Life Cycle Assessment (LCA) and climate accounting tools are currently proliferating in the healthcare area, driven by a strong desire of the sector to decarbonise. We argue that such fast development risks repeating or missing previous learnings from the LCA community and other sectors. Here, we used two case studies on sterilization packaging and surgical equipment, to compare attributional (ALCA) and consequential (CLCA) approaches and examine their relevance for product comparison and in procurement decision making. Consistent with previous studies, environmental outcomes were strongly determined by product lifetime, background energy systems, and material sourcing. However, we find that current reliance on attributional assessments may underestimate the longer-term benefits of reusables, or multi-use products. Attributional LCA can favour single-use options under current energy conditions, while consequential LCA, reflecting future decarbonization in Europe, highlighted benefits of reusables. The work also showed that sole reliance on carbon footprint as indicator risks burden shifting to other impact areas. We recommend that for procurement and policy applications, consequential or prospective scenario-based assessments should complement attributional studies to account for evolving energy and material systems. Considering the study scope, limited to environmental assessment, we emphasize that integrating LCA with circular design frameworks and operational/use considerations is essential to support credible, risk-aware sustainability decisions in the healthcare sector.
Eriksen et al. (Sun,) studied this question.
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