Evaluating the Environmental Impact of Clinical Research: A Full Life Cycle Analysis of a French Academic Randomised Clinical Trial

Climate change poses the greatest threat to human health in the 21st century. The healthcare sector contributes approximately 5% of global greenhouse gas emissions and has a significant environmental impact. Although clinical trials are crucial for identifying effective and safe treatments and preventing disease, their environmental impact is poorly documented. Our study aimed to assess the environmental impact of a publicly funded, academic clinical trial by adapting life cycle assessment (LCA) methodology to clinical research. We performed a retrospective, simplified, full LCA using the EF 3.0 methodology on a prospective, double-blind, randomised controlled neurosurgery trial. The trial included 202 patients at 18 university hospitals throughout France. To identify hotspots of interest, 16 impact indicators and their combination into a single score were evaluated. The results showed that climate change (or greenhouse gas emissions) was the most important indicator, accounting for almost 30% of the single score. Greenhouse gas emissions were estimated at 31.6 t of carbon dioxide equivalent. The next most important were resource use of fossils (24%), resource use of minerals and metals (12%), and particulate matter emissions (8%). The main hotspots identified were patient transport and travel by clinical research assistants for source data verification. In conclusion, by using a full LCA approach, our study confirms that conducting a clinical trial has a substantial environmental impact, particularly with regard to greenhouse gas emissions. The main hotspots identified were related to patient transport and clinical research assistants' travel. Trial Registration: The SUCRE study (Treatment of Chronic Subdural Hematoma by Corticosteroids: A Prospective Randomised Study)-clinicaltrials.gov identifier: NCT02650609.