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
