary up to two orders of magnitude for some of the selected impact categories, highlighting the importance of spatial detail in LCIA. This article met the requirements for a gold – gold JIE data openness badge described at http://jie.click/badges.

In this chapter we explore the need and opportunities to make the life cycle assessment (LCA) team more relevant for the business. Sustainability trends and alternatives for LCA are analyzed to identify what makes them relevant for and appealing to business managers, the difficulties LCA practitioners face to get their message across have been identified, and a five-step approach to make the LCA team a business partner will be described. The goal is to empower LCA teams and practitioners to create sustainable value for the business they work in.

Medical-product development has become increasingly challenging and resource-intensive. In 2004, the Food and Drug Administration (FDA) described critical challenges facing medical-product development by establishing the critical path initiative [1]. Priorities identified included the need for improved modeling and simulation tools, further emphasized in FDA's 2011 Strategic Plan for Regulatory Science [Appendix]. In an effort to support and advance model-informed medical-product development (MIMPD), the Critical Path Institute (C-Path) [www.c-path.org], FDA, and International Society of Pharmacometrics [www.go-isop.org] co-sponsored a workshop in Washington, D.C. on September 26, 2013, to examine integrated approaches to developing and applying model- MIMPD. The workshop brought together an international group of scientists from industry, academia, FDA, and the European Medicines Agency to discuss MIMPD strategies and their applications. A commentary on the proceedings of that workshop is presented here.

Purpose In life cycle impact assessment, various proposals have been made on how to characterise fossil resource scarcity, but they lack appropriateness or completeness. In this paper, we propose a method to assess fossil resource scarcity based on surplus cost, which is the global future cost increase due to marginal fossil resource used in the life cycle of products.

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Abstract The geometry and depositional history of the Maassluis Formation is described from an East-West oriented transect located in the west-central Netherlands and P- and Q-blocks in the Dutch offshore area. The Late Pliocene to Early Pleistocene Maassluis Formation was deposited under near coastal marine conditions. Two distinct facies are distinguished: (1) medium grained sands with a blocky GR/SP-log pattern that were deposited under intertidal and aeolian conditions and (2) medium to coarse grained sands deposited in a subtidal environment showing a clear coarsening upward trend. The lower part of the Maassluis Formation is laterally equivalent to the shallow marine Oosterhout Formation and gets progressively younger towards the West. The upper part is lateral equivalent to estuarine and mudflat deposits (Balk Member, c.q. Peize Formation) in the central part of The Netherlands and to river deposits (Peize Formation) further to the East.