Discharge of iodine-containing contrast media into the environment – problem analysis and implementation of measures to reduce discharge by means of separation toilets – experience from a pilot project

Abstract

Purpose Environmental aspects and sustainability are becoming increasingly important. In addition to energy consumption, the consumption and environmental discharge of contrast agents pose a particular challenge. Because of their desired stability, X-ray contrast agents (XCAs) are deposited in surface water at a rate of up to 400 tons per year.

Materials and Methods In a pilot project, a set of measures (installation of specific separation toilets, the establishment of feedback systems, interviews, questionnaires, and observation) was implemented to sensitize patients and staff to the problem of XCAs during outpatient CT examinations and a retention and recovery system for XCAs was evaluated.

Results In the initial baseline phase, a separation toilet with an additional collection system and a feedback/button system was installed. The built-in feedback system indicated that the separation toilets were used by approx. 16 % of patients without measures. In two subsequent intervention phases, accompanying measures significantly (p < 0.01) increased the use of these separation toilets to 21 % and 25 %, respectively. The measures to reduce the discharge of XCAs were positively assessed by both staff and patients.

Conclusion Measures to reduce the discharge of XCAs into the environment have a high acceptance among staff and patients. The subsequent installation of separation toilets is one possibility to achieve on-site retention of XCAs. However, this measure is likely to be of high value only if patients stay on site for a correspondingly long time, as is the case in cardiology, for example.

Key points: 

• The input of X-ray contrast agents into the environment is relevant in light of the quantity

• Measures to reduce the discharge of X-ray contrast agents into the environment have been investigated in pilot projects

• The (subsequent) installation of separation toilets is possible and allows retention of X-ray contrast agents

• This measure is considered useful by patients and staff

• The financing of these measures needs to be clarified

Citation Format

• Beer M, Schuler J, Kraus E et al. Discharge of iodine-containing contrast media into the environment – problem analysis and implementation of measures to reduce discharge by means of separation toilets – experience from a pilot project. Fortschr Röntgenstr 2023; 195: 1122 – 1127

Key words

economics - CT - contrast agents - equipment - health policy and practice - occupational/environmental hazards

Publikationsverlauf

Eingereicht: 06. Mai 2023

Angenommen: 19. August 2023

Artikel online veröffentlicht:
04. Oktober 2023

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