
A new book: “Environmentally Sustainable Primary Care” has many contributing authors from Greener Practice and is available for pre-order from today.
There are three quizzes to introduce you to some of the contents of the book. Here is the second one. You might enjoy trying either of them out on yourself or colleagues! More quiz questions are available here.
Please message tomsonmike72@gmail.com if you have identified ways to improve the clarity of the questions. You’re welcome to use these questions in your own not for profit work but please acknowledge the source!
1. Which one of the following is the reduction in emissions when switching from a car to
a bike for short journeys?
- A 33%
- B 50%
- C 65%
- D 75%
Answer
D 75%
There are some emissions related to the creation of the bike, and bikes though much, much
gentler on the road that heavier vehicles like cars do have some need for infrastructure … so
are not totally carbon free! + some impact on calories of food consumed…
Chapter 1 p3
2. The carbon footprint of the NHS as a proportion of the total UK carbon footprint is
which one of the following?
- A 0-1%
- B 2-3%
- C 4-5%
- D More than 6%
Answer
C
4-5% footprint (globally, the figure is about 5%). This is a significant proportion of our
national footprint. Chapter 1 p11
3. The UK is one of the world’s most nature depleted countries? True or false?
Answer
True.
The UK is one of the world’s most nature-depleted countries. There is poor biodiversity even in areas like our national parks which unlike national parks in many countries have little regulation of what agricultural chemicals can be used, or active promotion of biodiversity.
Chapter 1 p12
4. When considering wearing gloves when working with patients, which
one of the following is true?
- A It discourages handwashing which can increase the transmission of infection
- B it is always a great way to reduce transmission of infection
- C It’s a matter of choice and the environmental impact is not an appropriate consideration when deciding when to use them
- D It’s appropriate as it gives a clear message to patients that you respect the
- importance of preventing disease transmission whether body fluids are likely to be touched or not
Answer
A
Glove wearing reduces hand washing which can increase transmission of infection. (Because people feel safe with gloves on. they are more likely not to change gloves appropriately.) Appropriate use of gloves will help reduce transmission of disease but indiscriminate or thought free use may have the opposite effect. It is appropriate to look at all healthcare through different lenses, these lenses might include patient choice, financial considerations, environmental consideration and community implications.
Chapter 2 p15
5. In the UK which proportion of all prescribing is carried out by Primary Care ?
- A 15%
- B 25%
- C 50%
- D 75%
- E 88%
Answer
D
Most (75%) prescribing takes place in primary care. Chapter 5 p55
6. Studies suggest that the adverse effects of medicines are linked to what proportion of
UK hospital admissions?
- A 33% About 1 in 3 admissions
- B 18% Nearly 1 in 5 admissions
- C 14% Approx 1 in 7 admissions
- D 11% Around 1 in 9 admissions
Answer
B
18% or about one in five hospital admissions Chapter 5 p 55. A different study quoted in chapter 7 suggests prescribing in primary care accounts for 34% of clinically significant medication errors in the NHS. Overall medication related harm contributes to over 1700 deaths and 180,000 bed days annually.
7. Which of the following are true about dental amalgam?
- A 95% of UK dental amalgam is collected through separator technology
- B The mercury in amalgam is not dangerous and so there is no need to collect this
- C As of 2024 it is not used in UK as Resins have replaced it for fillings
- D It is responsible for one third of dental practice environmental impacts
Answer
A
It is a legal requirement that amalgam is collected in the UK, though not in all countries. There continue to be times when dental amalgam is the most appropriate material for use in fillings. Though the evidence for safety of amalgam in fillings is good there is a risk of breakdown in other environments. 2⁄3 of the environmental impact of Dentistry comes from travel and use of amalgam (and resins) makes up only a small part of the remaining impact. Chapter 2 p17
8. True or false. Regarding a community pharmacy which of the following is or are
true?
- A The acceptance of medication which is expired or unwanted by the patient by a community pharmacy is a contractual obligation
- B Once a medication has left the pharmacy it cannot be accepted back and
- supplied to another patient even if unopened
- C Community pharmacists must accept back Metered Dose inhalers and other
- medication even if they are from a different or online pharmacy
- D Community pharmacists are only obliged to accept back Metered dose inhalers
Answer
True A, B, C
Community pharmacies must accept all unused or unwanted medication and ensure that they are safely disposed of. This includes medication from hospitals or online or other local pharmacies. Pharmacies are expected to check all medications with the patient before dispensing them as once they are opened or taken out of the pharmacy
the pharmacy is not allowed to accept them for use. An informal survey showed only 16% of patients knew that returning their inhalers to the pharmacy was the most environmentally friendly way to dispose of their inhalers; however, 96% said they would be happy to do so.
Chapter 5 p60
9. What proportion of the carbon footprint of medicines is related to the manufacture of the Active Pharmaceutical ingredient?
- A 20%
- B 40%
- C 60%
- D 80%
- E 90%
Answer
D
80% of the carbon footprint is manufacture of the active drug, with 5-10% for transport
and a similar amount for plastic and packaging. Chapter 5 p65
Chapter 5 p60
10. What proportion on average of a child’s daily intake/exposure to air pollution is
on the school run?
- A 30%
- B 45%
- C 60%
- D 90%
Answer
C 60%
Air pollution is a massive social injustice; those who are least well off and already most at risk of these conditions live in the most polluted areas.
Chapter 13 p198