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Importance: Medications are associated with substantial environmental outcomes, yet frequently end up being unused by patients. Waste-minimizing interventions, such as redispensing of quality-approved oral anticancer drugs remaining unused by patients at home, could reduce the environmental footprint of cancer treatment., Objectives: To assess the environmental outcomes of redispensing quality-assured oral anticancer drugs and to explore how redispensing could be environmentally optimized., Design, Setting, and Participants: In this quality improvement study, a cradle-to-grave life cycle assessment was performed in the outpatient pharmacy of 4 Dutch hospitals, based on a prospective multicenter trial comprising 1071 patients with a clinical diagnosis of cancer and an active prescription for an oral anticancer drug stored at room temperature from February 1, 2021, to February 1, 2023, with a follow-up of 12 months per patient., Intervention: Participants received prescribed oral anticancer drugs with additional quality-assurance materials (ie, seal bags and time-temperature indicators), so the pharmacy could redispense quality-assured drugs based on authenticity, appearance, remaining shelf life, and/or adequate storage., Main Outcomes and Measures: The estimated environmental outcomes avoided due to waste reduction (ie, production and transport and incineration of redispensed oral anticancer drugs) corrected for outcomes of process burdens (ie, quality assurance materials), quantified in 3 outcome measures: human health damage (disability-adjusted life-years), ecosystems damage (species × year), and climate change (kg of carbon dioxide equivalent [CO2-eq]) per patient per year., Results: A volunteer sample of 1071 patients (median age, 70 years [IQR, 62-75 years]; 622 men [58.1%]) participated in the intervention. Redispensing oral anticancer drugs was initially associated with an environmental burden, mainly because of the high impact of time-temperature indicators. However, when quality-assurance materials were selectively used for temperature-sensitive oral anticancer drugs (ie, maximum storage temperature of 25 °C), redispensing was environmentally beneficial to human health and ecosystems, providing estimated climate benefits of 1.9 kg (95% CI, 1.4-2.6 kg) of CO2-eq per patient per year., Conclusions and Relevance: In this quality improvement study, redispensing unused oral anticancer drugs was found to be a suitable strategy to reduce waste and improve environmental sustainability of cancer treatment after process optimization. Redispensing unused oral anticancer drugs could contribute to sustainability of cancer treatment through reduced costs and environmental outcomes.

Direct air capture (DAC) in combination with storage of CO 2 can lower atmospheric CO 2 concentrations. This study investigates the environmental impact of a new fast-swing solid sorbent DAC system, including CO 2 transport and storage, over its life cycle, using prospective life cycle assessment. This DAC technology is currently on technology readiness level 5 and is expected to operate on an industrial scale by 2030. The technology was upscaled to the industrial scale and future changes in the background over the lifetime of the system were included, such as electricity grid mix decarbonization. Environmental trade-offs for the new DAC system were assessed by comparing environmental benefits from CO 2 sequestration with environmental burdens from production, operation and decommissioning. We considered three electricity generation configurations: grid-connected, wind-connected, and a hybrid configuration. We found net environmental benefits for all configurations and background scenarios for ecosystem damage and climate change. Net human health benefits were observed when the electricity grid decarbonizes quickly and without the use of a battery. The environmental benefits increase with decreasing electricity footprint and are comparable with other DAC technologies. This illustrates that the new DAC system can help to meet the climate goals., (© 2024. The Author(s).)

The flatness of muscovite mica makes it a convenient substrate to study epitaxy. We have analyzed the growth of rhodochrosite (MnCO 3 ) crystals in solution and on muscovite mica. Growth at high supersaturations occurs via the formation of amorphous MnCO 3 , which over time transforms into the crystalline form. In the presence of muscovite mica, epitaxial rhodochrosite crystals with a size of approximately 1 μm form. These crystals are kinetically roughened, because of the high supersaturation. The lattice match between MnCO 3 and muscovite was found not to be the main reason for epitaxy. If the growth experiment is performed twice, the original epitaxial MnCO 3 crystals are overgrown by many small crystallites. Similarly, spherical MnCO 3 crystals with many overgrown facets can be formed on a muscovite surface that is exposed to humidity or by using a higher MnCO 3 supersaturation. A comparison with calcite shows that epitaxy strongly depends on initial supersaturation for both carbonates. In contrast to previous studies, we find that at the right supersaturation, epitaxial calcite crystal growth is possible on freshly cleaved muscovite., Competing Interests: The authors declare no competing financial interest.