Life Cycle Analysis of the Production of Three Hospital Preparations through an Advanced Pharmaco- Technical Eco-Audit

Introduction and Objective
The environmental impact of pharmaceutical preparations is a crucial indicator for optimizing production methods in hospitals. This study aims to compare the carbon footprint of two sterile hospital pharmaceutical preparations packaged in (i) glass vials (50 mL) and (ii) pouches (250 mL), and (iii) a non-sterile hospital preparation of capsules (size 4).

Materials and Methods
The carbon footprint (CF) of three hospital preparations (batches of 300 units) was calculated as the sum of the carbon emissions (CE) associated with the use of (i) pharmaceutical raw materials (active ingredients, excipients), (ii) single-use materials for packaging or pharmaceutical production, (iii) equipment used in the production processes, whether directly or indirectly involved in the preparation (electricity and water requirements for the washer-disinfector, depyrogenation oven, autoclave) or in maintaining a controlled environment (energy requirements for controlled atmosphere zones, CAZ). The CEs were calculated as follows CE1 = ∑ (masses used × carbon emission factors); CE2 = electrical energy demand (kWh/day) × 0.233 kg CO₂/kWh; CE3 = thermal energy demand (kWh/day) × 0.184 kg CO₂/kWh; CE4 = water demand (L) × 0.2 kg CO₂/L.
CE = CE1 + CE2 + CE3 + CE4.

Results
The analysis showed that the CE1 ( 25 kg CO2) of glass preparations (50 mL) are low compared to the bags ( 55 kg CO2), while the EC2-4 for glass preparations are significant (106 kg CO2) due to the water and thermal treatment of CAZ and vials (CE2: 7 kg CO₂ CAZ + 3 kg CO₂ oven + 3 kg CO₂ washer + 14 kg CO₂ autoclave; CE3: 3 kg CO₂ CAZ; CE4: 76 kg CO₂ corresponding to 380 L), resulting in a total CE for vials CE_vial = 131 kg CO₂ and for pouches CE_pouches = 65 kg CO₂. The CEs for capsule preparation consider CE1 (1 kg CO₂); CE2 (7 kg CO₂); CE3 (3 kg CO₂); CE4 (6 kg CO₂), resulting in a total CE for capsules CE_capsules = 11 kg CO₂.

Discussion and Conclusions
The results indicate that the production of hospital preparations in glass vials present significant CEs due to the energy consumption required for washing, depyrogenation and sterilization of vials. The CE for pouches is two times lower than that for vials. Non-sterile hospital supplies in capsules have the lowest CE. These results highlight the importance of packaging and sterilization methods on the carbon footprint of hospital pharmaceutical preparations. The impact of the number of units per batch on the total CE will be evaluated in future studies.

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