BULLETIN No 13 - MARS 2026

Cette veille scientifique de l’INESSS a comme objectif de nourrir la réflexion sur l’impact environnemental des systèmes de santé et sur les considérations environnementales en évaluation des technologies en santé (ETS). Chaque bulletin présente une sélection de publications, issues des littératures scientifique et grise, organisée en trois axes :

Sources

PubMed, MEDLINE, Embase, CINAHL Complete, HealthcareLCA, GreenFILE, sites Web d’organisations en évaluation des technologies de la santé et d’associations pour la santé environnementale (dernière mise à jour : 2026-02-18).

Intégration des considérations environnementales en ETS

Methods for evaluating environmental sustainability in health technology assessment: Views of stakeholders
Environmental Research Health (mars 2026)

Implications of incorporating environmental sustainability into health technology assessment for digital health technologies
Value in Health (février 2026)

Exploring methods to include carbon emissions into a health technology assessment: The case of remote patient monitoring
Value in Health (décembre 2025)

Image : Cost-effectiveness of remote patient monitoring versus usual care from a societal perspective including environmental impact

Source : Kingma et al. (2025)

Environmental sustainability in diabetes: Improving the quality of diabetes management through HTA and system-level change?
International Journal of Technology Assessment in Health Care (décembre 2025)

Incorporating environmental sustainability into health technology assessment: A qualitative exploration
International Journal of Technology Assessment in Health Care (novembre 2025)

Which factors are holding up the integration of the environmental impact of health technologies in health technology assessment? Insights from a multi-stakeholder interview study
Applied Health Economics and Health Policy (octobre 2025)

Image : Themes emerging from the interviews

Source : Ardito et al. (2025)

Systèmes de santé et de services sociaux

Sous-thématiques

Impact environnemental

Reducing pharmaceutical pollution at the source: Wastewater treatment in hospitals
Health Care Without Harm – Europe (février 2026)

Healthcare experts urge the EU to tackle PFAS pollution
Health Care Without Harm – Europe (février 2026) –  Rapport de la Commission européenne (janvier 2026) : The cost of PFAS pollution for our society

Pharmaceutical pollution from health care: A systems-based strategy for mitigating risks to public and environmental health
The Lancet – Planetary Health (janvier 2026)

Image : Microanalysis of the UK health-care pharmaceutical system

Source : Thornber et al. (2026)

Healthcare waste in German hospitals: A nationwide benchmark study
Waste Management & Research (janvier 2026)

Unused medication: Mapping the impact across the Dutch healthcare system
The Journal of Climate Change and Health (novembre-décembre 2025)

Initiatives en cours à l'international

Strategy 2026-2030: Leading the movement for sustainable healthcare in Europe
Health Care Without Harm – Europe (février 2026)

From data to action: Measuring health system emissions
Alliance for Transformative Action on Climate and Health et collaborateurs (janvier 2026) 💻 Webinaire

PREMIER project: New open database on environmental risk assessment of pharmaceuticals
One Health Breakthrough Partnership (novembre 2025) – PREMIER project

PAS 2090:2025 – Pharmaceutical products. Product category rules for life cycle assessments
British Standards Institution (novembre 2025) – Communiqué de presse : « The world’s first global standard offering a harmonized, practical framework to measure and assess the environmental impact of pharmaceutical products throughout their lifecycle has been published by BSI. »

Québec – Canada

Forum interrégional pour un système de santé durable
Synergie Santé Environnement (2026) : « Cet événement est organisé par Synergie Santé Environnement en collaboration avec la Coalition canadienne pour un système de santé écologique, l’Association québécoise des médecins pour l’environnement (AQME), Agrément Canada et le CHUM. » – Programme du 30 avril 2026 

Pan-Canadian Network: Health system response to climate change
CASCADES (2026) : « We convene health delivery organizations and agencies across Canada to strengthen the health system’s response to climate and planetary health challenges. Through cross-jurisdiction learning and collaboration, the Network helps members share practical approaches, coordinate collective opportunities, accelerate the uptake of evidence-informed actions, and build on existing capacity within their own systems. » – Cadre de référence

Reducing inhaler waste and costs through sustainable interventions
Chest (février 2026)

Image : Systematic changes in inpatient inhaler management in 4 critical areas at the Institut Universitaire de Cardiologie et de Pneumologie de Québec

Source : Laguë et al. (2026)

Coalition launches Nix the Nitrous Resources and National Recognition Program
Canadian Coalition for Green Health Care (janvier 2026) – Boîte à outils sur le protoxyde d'azote  

Développement durable et pharmacie hospitalière : un portrait de la situation québécoise
Annales Pharmaceutiques Françaises (décembre 2025)

Réflexions sur les changements de pratiques

Scoping review to identify data needs and environmental hotspots for future LCA studies: Insights into pharmaceutical excipients and processes
European Journal of Pharmaceutical Sciences (avril 2026)

The Lancet Commission on Sustainable Health Care measurement framework for advancing sustainable health care transformation
The Lancet – Planetary Health (janvier 2026)

Image : The LCSH measurement framework for advancing sustainable health system

Source : Singh et al. (2026)

Leadership and governance approaches to drive environmentally sustainable healthcare in high-income countries: A rapid scoping review
BMJ Leader (décembre 2025)

Priority setting for environmentally sustainable health care: Emerging approaches to fair resource allocation
The Lancet – Planetary Health (décembre 2025)

Environmental Lessons Learned and Applied (ELLA): A new framework for identifying, prioritising and implementing decarbonisation interventions in clinical care pathways
BMJ Evidence-Based Medicine (décembre 2025)

Image : The Environmental Lessons Learned and Applied (ELLA) framework

Source : John et al. (2025)

Decarbonizing the healthcare supply chain strategic actions for health systems
World Health Organization et collaborateurs (décembre 2025)

How green is green? Differentiating within the bioplastics palette
CASCADES et Canadian Coalition for Green Health Care (décembre 2025) 💻 Webinaire

Pharmaceutical waste management
CASCADES (décembre 2025)

Integrating environmental sustainability in clinical counselling: A randomised, double-blind, experimental vignette study in the Netherlands
The Lancet – Planetary Health (novembre 2025)

Réutilisable en santé au Québec : entre recherche et action
CASCADES (septembre 2025) 💻 Webinaire

Applications en contextes cliniques

Sous-thématiques

Milieux de soins et pathologies

Telemedicine and reduction of travel-related environmental impact of digestive clinic care in a Canadian province
Journal of the Canadian Association of Gastroenterology (février 2026)

International environmental impact of CKD Care
Kidney International Reports (février 2026)

Image : International environmental impact of chronic kidney disease care – A life cycle assessment

Source : Barraclough et al. (2026)

Increasing the environmental sustainability of operating rooms in Canada: An evidence-informed guideline for policy
CMAJ (février 2026)

Environmentally friendly pediatric gastroenterology: A narrative review
European Journal of Pediatrics (janvier 2026)

Image : Proposed approach toward a more sustainable pediatric gastroenterology

Source : Borrione et al. (2026)

Assessment of greenhouse gas emission of type 2 diabetes management in adults: A modelling study in the UK
BMJ Open (janvier 2026)

A strategic framework for digital and sustainable transformation in allergy care: An EAACI position paper
Pediatric Allergy and Immunology (janvier 2026)

The carbon footprint of MRI access: A population-based study evaluating excess patient travel and CO2 emissions in Nova Scotia
Canadian Association of Radiologists Journal (janvier 2026)

Environmentally responsible use of hospital infusion systems: A systematic review of the literature
European Journal of Hospital Pharmacy (décembre 2025)

Cutting waste in endoscopy: A multicentre observational study in the German healthcare system
Gut (novembre 2025)

Sustainability in critical care units: An opinion paper from the SFAR (French Society of Anaesthesia and Critical Care) Sustainability and Critical Care committees
Anaesthesia Critical Care & Pain Medicine (novembre 2025)

Médicaments et technologies

Choosing wisely: Comparing the carbon footprint of three respiratory sampling techniques for ventilator-associated pneumonia
Annals of Intensive Care (février 2026)

Towards environmentally sustainable surgery: A comparison of robotic surgery with other approaches
Updates in Surgery (janvier 2026)

Impact des dispositifs médicaux dans l’empreinte carbone d’une unité de chirurgie ambulatoire : état des lieux et perspectives de décarbonation
Annales Pharmaceutiques Françaises (janvier 2026)

Reprocessing of single-use medical devices in cardiology: A systematic literature review of safety and performance characteristics applied to cardiac electrophysiology
EP Europace (janvier 2026)

Exploring environmental sustainability of artificial intelligence in radiology: A scoping review
European Journal of Radiology (janvier 2026)

Green imaging: Scoping review of radiology's environmental impact
Journal of the American College of Radiology (janvier 2026)

Image : What impact does radiology have on the environment?

Source : Woolen et al. (2026)

The climate and health impact of U.S. radiation therapy: Estimating greenhouse gas emissions, DALYs, and potential of hypofractionation
Radiotherapy and Oncology (janvier 2026)

Comparative analysis of the manufacturing carbon footprint of biologics for severe asthma
BMJ Open (janvier 2026)

Quantifying the global eco-footprint of wearable healthcare electronics
Nature (décembre 2025)

The carbon footprints of single-use and reusable medical devices: A systematic review
BMJ Open (décembre 2025)

Ecological footprint of salbutamol administration by metered-dose inhaler versus nebulisation in acute asthma: A life-cycle assessment
JRSM Open (novembre 2025)

Eco-responsible awareness raising interventions to reduce the use of long-acting MDIs and carbon footprint in a University Hospital Center (EARTH)
Annals of Pharmacotherapy (juin 2025)

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