Big issues, big ideas

Do ophthalmologists want to live in a “concrete jungle” and what role can they play in reducing “anthropogenic mass” on the planet?

Colin Kerr

Posted: Saturday, May 1, 2021

Since the beginning of the COVID-19 pandemic, I have found myself accessing research material outside of my normal remit as Executive Editor of EuroTimes. In a series of articles in the coming months, I will explore some of the ideas discussed in this material that may impact on how ophthalmologists practice as they attempt to come to terms with their “New Normal”.

An article published recently by BBC Environment Correspondent Helen Briggs reported that the mass of all human-produced materials including concrete, steel and asphalt has now grown to equal the mass of all life on the planet. (www. Briggs’ report was based on a recent study carried out at the Weizmann Institute of Science in Rehovot, Israel. (

The study, published in Nature (Elhacham, E., Ben-Uri, L., Grozovski, J. et al. Global human-made mass exceeds all living biomass. Nature 588, 442–444 (2020) shows that at the beginning of the 20th Century, human-produced “anthropogenic mass” equalled just around 3% of the total biomass. Today, on average, for each person on the planet, a quantity of anthropogenic mass greater than their body weight is produced every week.

Prof Ron Milo of the Plant and Environmental Sciences Department, Emily Elhacham and Liad Ben Uri say that their research can provide a crucial understanding of the future shape of the face of the Earth. It also suggests that human beings as a species, will need to behave more responsibly.

“The significance is symbolic in the sense that it tells us something about the major role that humanity now plays in shaping the world and the state of the Earth around us,” Dr Ron Milo, who led the research, told Briggs. “It is a reason for all of us to ponder our role, how much consumption we do and how can we try to get a better balance between the living world and humanity.”

This begs the question; how can ophthalmologists help to achieve this balance? Juan José Mura MD, MHA, speaking at the 37th Congress of the ESCRS in Paris, France suggested that a start could be made by looking at the use of new disposable technology. (EuroTimes Vol 25 Issue 5, May 2020). In his presentation to the ESCRS, Dr Mura discussed the economic costs, impact on marine life and adverse health consequences of plastic pollution. In addition, he cited a published study that analysed waste generation and life cycle environmental emissions from cataract surgery via phacoemulsification at the Aravind Eye Care System in India (Thiel CL, et al. J Cataract Refract Surg. 2017;43(11):1391-1398).

Dr Mura also proposed that a large portion of the carbon footprint created through cataract surgery could be reduced by changes in practice to incorporate readily available resource efficiency measures. They include optimising the use of reusable instruments and supplies, maximising single-use device reprocessing, promoting minimum waste and recycling practices, using energy efficient appliances and air handling systems, investing in low carbon energy sources, and using flash autoclaving (also known as immediate-use sterile supplies).

Returning to the theme of this article, Dr Mura’s proposals may be the first steps to reducing the reducing the anthropogenic mass. These are challenging times and we need big ideas to help us prepare for the journey that lies ahead.

For an excellent visual display of Anthropogenic Mass visit

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