Environmental Sustainability in the Orthopaedic Operating Room.

Hotter global temperatures and increasingly variable climate patterns negatively affect human health, with a wide recognition that climate change is a major global health threat. Human activities, including those conducted in the orthopaedic operating room (OR), contribute to climate change by generating greenhouse gases that trap infrared radiation from the earth's surface. This review provides an overview of the environmental effect of the orthopaedic OR and efforts to address environmental sustainability in the OR. These concepts are presented with a particular focus on patient safety and cost savings because roll-out of these efforts must be conducted with a pragmatic and patient-centered focus. Orthopaedic surgeons have an opportunity to lead efforts to improve environmental sustainability in the OR and thus contribute to efforts to curb climate change.

Active transportation and cardiovascular disease risk factors in U.S. adults.

BACKGROUND: Evidence of associations between active transportation (walking and bicycling for transportation) and health outcomes is limited. Better understanding of this relationship would inform efforts to increase physical activity by promoting active transportation. PURPOSE: This study examined associations between active transportation and cardiovascular disease risk factors in U.S. adults. METHODS: Using the 2007-2008 and 2009-2010 cycles of the National Health and Nutrition Examination Survey (NHANES), adults (N=9933) were classified by level of active transportation. Multivariable linear and logistic regression analyses controlled for sociodemographic characteristics, smoking status, and minutes/week of non-active transportation physical activity. Analyses were conducted in 2011. RESULTS: Overall, 76% reported no active transportation. Compared with no active transportation, mean BMI was lower among individuals with low (-0.9, 95% CI= -1.4, -0.5) and high (-1.2, 95% CI= -1.7, -0.8) levels of active transportation. Mean waist circumference was lower in the low (-2.2 cm, 95% CI= -3.2, -1.2) and high (-3.1 cm, 95% CI= -4.3, -1.9) active transportation groups. The odds of hypertension were 24% lower (AOR=0.76, 95% CI=0.61, 0.94) and 31% lower (AOR=0.69, 95% CI=0.58, 0.83) among individuals with low and high levels of active transportation, respectively, compared with no active transportation. High active transportation was associated with 31% lower odds of diabetes (AOR=0.69, 95% CI=0.54, 0.88). Active transportation was not associated with high-density lipoprotein level. CONCLUSIONS: Active transportation was associated with more-favorable cardiovascular risk factor profiles, providing additional justification for infrastructure and policies that permit and encourage active transportation.