Environmental sustainability, veterinary professionals and mental well-being

There is no reasonable doubt that our planet is facing and experiencing catastrophic environmental crises. Costello et al (2009) stated that climate change is the greatest threat to global human health. This crisis has been created by higher income countries and yet less affluent countries are impacted the most. It is imperative that we make changes for environmental sustainability, in all aspects of our lives, and that we make these changes now.

We have a moral responsibility as individuals, and as a profession, for the planet and all those that inhabit it. We must be good ancestors and consider the impact of our day-to-day activities upon future generations. Businesses not only have a social, environmental and moral responsibility to embrace sustainability practises: it is also essential for business resilience and provision of outstanding veterinary care into the future.

Mental wellbeing in the veterinary community importantly receives attention. As professionals, we have a great burden to deal with already, especially with the pandemic, and fully opening our eyes to the environmental crises may seem like too much to bear. However, awareness and engagement with the sustainability agenda, affords many benefits, including supporting team members already expressing concern. It is well documented that businesses with good environmental credentials have improved recruitment, wellbeing and retention of team members, in addition to being desirable to clients (Deluty et al., 2021). These are yet further reasons why your management team, or you as a manager, should be receptive to sustainability initiatives.

Eco-anxiety

Eco-anxiety is a chronic fear of environmental and ecological disaster. It is not irrational and must not be denounced, in particular when contemplating the recent and ongoing environmental disasters faced globally, and in particular in the Global South. The counsellor or friend who offers just reassurance to the person affected with anxiety about the environmental crises does nothing to allay their worries, in fact it may heighten them. But what can we do? It is important to focus this energy on doing something positive and engaging with the issues we face: making changes in your day-today life and work, connecting with like-minded people and aligning your life and work with your values (Ro, 2018).

Sustainability and health care

The veterinary team have a unique perspective of animal, human and environmental health and it is not surprising that vets are personally engaged with environmental matters. A BVA (2019) survey documented that 89% of Veterinary professionals wanted to embrace sustainability in the profession. Whilst this is the general feeling of the profession, it is uncomfortable to recognise that our daily clinical activities have a high environmental impact. Healthcare without harm, an environmental charity, states that if healthcare were a country, it would be the fifth largest carbon emitter in the world. Healthcare is energy intensive, produces high carbon emissions from procurement and generates high volumes of waste. For the sustainably minded member of the veterinary team, there can be a cognitive dissonance experienced due to the mismatch between, for example, efforts to be plastic-free at home and the number of single use items utilised in the clinic. Cognitive dissonance is the mental discomfort from holding two different beliefs, values or attitudes, in this instance adopting different attitudes in different environments.

We of course have the responsibility and desire to maintain outstanding levels of patient care. Are there other approaches that we could use that achieve the same result for our patient and yet have less of an environmental impact? Single-use items are utilised due to a combination of infection control measures, convenience and lower cost. Whilst the use of plastics in modern healthcare has been revolutionary, we must avoid the “illusion of quality improvement” from the use of a disposable item (Naumann et al., 2020). An example of this phenomenon is exemplified by an NHS campaign regarding the use of non-sterile gloves. In 2018, Great Ormond Street ran a “gloves off campaign” to address inappropriate over-use of non-sterile gloves (Leonard et al, 2019). It had been recognised in hand hygiene audits that over wearing of non-sterile gloves was preventing adherence to regular hand-hygiene practices (Lindberg et al., 2020). A campaign was run to re-educate teams regarding appropriate non-sterile glove wearing and re-emphasise key-points for handwashing. The campaign appeared very effective: in the “year after the campaign, Great Ormond Street Hospital ordered 3.7 million fewer gloves compared to the year before, saving over £90,000 and avoiding the use of 18 tonnes of plastic. Plus, staff reported hand dermatitis less frequently” (Dunn H, 2019). The campaign was motivated by concerns regarding infection control (Lindberg et al., 2020), but had additional benefits by reducing use of consumables, therefore affording financial and environmental benefits. It is important that we consider the evidence base for consumables we use.

"A BVA (2019) survey documented that 89% of Veterinary professionals wanted to embrace sustainability in the profession. Whilst this is the general feeling of the profession, it is uncomfortable to recognise that our daily clinical activities have a high environmental impact."

The human medical sector has been looking at environmental sustainability in healthcare for some time and there is now a growing number of resources in the veterinary medical sector too. Vet Sustain, together with BVA, BVNA and SPVS launched the Greener Veterinary Practice checklist in 2021 and there is a wealth of resources on the Davies Veterinary Specialists website. If you want to become more sustainable in your clinic, then chat with your colleagues, it is likely that others share your passions too. Appreciating nature, and spending time in nature, also improves our wellbeing and awareness of how wonderful the natural world is. Connecting with others and coming together, locally and globally, restores a sense of community. There is a positive low-carbon future to look forward to, we just need to make changes now and support each other to do so.

References

BVA, (2019), Vets are central to the sustainability agenda, says BVA, online https://www.bva.co.uk/news-and-blog/news-article/vetsare-central-to-the-sustainability-agenda-says-bva/

Costello, A., Abbas., M, Allen, A. et al., (2009), Managing the health effects of climate change, The Lancet Commissions, 373: 1693-1733.

Deluty, S. B., Scott, D. M., Waugh, S. C., Martin, V. K., McCaw, K. A., Rupert, J. R., Webb, T. L., Baumgarn, S. A., Carpenter, M. J. and Duncan, C. G. (2021) 'Client Choice May Provide an Economic Incentive for Veterinary Practices to Invest in Sustainable Infrastructure and Climate Change Education', Frontiers in Veterinary Science, 7

Health Care Without Harm, (2019), Health Care climate footprint report, https://noharm-europe.org/content/global/health-careclimate-footprint-report

Leonard, A., Wilson, N. and Dunn, H. (2019) '6 The gloves are off; safer in our hands. Changing glove use at an acute children’s trust', Archives of Disease in Childhood, 104(Suppl 4), pp. A2

Lindberg, M., Skytt, B. and Lindberg, M. (2020) 'Continued wearing of gloves: a risk behaviour in patient care', Infection Prevention in Practice, 2(4), pp. 100091.

Naumann, D. N., Marsden, M. E. R., Brandt, M. L. and Bowley, D. M. (2020) 'The Bouffant Hat Debate and the Illusion of Quality Improvement', Ann Surg, 271(4), pp. 635-636.

Ro, C. (2018), How to cure the ecoanxious, welcome collection,