Estimating the Carbon Emissions of a Single Prostate-specific Antigen Test: Results from a Cradle-to-grave Life Cycle Assessment.

[BACKGROUND AND OBJECTIVE] The health care sector is a significant contributor to greenhouse gas (GHG) emissions, and assessments of the environmental impacts of health services are essential. We aimed to evaluate the environmental impact of a highly common but controversial urology-specific blood test: the prostate-specific antigen (PSA) test.

[METHODS] A cradle-to-grave life cycle assessment was performed to estimate the emissions of a single PSA test. Primary data collection included laboratory site assessment, disassembly, and weighing of materials. The primary outcome was GHG emissions in grams of carbon dioxide equivalent (COe). The secondary outcome was the health impact attributed to the environmental harm of the test.

[KEY FINDINGS AND LIMITATIONS] A single PSA test generates an estimated total of 189.7 g of COe. The majority of emissions (88.2%) were generated by the raw materials, manufacturing, production, and disposal of the blood draw equipment. Annual COe emissions from PSA testing in the USA were estimated at 5 691 000 kg COe, equivalent to driving 14.5 million miles, with a resulting human health impact of 6.6 disability-adjusted life years annually. This study focused on the PSA test itself, and not on emissions from staff, patient, or sample transportation; building infrastructure; or cleaning.

[CONCLUSIONS AND CLINICAL IMPLICATIONS] Although the carbon footprint of a single PSA test is small, the cumulative impact of the estimated total of 30 million PSA tests performed annually in the USA is substantial, especially when considering that a notable proportion of these tests may be performed on men who are unlikely to benefit.