An Analysis of Water Used and Wasted at Operating Room Scrub Sinks - and Call to Action for Reducing Water Waste

Sep 30, 2026

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Objective modeling quantifies how much water is used and wasted during wet scrubs at operating room scrub sinks and identifies modifiable drivers of water waste. Using a 2-component observational design, the study combines onsite observation of handwashing practices and water usage at one medical center with two anonymous surveys assessing scrub practices and beliefs among surgeons and OR staff. Annual water-use and waste volumes are estimated from both components, with results showing substantial wastage concentrated in sink control types. Conclusions link waste to scrub sink characteristics and user behaviors and support action to conserve water without compromising patient safety.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Objective

Background

Methods

Study design

Types of OR scrub sinks

Results

Conclusions

Key words

An Analysis of Water Used and Wasted at Operating Room Scrub Sinks and Call to Action for Reducing Water Waste Carolyn J. Hu, BS,* Margaret Reilly, MD, MS,* Imadh Khan, BS,† Andrew W. Hoel, MD,* Cord Sturgeon, MD,* and Karen J. Ho, MD*✉ Objective: To model the volume of water used and wasted during wet scrubs at operating room (OR) scrub sinks and identify factors for reducing water waste. Background: Wasteful consumption of water by US health care systems has not been well characterized. Methods: This is a 2-component observational study. The ﬁrst was an observational study of handwashing practices and water usage at scrub sinks in the OR at a single medical center. The second component was a series of 2 anonymous surveys of surgeons and OR staff to assess hand scrub practices and perspectives. Data from both components were used to estimate the volume of water used and wasted annually at OR scrub sinks. Results: The median total volume of water wasted at OR scrub sinks for 34,554 cases over 1 year is 337,595.6 L (interquartile range 139,010 .0;911,210 . 5) . This represents 34 .2% of the total volume of water associated with wet scrubs (ie, water used during scrubbing and wasted after the conclusion of the scrub) . Other pertinent ﬁndings are that attending surgeons and OR staff perform wet scrubs in 25.9% of cases; there are signiﬁcant differences in scrub type preferences among OR users; the median volume of water wasted in a single wet scrub at timer-controlled sinks is 10 L; and signiﬁcantly more water is wasted at timer-controlled sinks than knee-operated sinks. Conclusions: OR wet scrubs are a source of enormous water waste. We identiﬁed scrub sink characteristics and OR user beliefs and behaviors as modiﬁable factors for water waste reduction. We encourage all institutions and OR users to carefully examine their facility characteristics and practices to implement plans that will conserve water without compromising patient safety. Key Words: hand disinfection, handwashing, operating rooms, water, waste, surgeons, delivery of health care (Ann Surg 2026;283:248–254) From the *Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL; and †Southern Illinois University School of Medicine, Springﬁeld, IL. ✉ [kho1@nm.org](kho1@nm.org). M.R. was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number T32HL094293 . The content is solely the responsibility of the authors and does not necessarily represent the ofﬁcial views of the National Institutes of Health. I.K. was supported by the Northwestern University Feinberg School of Medicine Vascular Surgery Student Research Award from the Joseph B. and Marjorie M. Lanterman Endowed Research and Education Fund. The authors have no related conﬂicts of interest. Copyright © 2024 The Author(s) . Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. DOI: 10.1097/SLA.0000000000006406 [248](248 | www.annalsofsurgery.com)[ |](248 | www.annalsofsurgery.com)[ www.annalsofsurgery.com](248 | www.annalsofsurgery.com) Health care systems adversely impact the environment through energy and water consumption, generation of waste, and emission of greenhouse gases, 1–3 which have long-ranging negative consequences for human health.2,4 Characterizing the waste generated by current health care system practices would enable the design of interventions to reduce waste. Wasteful use of operating room (OR) supplies and equipment has been studied in American health care systems,5–7 but consumption of water, a precious natural resource, has not been well characterized. A

FAQs

What is the study’s primary objective?

To model the volume of water used and wasted during wet scrubs at operating room scrub sinks and identify factors that can reduce water waste.

How was water usage and waste assessed in the methods?

The study used a 2-component observational approach: onsite observation of handwashing practices and water usage at scrub sinks plus two anonymous surveys of surgeons and OR staff.

Which findings relate sink control type to water waste?

More water is wasted at timer-controlled sinks than at knee-operated sinks, and the median water wasted in a single wet scrub at timer-controlled sinks is reported as 10 L.

Sep 30, 2026

Uploaded by Ivy