Curbing Healthcare's Contributions to Climate Change
In This Article
- The healthcare industry is responsible for roughly 9% of the annual greenhouse gas emissions in the U.S.
- Radiology accounts for a disproportionate amount of these emissions
- In a recent study, researchers at Massachusetts General Hospital outlined ways in which radiology departments can work to reduce their contribution to climate change
Human-attributable climate change can have a significant impact on human health. The Centers for Disease Control and Prevention (CDC) report that it can lead to higher rates of respiratory and cardiovascular disease, increased prevalence of food- and water-borne illnesses (and altered patterns in the geographical distribution of those illnesses), and more.
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In response, healthcare providers and scientists working in the biomedical arena are seeking improved understandings of disease prevalence stemming from climate change and redeploying resources to meet the resulting healthcare needs.
Beyond tackling the effects of climate change, though, the healthcare industry must also work to mitigate its own contributions to such change. Ultimately, these contributions can also play a role in adverse, climate-related health outcomes.
Michael E. Zalis, MD, a cardiovascular and interventional radiologist at Massachusetts General Hospital and director of the Mass General Brigham Radiology Center for Sustainability, is working to address this.
In a recent paper published in the Journal of the American College of Radiology, Dr. Zalis and Jonathan E. Slutzman, MD, a physician in the Department of Emergency Medicine and director of the Center for the Environment and Health, outlined ways in which the practice of healthcare contributes to climate change and proposed steps to minimize its impact.
New Technologies Could Lead to Lower Emissions
Healthcare is responsible for approximately 9% of the annual greenhouse gas (GHG) emissions in the U.S.: some 553 million metric tons of CO2. For perspective, Drs. Zalis and Slutzman write that this is roughly equivalent to the CO2 emissions that would be produced by driving a gasoline automobile roundtrip from Boston to Orlando, Florida—553 million times every year.
Radiology is responsible for a disproportionate amount of these emissions—not least because of the tremendous advances in medical imaging over the past half century, particularly in the development of ever-more-powerful MRI and CT technologies. At Mass General, for example, the Department of Radiology occupies 4% of the hospital's square footage and accounts for 15% of its total electricity use.
For these reasons, Drs. Zalis and Slutzman argue that healthcare and the field of radiology especially should adopt sustainability goals such as net zero: "the goal of reducing to nearly zero the human-attributable addition of GHG."
Technological advances offer a path to achieving this: most notably, perhaps, with MRI. For decades, improving MRI technology often meant increasing the field strength of the magnet used with the scanner and, thus, enhancing the sensitivity and specificity of the scanner. However, higher field strengths bring with them greater power needs, driving up the emissions associated with MR imaging.
The development of low-field MRI technologies can help reduce these emissions. In recent years, researchers have introduced systems whose field strength and associated spatial resolution are much lower than those of conventional clinical systems but are still more than sufficient to answer particular biomedical questions—for example, the diagnosis of stroke at point-of-care locations. Low-field scanners are less power-hungry than those currently in use and, thus, more likely to advance sustainable imaging. At the same time, they are far less expensive both to install and to operate and, for this reason, can be deployed more widely than conventional systems, increasing access to MRI and improving health equity.
Similarly, potential advances in X-ray technology, including the development of high-resolution detectors and coherent X-ray generation, could improve the efficiency of X-ray imaging—currently, only about 0.03% of the electricity delivered to an X-ray tube is successfully used for the imaging itself—and thus reduce the amount of power consumed.
Operational Change Is Possible, Even With Limited Financial Incentive
Drs. Zalis and Slutzman list other ways to reduce power consumption in departments of radiology—with CT and fluoroscopic systems, for example, departments can dramatically lower their energy usage simply by powering down during the systems' idle times—but they also acknowledge the limited incentives to implement such changes. While sustainability in imaging can yield substantial financial savings, those savings are in cost areas usually covered by the institution (electricity use, water consumption, etc.), so the efforts will not benefit the department's bottom line.
With this in mind, the authors suggest practical, incremental steps departments and even individuals can take to help reduce radiology's contributions to CO2 emissions. These include gain sharing, or at-risk budgeting, in which ongoing institutional support for a team's sustainability efforts is tied to the success of those efforts during the previous budget period.
Learn more about the Mass General Center for the Environment and Health
Learn more about research in the Department of Radiology