Climate change threatens global health, yet the healthcare sector itself is a significant contributor to the problem. Operating rooms (ORs) are the most resource-intensive areas within hospitals, consuming substantial energy, generating considerable waste, and emitting volatile anesthetic gases. While the United Arab Emirates (UAE) has committed to achieving Net Zero by 2050, perioperative sustainability strategies remain absent from national healthcare policy-a critical gap in the country's decarbonization efforts. This literature review synthesizes findings from 37 peer-reviewed publications, institutional sustainability reports, and policy documents to examine operating room environmental impacts, waste management practices, global sustainability interventions, and UAE-specific healthcare initiatives. Sources were analyzed to extract data on waste generation, energy consumption, anesthetic gas emissions, international best practices, and regional sustainability programs. Global evidence shows that operating rooms contribute to healthcare emissions through three main pathways: waste generation, energy consumption, and anesthetic gas emissions. Multidisciplinary Green Teams implementing the 5R circular economy framework (Reduce, Reuse, Recycle, Rethink, Research) have successfully reduced environmental impacts while maintaining clinical safety standards. Effective interventions include comprehensive waste segregation programs, transitioning to reusable medical equipment, investing in energy-efficient technologies, and optimizing anesthetic gas delivery systems. While the UAE has made progress in broader sustainability practices, significant gaps exist in OR-specific data and implementation guidelines. Substantial perioperative emission reductions are achievable through systematic implementation of evidence-based interventions. However, this requires comprehensive audits, targeted policy development, and stakeholder engagement to align the UAE's perioperative care with its Net Zero 2050 commitment.
Gadalla et al. (Mon,) studied this question.