First study on the carbon footprint of UK Brachytherapy

Climate change is acknowledged to be the single biggest threat to human health this century and healthcare is responsible for 4-5% of global carbon emissions. This is the first study of the carbon footprint of brachytherapy delivery as practiced in the UK.

Nine UK centres collected data for four brachytherapy pathways: high dose rate (HDR) prostate, low dose rate (LDR) prostate, HDR cervix and HDR vaginal vault. Data was collected for power use from imaging and treatment machines, power use from time on wards and in theatre, anaesthetics, consumables waste and patient travel. Emissions were quantified by itemising each component of the process and using a conversion coefficient in units of kg CO₂e per unit of activity.

Expressed in kg CO₂e per patient, HDR vault had the lowest associated emissions (median 35, mean 59) whereas LDR and HDR prostate had similar carbon emissions per patient (LDR: median 117, mean 134; HDR: median 132, mean 128), and HDR cervix had the largest (median 182, mean 184). Patient travel was a significant contributor in all pathways, particularly LDR prostate (51% of total CO₂e for the pathway) and HDR vault (77%). Theatre and ward time contributed between 31% and 61% for pathways other than vault, and consumables contributed a similar amount (10-14%) in each pathway.

This initial estimate of the carbon footprint of the UK brachytherapy process suggests median figures from 35 kg CO₂e per patient (for a vault treatment) to 182 kg CO₂e per patient (for a cervix treatment). Significant contributors were patient travel, theatre and ward time, and consumables use.