Leveraging wastewater data to enhance understanding of medical radionuclide usage in the UK.

Objective: The secure supply of medical radionuclides, such as Tc-99m and I-131, is at risk because of aging production facilities worldwide. To advocate for investment in radionuclide production infrastructure in the UK, it is essential to understand current radionuclide usage. Accessing hospital data to determine the types and numbers of procedures performed with radionuclides is challenging, and reporting is inconsistent across the devolved nations. By utilising open-source records of radioactive waste discharge held by environmental agencies and creating an interactive map that visualizes the amount and types of radionuclides used in healthcare centers across the UK, we can gain insights into the UK's radionuclide usage and provide valuable information to inform future policies and address geographic disparities.

Methods: Waste discharge records from different environmental agencies were interrogated to calculate the amount of administered radionuclide radioactivity at healthcare sites across the UK, which was cross-checked against hospital workload data of procedures performed with Tc-99m, I-131, and Lu-177.

Results: The findings indicate that the wastewater data provides a reliable overview of radionuclide use, particularly for Lu-177 and I-131, with agreement between reported and calculated excreted activity within 10%. For Tc-99m, the agreement was within 40%, likely because of variations in clinical practices.

Conclusion: The wastewater-reported data offers an independent and valuable source for understanding radionuclide usage across the UK. Enhancing coordination between environmental agencies and improving data collection practices would help improve the interrogation of radionuclide usage in the UK and hence support national strategy and planning for medical radionuclide supply.