McAlister Scott, McGain Forbes, Petersen Matilde, Story David, Charlesworth Kate, Ison Glenn, Barratt Alexandra
The Centre for Health Policy, The University of Melbourne, Australia, Wiser Healthcare and Faculty of Medicine and Health, The University of Sydney, Australia, and Department of Critical Care, The University of Melbourne, Grattan St, Parkville, VIC 3010, Australia.
Department of Critical Care, The University of Melbourne, Australia and Western Health, Melbourne, Australia.
Lancet Reg Health West Pac. 2022 May 3;24:100459. doi: 10.1016/j.lanwpc.2022.100459. eCollection 2022 Jul.
Pathology testing and diagnostic imaging together contribute 9% of healthcare's carbon footprint. Whilst the carbon footprint of pathology testing has been undertaken, to date, the carbon footprint of the four most common imaging modalities is unclear.
We performed a prospective life cycle assessment at two Australian university-affiliated health services of five imaging modalities: chest X-ray (CXR), mobile chest X-ray (MCXR), computerised tomography (CT), magnetic resonance imaging (MRI) and ultrasound (US). We included scanner electricity use and all consumables and associated waste, including bedding, imaging contrast, and gloves. Analysis was performed using both attributional and consequential life cycle assessment methods. The primary outcome was the greenhouse gas footprint, measured in carbon dioxide equivalent (COe) emissions.
Mean COe emissions were 17·5 kg/scan for MRI; 9·2 kg/scan for CT; 0·8 kg/scan for CXR; 0·5 kg/scan for MCXR; and 0·5 kg/scan for US. Emissions from scanners from standby energy were substantial. When expressed as emissions per additional scan (results of consequential analysis) impacts were lower: 1·1 kg/scan for MRI; 1·1 kg/scan for CT; 0·6 kg/scan for CXR; 0·1 kg/scan for MCXR; and 0·1 kg/scan for US, due to emissions from standby power being excluded.
Clinicians and administrators can reduce carbon emissions from diagnostic imaging, firstly by reducing the ordering of unnecessary imaging, or by ordering low-impact imaging (X-ray and US) in place of high-impact MRI and CT when clinically appropriate to do so. Secondly, whenever possible, scanners should be turned off to reduce emissions from standby power. Thirdly, ensuring high utilisation rates for scanners both reduces the time they spend in standby, and apportions the impacts of the reduced standby power of a greater number of scans. This therefore reduces the impact on any individual scan, maximising resource efficiency.
Healthy Urban Environments (HUE) Collaboratory of the Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise MBG SPHERE. The National Health and Medical Research Council (NHMRC) PhD scholarship.
病理检测和诊断成像共同占医疗保健碳足迹的9%。虽然迄今为止已对病理检测的碳足迹进行了研究，但四种最常见成像方式的碳足迹尚不清楚。
我们在澳大利亚两所大学附属医疗服务机构对五种成像方式进行了前瞻性生命周期评估：胸部X光（CXR）、移动胸部X光（MCXR）、计算机断层扫描（CT）、磁共振成像（MRI）和超声（US）。我们纳入了扫描仪的电力使用以及所有耗材和相关废物，包括床单、成像造影剂和手套。使用归因生命周期评估方法和后果生命周期评估方法进行分析。主要结果是温室气体足迹，以二氧化碳当量（COe）排放量衡量。
MRI的平均COe排放量为17.5千克/次扫描；CT为9.2千克/次扫描；CXR为0.8千克/次扫描；MCXR为0.5千克/次扫描；US为0.5千克/次扫描。扫描仪待机能量的排放相当可观。当以每次额外扫描的排放量表示（后果分析结果）时，影响较低：MRI为1.1千克/次扫描；CT为1.1千克/次扫描；CXR为0.6千克/次扫描；MCXR为0.1千克/次扫描；US为0.1千克/次扫描，这是因为排除了待机电力的排放。
临床医生和管理人员可以减少诊断成像的碳排放，首先通过减少不必要成像的开具，或者在临床适当时开具低影响成像（X光和超声）以替代高影响的MRI和CT。其次，只要有可能，应关闭扫描仪以减少待机电力的排放。第三，确保扫描仪的高利用率既能减少其待机时间，又能将减少的待机电力影响分摊到更多的扫描中。因此，这减少了对任何一次单独扫描的影响，最大限度地提高了资源效率。
悉尼健康、教育、研究与企业伙伴关系马里杜鲁·布迪亚里·古马尔健康城市环境（HUE）合作实验室。国家卫生与医学研究委员会（NHMRC）博士奖学金。
