Good day, and thank you for listening to this audio poster presentation of Quantitation and Patterns of Carbon Expenditure for the 2019 AOFAS Annual Meeting Attendance. A carbon footprint is defined as the amount of carbon dioxide and other carbon compounds emitted due to the consumption of fossil fuels by a particular person, group, or other entity. The carbon footprint is traditionally expressed in metric tons, or 2,000 kg, of CO2 equivalents. This is because it is the prototypic greenhouse gas. Other greenhouse gases include methane, carbon monoxide, ozone, water vapor, and chlorofluorocarbons. The Paris Agreement stipulates that annual per-person CO2 production not exceed 2.3 metric tons to limit global warming to 1.5 degrees Celsius by the year 2030. Currently, the annual U.S. per-person CO2 production is estimated at 15.2 metric tons. We as physicians and surgeons should be concerned about global warming's detrimental effects on health, specifically because of its effects on population migration, increased heat-related deaths, decreased crop yields and famine, worsening infectious disease, and worsening respiratory disease. Why did we choose to analyze 2019's AOFAS Annual Meeting Attendance? This was the last year of all in-person meeting attendance. As such, it gives us the most recent estimate of CO2 production for all in-person meeting attendance. As can be seen from this bar graph representing the number of registered attendees by year at the AOFAS Annual Meeting since accurate records have been kept, there has been a steady increase in attendees year after year. To calculate the CO2 production for the Annual Meeting, we first estimated the amount of CO2 production from airline travel. To do this, we obtained anonymized home location of all registered attendees by their U.S. postal zip and international codes. We assumed that all attendees who lived greater than 100 miles from Chicago flew to the meeting. We determined their home airport by localizing it with the closest airport app. We estimated the CO2 produced by round-trip flight from the nearest large airport to O'Hare using a web-based calculator. We assumed that all attendees traveled coach class. And we also estimated the CO2 produced from lodging and food preparation and waste. For this meeting, there were a total of 1,271 registered attendees. Of these, 924, or 72.7%, were domestic, with the remainder being international attendees representing 41 other countries. The points of origin for flights of all registered attendees that were domestic and international are represented in panels A and B, respectively. From this data, we calculated that the flight CO2 produced per attendee ranged from 0.06 to 6.3 metric tons. The total flight CO2 produced from all registered attendees equaled 1,026 metric tons. The pie chart on this slide breaks down the percentage of attendees by amount of travel-produced CO2. The lodging CO2 was estimated at 321 metric tons. Summing the total flight CO2 produced as well as the lodging CO2, reveals that the average CO2 produced per attendee was 1.1 metric tons. In conclusion, in-person AOFAS annual meeting attendance generates large amounts of greenhouse gases. Given the recommendations for per capita CO2 production, we need to rethink returning to our previous normal in terms of scientific meeting attendance. Options to think about include more virtual attendance, smaller regional meetings, and perhaps limiting international attendance. There are weaknesses to our study. The first is that we used a 100-mile threshold to calculate those attendees that flew to the meeting. This may overestimate the CO2 produced by flights to the meeting, but these would be small contributors since they would be commuter-type flights. The second is that these are all estimates, but they are almost certainly conservative estimates. We are not able to calculate the effects of business or first-class travel, and these could be large increases in the number of CO2 produced on a per capita basis. Ground transportation was not estimated either, but this would be a relatively small contributor to our overall total. Contribution from industry exhibitors was not able to be calculated either, and this may include the amount of CO2 produced by shipping their exhibits and the amount of CO2 production for the production of the exhibits themselves. This study will certainly generate questions, perhaps the foremost of which is how do we reap conference benefits without meeting in person? The effects on networking could be substantial, and the impact may be inversely related to the age of the members. We also need to consider the social benefits we all reap from attendance at the annual meeting. And lastly, there are positive economic effects to the host city economy that will be lost by increased virtual meetings. I'll close with a question. As surgeons, how do we set the example and contribute to the solution while minimizing the impact on the benefits of in-person conferences? I want to thank my co-investigators and invite you to reach out to me to discuss any aspects of this investigation. Thank you.

carbon footprint

CO2 production

AOFAS Annual Meeting

virtual attendance

greenhouse gas emissions