Recently, hospitals on three separate continents independently discovered that most of their nitrous oxide (between 75% and 95%) leaks out through central piping manifolds prior to use, wasting money and polluting the atmosphere (Anaesthesia 2022;77:1023-9). This led to the creation of the Nitrous Oxide Project in the United Kingdom and the recommendation by the Association of Anaesthetists in the U.K. and the ASA Committee on Environmental Health to abandon central nitrous piping in old buildings and avoid installation in new construction (asamonitor.pub/3nW8rRz; asamonitor.pub/GORPA).

Nitrous oxide is a potent greenhouse gas that persists in the atmosphere for over a century, with a global warming potential 273 times that of the reference unit carbon dioxide (Anesth Analg 2012;114:1081-5). Further, nitrous oxide is the most dominant ozone-depleting gas, increasing skin cancer risks to humans and other animals from excessive ultraviolet light exposure (Science 2009;326:123-5...

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