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Location

Reykjavík, Iceland (Reykjavík Capital Region).

Initiation date

Environmental management efforts began in 2012. A formal climate action plan was adopted in 2016 with a target of 40% CO₂ reduction by 2020.

Sector setting

Landspítali is the National University Hospital of Iceland, located in Reykjavík and serving the entire country. Landspítali provides comprehensive medical services (inpatient, outpatient, emergency) and is a leading teaching hospital for the University of Iceland. 

Key responsible actors 

  • Internally: Environmental Manager, environmental committee, procurement and operations staff. 

  • Externally: Icelandic Health Service Authority, City of Reykjavík, national government green programs, and compliant suppliers. [6] 

Mitigation initiative

Since 2012, Landspítali National University Hospital has operated a comprehensive environmental management program integrating sustainability across clinical care, operations, and procurement, based on ISO 14001 principles and aligned with Iceland’s “Green Steps in Government.” [1], [2] 

The initiative aimed to reduce the hospital’s carbon emissions by 40% by 2020 (compared to 2016). Five key objectives and activities supported this: 

  1. Eliminate high-global warming potential (GWP) anesthetic gases and treat residual nitrous oxide. N₂O abatement units ave been installed and desflurane has been phased out. [2] [3] 
  2. Promote low-carbon commuting with incentives and infrastructure. The staff “green travel agreements” were launched, a transit subsity has been introduced, and secure bike shelters and showers have been added. [4]
  3. Reduce waste by ending single-use plastics and expanding recycling. The hospital ended the use of plastic trolley covers, expanded to 26 waste streams, and diverted kitchen waste to composting. [1] [2] [5]
  4. Integrate environmental criteria into procurement, favoring eco-labeled, reusable products. [1] [2] [3]
  5. Eco-label and reuse requirements were embedded into tenders for medical and non-medical goods. [1] [2] [5] 

GHG emission reduction measures  

Scope 1- Reducing direct emisions from anesthetic gases and on-site heating

The hospital installed N₂O abatement units (starting with the maternity ward), eliminated desflurane, and shifted to low-flow anesthetic protocols, reducing emissions by ~20–24%. Decommissioning the oil boiler in 2019 removed an additional ~5% of emissions (~100 cars/year equivalent). The hospital also began transitioning its fleet to EVs and hybrids. [2] [3]

Scope 2 - Reducing emissions from energy

With Iceland’s 93% renewable energy mix, electricity and heat carry minimal emissions. Replacing oil heating with electric boilers further cut indirect emissions. Energy conservation measures (e.g., LED lighting) also support low Scope 2 impacts, though not all data are quantified. [3]

Scope 3 - Reducing emissions from commuting, procurement, and waste

Staff green travel incentives reduced 120 tCO₂e/year by 2016, quadrupling bus ridership by 2019. Eco-procurement practices (Nordic Swan labels, reusable goods, minimal packaging) cut upstream emissions, although no specific results are presented. Recycling expanded to 43% of total waste by 2021, diverting nearly 5 t/week of organic waste to biogas production. Paper recycling rose from 11 t (2012) to 124 t (2020), and over 850 kg/month of glass is now recycled. [1] [2] [5]

Key learnings

Strong leadership and an empowered environmental manager were critical. Early wins built engagement, while transparent “green accounting” kept momentum. Behavioural nudges, such as visible bike facilities and personalised travel plans, proved highly effective. The experience also shows that several measures can be transferred to other healthcare settings, including switching anaesthetic gases, deploying N₂O abatement, promoting low-carbon commuting, and greening procurement. Iceland’s clean grid strengthened the results, but the wider approach remains relevant elsewhere when combined with structured environmental management systems, such as ISO 14001, and supportive public-sector sustainability programmes. Upfront costs for new equipment posed challenges but were justified by long-term savings. [2] [3] [4] [6] 

Initiative outcomes

Evidence of Success  

By 2020, the hospital met its 40% emissions reduction target, avoiding ~1,900 tCO₂e since 2015—equivalent to removing 800 cars from the road. N₂O abatement alone accounted for ~24% of this cut, oil boiler retirement for ~5%, and transport shifts for ~120 tCO₂e annually. Waste reforms helped surpass a 40% recycling rate, and nearly all energy used is now carbon-free. [1] [3] [4] 

Co-benefits 

Air quality improved with reduced fuel use. A 2014 staff survey found 82% of green commuters reported improved well-being. Annual savings from ending oil use are estimated at ISK 20–30 million ($150–200k). The hospital earned a Nordic Swan eco-label for its canteens and was awarded Reykjavík’s climate leadership prize in 2020. This eco-label does not quantify emission reductions directly, but support broader environmental performance. [3] [4]  

 

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This translation is generated by eTranslation, a machine translation tool provided by the European Commission.