Mitigating the environmental effects of healthcare: the role of the endocrinologist

Healthcare provision holds unintended consequences for planetary health, upon which human health depends. Emissions from the healthcare sector to the environment include greenhouse gases, air pollution, and plastic pollution, alongside chemical contamination. Chemical pollution resulting in endocrine disruption has been associated with plastics- a source of concerning additives such as phthalates, bisphenols, per- and polyfluoroalkyl substances, and flame retardants, all of which are routinely found within healthcare products. Many endocrine disrupting chemicals are persistent and ubiquitous in the environment (including water and food sources), with potential secondary harms for human health, including disrupting reproductive, metabolic, and thyroid function. Here we review evidence-based strategies for mitigating environmental impacts of healthcare delivery, focusing on what endocrinologists can do, including reducing demand for healthcare services through better preventative health and addressing low-value care, and improving sustainability of medical equipment and pharmaceuticals through adopting circular economy principles (including reduce, reuse, and as a last resort- recycle). The specific issue of endocrine disrupting chemicals may be mitigated through responsible disposal and processing, alongside advocating for use of alternative materials and replacing additive chemicals with lower toxicity, and tighter regulations. We must work to urgently transition to sustainable models of care provision, minimizing negative impacts on human and planetary health.