Anesthetics/greenhouse gases

AN ACT Relating to emissions of greenhouse gases used for 1
anesthetic purposes; adding a new section to chapter 43.21A RCW; and 2
creating new sections. 3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:4
NEW SECTION. Sec. 1. (1) The legislature finds that a great 5
deal of emphasis in greenhouse gas emissions policymaking in the 6
state has appropriately focused on reducing sources of carbon 7
dioxide, methane, and refrigerant gases, which remain the most 8
significant types of greenhouse gases emitted in the state. However, 9
the legislature also finds it prudent not to overlook meaningful 10
opportunities to reduce emissions of other types of greenhouse gases 11
from more niche sources such as anesthetic gases.12
(2) The legislature finds that gases used as an anesthetic in 13
medical, dental, and veterinary contexts, including desflurane, 14
isoflurane, sevoflurane, halothane, and nitrous oxide, are potent 15
greenhouse gases. Efforts in the medical community are already 16
underway to minimize the emissions from these gases, including by 17
national and international anesthesiologist associations. In other 18
jurisdictions, including Scotland and England, efforts are also 19
underway to phase out the use of the anesthetic gases with the 20
greatest potential greenhouse gas emissions. 21
S-0530.1
SENATE BILL 5236
State of Washington 69th Legislature 2025 Regular Session
By Senators Slatter, Harris, Nobles, and Shewmake
Read first time 01/14/25. Referred to Committee on Environment,
Energy & Technology.
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(3) Therefore, it is the intent of the legislature to reduce 1
emissions from these sources of greenhouse gases, in spite of their 2
obscurity, by: 3
(a) Studying these gases; and 4
(b) Developing guidance to reduce emissions of greenhouse gases 5
used for anesthetic purposes. 6
NEW SECTION. Sec. 2. (1) The department of ecology must 7
commission a study to be completed by July 1, 2026, that:8
(a) Determines the potential sources of gases with a high global 9
warming potential that are used for anesthetic purposes within 10
Washington; 11
(b) Determines how these gases are used in Washington;12
(c) Estimates the quantity of emissions; 13
(d) Recommends potential points of regulation for each of these 14
gases; and 15
(e) Recommends measures for reducing or eliminating emissions of 16
these gases. 17
(2) By October 1, 2026, the department of ecology, in 18
consultation with the department of health and considering the 19
results of the study commissioned under subsection (1) of this 20
section, must submit recommendations to the appropriate committees of 21
the legislature regarding any further statutory changes needed in 22
order to appropriately and effectively reduce greenhouse gas 23
emissions associated with the use of anesthetic gases, including any 24
recommendations to prohibit the manufacture, distribution, sale, or 25
use of specific anesthetic gases. The department of ecology must 26
note, in the report to the legislature under this section, any 27
recommendations that the department of health does not endorse and 28
must provide an opportunity for the department of health to share 29
their opinions on such matters as an appendix to the recommendations.30
NEW SECTION. Sec. 3. A new section is added to chapter 43.21A 31
RCW to read as follows: 32
(1) By January 1, 2027, the department must develop and publish a 33
guidance document intended to reduce greenhouse gas emissions 34
associated with the use of gases with a high global warming potential 35
that are used for anesthetic purposes in medical, dental, veterinary, 36
or other similar facilities and settings. Gases subject to the 37
guidance document must include, at minimum: Sevoflurane; desflurane; 38
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isoflurane; halothane; and nitrous oxide. In developing the guidance 1
document, the department of ecology must consult with the department 2
of health, and solicit the input from the following:3
(a) The state board of health; 4
(b) The Washington medical commission; 5
(c) The Washington state board of nursing; 6
(d) The dental quality assurance commission; 7
(e) The board of osteopathic medicine and surgery;8
(f) The veterinary board of governors; 9
(g) The University of Washington and Washington State University;10
(h) Associations representing medical, dental, or veterinary 11
practitioners that use anesthetic gases; 12
(i) Associations representing facilities at which anesthetic 13
gases are used; 14
(j) Environmental organizations with a focus on efforts to reduce 15
greenhouse gas emissions; and 16
(k) Subject matter experts with knowledge of the most efficient 17
and effective methods to reduce greenhouse gas emissions from 18
anesthetic gas use. 19
(2) In developing the guidance document, the department must 20
consider: 21
(a) The efforts of other jurisdictions, including those in 22
Europe, to restrict the use of high global warming potential 23
greenhouse gases or to otherwise reduce greenhouse gas emissions 24
associated with the use of anesthesia; 25
(b) The guidance documents or best practices prepared by national 26
and international anesthesiology professionals, including the 27
American society of anesthesiologists, the world federation of 28
societies of anaesthesiologists, and the association of anesthetists; 29
and guidance documents published in peer-reviewed medical journals;30
(c) Existing practices in place at facilities and by 31
practitioners in Washington to limit greenhouse gas emissions 32
associated with anesthesia use; 33
(d) Input related to professional liability and medical procedure 34
risks associated with the implementation of alternative anesthetic 35
options intended to lower greenhouse gas emissions associated with 36
the use of anesthetic gases; and 37
(e) Any additional financial considerations in the use of changes 38
intended to reduce emissions of anesthetic gases. 39
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(3) The goal of the guidance document must be to reduce 1
greenhouse gas emissions associated with the use of anesthetic gases, 2
but without limiting the judgment or needs of medical, dental, or 3
veterinary professionals in providing safe and effective care, while 4
allowing flexibility for extenuating clinical circumstances when, in 5
the opinion of the medical professional, unrestricted use of 6
anesthetic gases is needed for patient safety and comfort. Nothing in 7
the guidance document may be construed to require a facility or 8
practitioner to provide medical care in a manner that increases 9
medical procedure or professional liability risks in the judgment of 10
the facility owner or operator or the medical professional.11
(4) By January 1, 2028, facilities at which anesthetic gases are 12
used, and the medical, dental, or veterinary practitioners that use 13
such gases, may only use anesthesia in a manner consistent with the 14
guidance document published under this section. The department may 15
not issue penalties under this section to a facility owner or 16
operator of a practitioner for a failure to follow the guidance 17
document. 18
NEW SECTION. Sec. 4. If any provision of this act or its 19
application to any person or circumstance is held invalid, the 20
remainder of the act or the application of the provision to other 21
persons or circumstances is not affected.22
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