Climate Change,Health Equity,and Environmentally Sustainable Radiology

We thank Dr. Leguízamo-Isaza et al for their interest in our work. ¹ Radiology contributes to the climate crisis by generating greenhouse gas (GHG) emissions across the entire lifecycle of imaging equipment, from production, to manufacture, transportation, use, and disposal. ² In a large Canadian academic radiology department, we found that MRI and CT were the largest contributors to GHG emissions by modality (41% and 34%, respectively), despite only accounting for 12% and 24% of imaging tests, respectively. ³

We agree that both individual and collective action are needed to improve environmental sustainability and address the detrimental effects of climate change.^4,5 The authors have highlighted several mitigation strategies to reduce the environmental impact of radiology services, including powering down medical imaging equipment when not in use and optimizing waste management. At the same time, radiology departments must also build resiliency to current and future impacts of the climate crisis through adaptation. ⁴

A health centred focus is essential to engage health professionals, patients, and other stakeholders in climate action. Climate change negatively impacts individual and population level health through multiple pathways, including poor air quality, extreme heat, and changes in infectious disease. ⁶ Everyone is impacted; however, the effects are not experienced equally. Vulnerability to the adverse effects of climate change is determined by exposure to environmental hazards along with the capacity to respond to them.

In the global context, actions to ensure equitable access to medical imaging require capacity building while minimizing the detrimental environmental effects of the delivery of radiology services. Coordinated efforts are needed to reduce health disparities and improve health equity. Each radiology practice should prioritize sustainable actions that are easiest to implement with the greatest potential impact. ⁴ Co-benefits of climate strategies should be emphasized including lower cost and improved patient health.

We all have a role to play in addressing the climate crisis and we must work together to deliver environmentally sustainable and climate-resilient radiology services.