In reply: We thank Yen, Badrick and Dray et al for their comments on our research. There are a number of points that we would like to elaborate on. We apologise if we gave the impression that pathology organisations are environmentally unaware. Inherent in our statement that there are limited opportunities for reuse and recycling was recognition that pathology organisations are already implementing procedures to reduce environmental waste.1
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- 1. McAlister S, Barratt AL, Bell KJ, McGain F. The carbon footprint of pathology testing. Med J Aust 2020; 212: 377–382. https://www.mja.com.au/journal/2020/212/8/carbon-footprint-pathology-testing
- 2. Malik A, Lenzen M, McAlister S, McGain F. The carbon footprint of Australian health care. Lancet Planet Health 2018; 2: 27–35.
- 3. Tennison I. Indicative carbon emissions per unit of healthcare activity [briefing No. 23]. Cambridge: Eastern Region Public Health Observatory, NHS Sustainable Development Unit; 2010. https://www.sduhealth.org.uk/documents/publications/Bed_Days1.pdf (viewed June 2020)
- 4. O'Sullivan JW, Stevens S, Hobbs FDR, et al. Temporal trends in use of tests in UK primary care, 2000–15: retrospective analysis of 250 million tests. BMJ 2018; 363: k4666.
- 5. O'Sullivan JW, Albasri A, Nicholson BD, et al. Overtesting and undertesting in primary care: a systematic review and meta‐analysis. BMJ Open 2018; 8: e018557.
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