Revisiting the Environmental Impact of Inappropriate Clinical Laboratory Testing: A Comprehensive Overview of Sustainability, Economic, and Quality of Care Outcomes

• Published in: The journal of applied laboratory medicine 2025-01, Vol.10 (1), p.113-129
• Main Authors: Devis, Luigi, Closset, Mélanie, Degosserie, Jonathan, Lessire, Sarah, Modrie, Pauline, Gruson, Damien, Favaloro, Emmanuel J, Lippi, Giuseppe, Mullier, François, Catry, Emilie
• Format: Article
• Language: English
• Subjects: Clinical Laboratory Techniques - economics; Clinical Laboratory Techniques - standards; Cost-Benefit Analysis; Environment; Humans; Laboratories, Clinical; Patient Safety; Quality of Health Care - economics; Unnecessary Procedures - economics; Unnecessary Procedures - statistics & numerical data
• ISSN: 2576-9456; 2475-7241; 2475-7241
• DOI: 10.1093/jalm/jfae087

The use of laboratory resources has seen a substantial increase in recent years, driven by automation and emerging technologies. However, inappropriate use of laboratory testing, encompassing both overuse and underuse, poses significant challenges. This review explores the complex interplay between patient safety, economic, and environmental factors-known as the "triple bottom line" or "3Ps" for people, profit, and planet-associated with inappropriate use of laboratory resources. The first part of the review outlines the impact of inappropriate laboratory testing on patient safety and economic outcomes. Then the review examines the available literature on the environmental impact of laboratory activities. Several practical solutions for mitigating the environmental impact of laboratories are discussed. Finally, this review emphasizes how decreasing unnecessary laboratory testing results in cost savings and environmental benefits, as evidenced by interventional studies, without compromising patient safety. The implementation of sustainable practices in laboratories can create a virtuous circle in which reduced testing enhances cost-efficiency, reduces the environmental footprint, and ensures patient safety, thereby benefiting the 3Ps. This review highlights the critical need for appropriate laboratory resource utilization in achieving sustainability in healthcare.