Abstract:
Contrast media are essential for diagnostic and interventional procedures. Iodinated contrast media are the most commonly used agents, with CT requiring the largest overall quantities. Data show that these iodinated contrast media are found in sewage water, surface water and drinking water in many regions in the world. Because standard drinking water purification techniques only provide poor to moderate removal of iodinated contrast media, these substances pose a problem for drinking water preparation that has not yet been solved. There is a growing body of evidence supporting the negative environmental effects of iodinated contrast media via their breakdown products. The environmental impact of iodinated contrast media can be mitigated by measures focusing on the application of contrast media or the excretion of contrast media. Measures with respect to contrast application include reducing the utilization of contrast media, reducing the waste of contrast media and collecting residues of contrast media at the point of application. The amount of contrast media excreted into the sewage water can be decreased by introducing urine bags and/or special urine collection and waste-water processing techniques in the hospital. To tackle the problem of contrast media in the water system in its entirety, it is necessary for all parties involved to cooperate, from the producer of contrast medium to the consumer of drinking water. This paper aims to make health professionals aware of the opportunity to take the lead now in more conscious decisions regarding use of contrast media and gives an overview of the different perspectives for action.
摘要:
造影剂对于诊断和介入程序至关重要。碘化造影剂是最常用的造影剂,CT需要最大的总量。数据显示,这些碘化造影剂存在于污水中,地表水和饮用水在世界上许多地区。因为标准的饮用水净化技术只能提供较差到中等程度的碘化造影剂去除,这些物质给饮用水制备带来了尚未解决的问题。越来越多的证据支持碘化造影剂通过其分解产物对环境的负面影响。碘化造影剂的环境影响可以通过关注造影剂的应用或造影剂的排泄的措施来减轻。关于造影剂应用的措施包括减少造影剂的使用,减少造影剂的浪费,并在应用时收集造影剂的残留物。通过在医院中引入尿袋和/或特殊的尿液收集和废水处理技术,可以减少排泄到污水中的造影剂的量。为了全面解决水系统中的造影剂问题,有关各方有必要合作,从造影剂的生产者到饮用水的消费者。本文旨在使卫生专业人员意识到现在有机会带头做出有关使用对比媒介的更有意识的决定,并概述了行动的不同观点。