The environmental impact of pediatric celiac disease diagnosis and follow‐up

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ABSTRACT Objectives To evaluate carbon dioxide (CO2) footprint of celiac disease (CeD) diagnostic guidelines and follow‐up practices for children/adolescents. Methods Two‐hundred and thirty‐six patients diagnosed and followed up for CeD in Umbria region during 2020–2023 were included in this retrospective study. Patients were divided in two groups: Group 1 included patients diagnosed by duodenal biopsies (total: 43), while Group 2 included no‐biopsy patients (total: 193). Transport emissions of CO2 per kilometer traveled by a diesel car was estimated as 171 g/km. CO2 cost was estimated as 22 kg for each anesthesia and as 5.4 kg for each upper GI endoscopy. Results The median CO2 cost/patient/year in Group 1 was 397.9 kg, while the median CO2 cost/patient/year in Group 2 was 57.2 kg (p < 0.001). As regards the follow‐up of these children, we estimated a median CO2 amount of 39.3 kg produced per year by car emission and there was no difference between the two groups (Group 1 40.5 kg vs. Group 2 38.1 kg; p:ns). Conclusions The no‐biopsy approach for the CeD diagnosis strongly decreases the CO2 emissions. Whether implementing telemedicine, handing over to primary care or reducing outpatient consultations for follow‐up will be feasible and environmentally more sustainable should be evaluated.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.