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

Objective: To assess the environmental impact of radiography and fluoroscopy, using life cycle assessment (LCA), focusing on energy use and emissions.

Methods: This 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.

Results: 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.

Discussion: 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.