Department of Radiation Oncology, University of California, San Francisco, California.
Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
Pract Radiat Oncol. 2023 Nov-Dec;13(6):e471-e474. doi: 10.1016/j.prro.2023.06.003. Epub 2023 Jul 4.
Sulfur hexafluoride (SF) is a widely used insulating gas in medical linear accelerators (LINACs) due to its high dielectric strength, heat transfer capabilities, and chemical stability. However, its long lifespan and high Global Warming Potential (GWP) make it a significant contributor to the environmental impact of radiation oncology. SF has an atmospheric lifespan of 3200 years and a GWP 23,000 times that of carbon dioxide. The amount of SF that can be emitted through leakage from machines is also concerning. It is estimated that the approximate 15,042 LINACs globally may leak up to 64,884,185.9 carbon dioxide equivalent per year, which is the equivalent greenhouse gas emissions of 13,981 gasoline-powered passenger vehicles driven for 1 year. Despite being regulated as a greenhouse gas under the United Nations Framework Convention on Climate Change, SF use within health care is often exempt from regulation, and only a few states in the United States have specific SF management regulations. This article highlights the need for radiation oncology centers and LINAC manufacturers to take responsibility for minimizing SF emissions. Programs that track usage and disposal, conduct life-cycle assessments, and implement leakage detection can help identify SF sources and promote recovery and recycling. Manufacturers are investing in research and development to identify alternative gases, improve leak detection, and minimize SF gas leakage during operation and maintenance. Alternative gases with lower GWP, such as nitrogen, compressed air, and perfluoropropane, may be considered as replacements for SF; however, more research is needed to evaluate their feasibility and performance in radiation oncology. The article emphasizes the need for all sectors, including health care, to reduce their emissions to meet the goals of the Paris Agreement and ensure the sustainability of health care and our patients. Although SF is practical in radiation oncology, its environmental impact and contribution to the climate crisis cannot be ignored. Radiation oncology centers and manufacturers must take responsibility for reducing SF emissions by implementing best practices and promoting research and development around alternatives. To meet global emissions reduction goals and protect both planetary and patient health, the reduction of SF emissions will be essential.
六氟化硫（SF）由于其高介电强度、传热能力和化学稳定性，是医用直线加速器（LINAC）中广泛使用的绝缘气体。然而，其长寿命和高全球变暖潜能值（GWP）使其成为放射肿瘤学中辐射对环境影响的重要贡献者。SF 的大气寿命为 3200 年，全球变暖潜能值是二氧化碳的 23000 倍。机器泄漏可能排放的 SF 量也令人担忧。据估计，全球约 15042 台 LINAC 每年可能泄漏多达 64884185.9 二氧化碳当量，相当于 13981 辆汽油动力乘用车行驶 1 年的温室气体排放量。尽管 SF 作为一种温室气体在《联合国气候变化框架公约》下受到管制，但医疗保健中的 SF 使用通常不受管制，美国只有少数几个州有具体的 SF 管理法规。本文强调了放射肿瘤学中心和 LINAC 制造商有责任尽量减少 SF 排放。跟踪使用和处置情况、进行生命周期评估以及实施泄漏检测的计划有助于确定 SF 来源，并促进回收和再循环。制造商正在投资于研究和开发，以寻找替代气体、改进泄漏检测以及在操作和维护期间减少 SF 气体泄漏。温室效应潜能值较低的替代气体，如氮气、压缩空气和全氟丙烷，可考虑替代 SF；然而，需要进行更多研究来评估它们在放射肿瘤学中的可行性和性能。本文强调了所有部门（包括医疗保健）都需要减少排放，以实现《巴黎协定》的目标，并确保医疗保健和患者的可持续性。虽然 SF 在放射肿瘤学中实用，但不能忽视其对环境的影响及其对气候危机的贡献。放射肿瘤学中心和制造商必须通过实施最佳实践和促进替代方案的研究和开发来承担减少 SF 排放的责任。为了实现全球减排目标并保护行星和患者健康，减少 SF 排放将是至关重要的。
