The Hidden Impact of Radiography and Fluoroscopy-An Environmental Life Cycle Assessment.

Abstract

To assess the environmental impact of radiography and fluoroscopy, using life cycle assessment (LCA), focusing on energy use and emissions. This International Organization for Standardization (ISO) 14040-guided LCA-based study focused on radiography and fluoroscopy services, including the production and use of two radiography and two fluoroscopy machines, at a quaternary care 800-bed academic medical center in the Southeastern United States over a 1-year period. Data were collected through direct observation, record review, staff interviews, and energy metering. Environmental impacts were assessed using SimaPro 9.3.0.2 and the Ecoinvent v3.8 database. Radiography and fluoroscopy activities generated an estimated 55,100 kilograms of CO₂ equivalents (kg CO₂e) per year. Energy use was the main contributor (47%), with fluoroscopy having much higher per-scan emissions (4.8 and 9.6 kg CO₂e per scan) than radiography (0.8 kg CO₂e per scan). Medical linens or textiles accounted for 24% of total emissions. Other significant environmental impacts included ozone depletion, smog, acidification, and eutrophication. Reducing energy consumption by decarbonizing electricity sources and optimizing equipment use can significantly decrease greenhouse gas emissions. Implementing sustainable practices in linen use, procurement, and end-of-life management is also crucial. Reducing low-value imaging can further mitigate environmental impact.