Glass or Plastic: An Environmental Life Cycle Assessment

(LCA) and Related Economic Impact of Contrast Media

Packaging

Poster No.: C-2599

Congress: ECR 2015
Type: Scientific Exhibit
Authors: 1 2 3 1
W. P. Flanagan , H. Dhaliwal , M. Browne ; Niskayuna, New
2 3
York/US, Huntington, VT/US, Oslo/NO
Keywords: Contrast agents, CT, MR, Contrast agent-intravenous, Economics
DOI: 10.1594/ecr2015/C-2599

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Page 1 of 16
Aims and objectives

This study compares environmental and operational impacts of two packaging options
for contrast media: polymer bottle and traditional glass bottle. The study includes all life
cycle stages and evaluates a variety of end-of-life disposal scenarios, with operational
budget implications for health care facilities handling contrast media.

Life cycle assessment (LCA) is an internationally recognized methodology [1,2] that

examines environmental impacts across the full life cycle of a product, from raw
material extraction and refining through manufacturing, use, and end-of-life disposal or
recycling (Fig. 1). By including impacts throughout the product life cycle, LCA provides
a comprehensive view of environmental impacts and a more accurate picture of the
environmental trade-offs and improvement opportunities.

Fig. 1: Product life cycle

References: Ecoassessment Center of Excellence, General Electric - Niskayuna/US

Page 2 of 16
This study documents the findings of an LCA study comparing polymer and glass bottles
for delivering contrast media. The polymer bottle is made from a pharmaceutical-grade
polypropylene vial body, rubber stopper, and polypropylene cap. The glass bottle is made
from a glass vial body, a crimp seal made of aluminum and plastic, and a rubber stopper.
The vials are filled with contrast media, sealed, autoclaved, inspected, packaged, and
then distributed to different global markets including the US, Europe, China, India, and
Korea.

Operational budget implications of using polymer or glass bottles for contrast media
were also evaluated. The scenario was based on a typical 200-bed hospital radiology
department in the US that purchases approximately 11 700 bottles of contrast media
per year. The evaluation focused on the cost of medical waste* disposal associated with
polymer and glass bottles used for contrast media.

*referred to as "red bag" waste in the US

Images for this section:

Page 3 of 16
Fig. 1: Product life cycle

Page 4 of 16
Methods and materials

The environmental impact assessment categories include greenhouse gas emissions,

cumulative energy demand, human health, ecosystems, and resources. Operational
budget impact is modeled based on a comparison of medical waste disposal costs
associated with contrast media packaging within a typical radiology department.

Environmental Life Cycle Assessment (LCA)

This study looks at the full life cycle of both polymer and glass bottles including supply
chain, product manufacturing, distribution, use, and end-of-life. The system boundaries
for polymer and glass bottles are shown in Fig. 2.

Fig. 2: Product life cycle system boundaries for polymer bottle (A) and glass bottle (B)
References: Ecoassessment Center of Excellence, General Electric - Niskayuna/US

Page 5 of 16
Impact assessment methods are used to convert the life cycle inventory data (material,
energy, and emissions inputs and/or outputs throughout the product life cycle) into
a set of environmental impacts. Since this study focuses on a healthcare product,
human health impacts are of primary importance. The healthcare industry is also keenly
aware of energy and solid waste issues. To address these perspectives, this study
uses human health midpoint impact categories and ecosystem quality and resources
endpoint impact categories from the internationally accepted method ReCiPe (H/A) [3],
along with Cumulative Energy Demand (CED) [4], which expresses both embodied and
process energy associated with a product's life cycle. A summary of environmental impact
categories used in this study is shown in Table 1.

Table 1. Environmental impact categories considered

Impact category Unit Source method
Climate change kg CO2eq ReCiPe Midpoint (H) v
1.07 [3]
Ozone depletion kg CFC-11eq
Human toxicity kg 1,4-DBeq
Photochemical oxidant kg NMVOC
formation
Particulate matter kg PM10eq
formation
Ionizing radiation kg U235eq
Ecosystem quality species.yr ReCiPe Endpoint (H) /
World ReCiPe (H/A) v 1.07
Resources economic unit
[3]
Cumulative energy MJ Cumulative energy
demand demand v 1.08 [4]

The climate change impact category within the ReCiPe (H) Midpoint method includes
all greenhouse gases specified in the Kyoto Protocol (carbon dioxide, methane, nitrous
oxide, hydrofluorocarbons, perfluorocarbons, and sulphur hexafluoride) using global
warming potentials from the IPCC 4th Assessment Report with a 100-year time horizon
[5].

The primary results presented here focus on the 100 mL bottle size, but the study also
compared several different bottle sizes on a functionally equivalent "per dose" basis - two
50 mL bottles, one 100 mL bottle, half of a 200 mL bottle, and one fifth of a 500 mL bottle.

Page 6 of 16
The study considered a variety of end-of-life disposal options for both bottle types
including: (i) municipal waste disposal; (ii) autoclave and landfill; (iii) autoclave and
incineration; (iv) pre-shred, autoclave and incineration; (v) incineration; and (vi) recycling.

Additional sensitivity analyses were performed to assess the effect of different electricity
grids (manufacturing geographies), recycled content in glass bottles, mode of distribution
transport, different contrast media solutions, and X-ray vs. MRI diagnostic applications.

This assessment was conducted according to the ISO 14040-44 standards for
comparative LCA [1,2] and was independently reviewed by a third-party critical review
panel.

Economic Evaluation

The operational budget scenario was based on a typical 200-bed hospital radiology
department in the US that purchases approximately 11 700 bottles of contrast media per
year.

For each bottle type (polymer or glass), an average bottle weight was calculated by
measuring the weight per unit of each bottle size and then weight-averaging based
on 2013 sales volume percentages for each bottle size (the sales volume bottle size
distributions were the same for both polymer and glass bottles).

The cost of medical waste disposal was estimated at $0,17/lb [0,32 EUR/kg] based on
published data [6], and cross-checked with a secondary published source [7]. The more
conservative data source [6] was used in the calculations.

Annual cost reduction associated with medical waste disposal was calculated as the
annual weight reduction (glass - polymer) x 0,32 EUR/kg.

Images for this section:

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Fig. 2: Product life cycle system boundaries for polymer bottle (A) and glass bottle (B)

Page 8 of 16
Results

This study indicates that polymer bottles have considerably lower environmental impacts
than glass across all categories. Weight comparison of common bottle sizes indicated an
average 78,7% reduction. The specific medical waste disposal scenario for a typical US
site shows that approximately 406 EUR can be saved annually assuming 11 700 units
of contrast media consumed.

Environmental Life Cycle Assessment

The polymer bottle significantly outperforms the glass bottle for all environmental impact
categories considered (Fig. 3).

Fig. 3: Life cycle comparison of 100-mL polymer and glass bottles for contrast
media. Vial manufacturing includes vial body, cap, stopper, crimp, depyrogenation,
and autoclaving. Packaging includes secondary packaging and shipping container.
Transport includes raw material transport and distribution transport. 'Other' includes QC
reject, broken and frozen bottles, lost contrast media, and incubation.
References: Ecoassessment Center of Excellence, General Electric - Niskayuna/US

Compared to glass, the polymer bottle offers the following life cycle environmental
benefits:

• significantly lower greenhouse gas emissions (46%)

• significantly less cumulative energy (55%)

Page 9 of 16
 • lower impact on ecosystem quality (39%) and resources (59%)
• lower impacts in all other categories studied (ranging from 23-43%)

Manufacturing of the bottle components (vial body, cap and stopper) are the most
significant contributors to environmental impact for the polymer bottle, and the vial body
has the highest impacts among the bottle components. Secondary packaging - meaning
the outer box and dividers - and shipping container also contribute to impact. However,
broken bottle, lost contrast media, and autoclaving impacts during manufacturing are
negligible.

For the glass bottles, the glass vial body accounts for a large share of the impacts.
The aluminum crimp seal, rubber stopper, and secondary packaging are other important
sources of impact. Broken bottles, lost contrast media, and autoclaving impacts are
negligible.

The polymer bottle outperforms the glass bottle for each bottle size studied (Fig. 4). The
500 mL bottle has the lowest impacts per dose and the 50 mL bottle has the highest
impacts per dose for both types of bottles. This can be attributed to the need for less
bottle material and packaging (per dose) for the larger bottle sizes.

Fig. 4: Life cycle results for different bottle sizes (50 mL, 100 mL, 200 mL, 500 mL).
Results are normalized relative to the 50 mL glass bottle (100%).
References: Ecoassessment Center of Excellence, General Electric - Niskayuna/US

Page 10 of 16
The study results also indicate that the polymer bottle is environmentally favorable
compared to the glass bottle regardless of the end-of-life disposal method used for either
bottle type. In addition, the polymer bottle had lower environmental impact than the glass
bottle regardless of electricity grids (manufacturing geographies), recycled content in
glass bottles, mode of distribution transport, different contrast media solutions, and X-ray
vs. MRI diagnostic applications. Full details are reported elsewhere [8].

Economic

By switching from glass packaging to polymer bottle, a radiology department could reduce
the weight of its contrast media packaging waste. For example, a typical 200-bed hospital
radiology department in the US that purchases approximately 11 700 bottles of contrast
media per year could reduce annual contrast media medical waste by 78,7%, or 1279
kg, corresponding to $478 [407 EUR] in contrast media medical waste disposal costs
annually (Table 2).

Table 2. Waste reduction benefit of polymer vs. glass contrast media packaging
Total weight of glass 1624 kg/yr
bottles
Total weight of polymer 345 kg/yr
bottles
Medical waste avoided 1279 kg/yr
Medical waste disposal 0,32 EUR/kg
cost
Medical waste cost savings 406,9 EUR/yr
% of weight and waste 78,7 %
disposal costs avoided

Discussion

Packaging for modern supply chains is increasingly complex. The goal is to find the
optimum solution of many conflicting interests such as end-user convenience, shelf-
life, cost, compatibility between product and packaging materials, regulatory compliance
and integration with existing processing equipment while reducing the associated
environmental impact. In an effort to improve its packaging for contrast media used in
medical imaging procedures such as X-rays and MRIs, GE Healthcare launched its first
polypropylene bottle in the early 1990's. An important driver for this packaging was that
it was believed to be an environmentally friendlier alternative than its traditional glass
counterpart. In subsequent years the packaging line was extended with a new variant
that competes primarily against glass bottles in a variety of sizes. Switching from glass

Page 11 of 16
packaging to polymer bottle for the same scenario could eliminate over 20 annual glass
bottle related sharps injuries per technologist and lead to productivity savings of 3,5 hours
per month [9].

The study results are intended to provide comparative insight regarding the
environmental and operational differences between polymer and glass bottles for contrast
media delivery. By analyzing the polymer and glass bottles in detail, this study provides
useful insight regarding the comparative environmental and operational impacts of each
bottle type, as well as where the largest environmental impacts are occurring for each
bottle type.

Images for this section:

Fig. 3: Life cycle comparison of 100-mL polymer and glass bottles for contrast media. Vial
manufacturing includes vial body, cap, stopper, crimp, depyrogenation, and autoclaving.
Packaging includes secondary packaging and shipping container. Transport includes raw
material transport and distribution transport. 'Other' includes QC reject, broken and frozen
bottles, lost contrast media, and incubation.

Page 12 of 16
Fig. 4: Life cycle results for different bottle sizes (50 mL, 100 mL, 200 mL, 500 mL).
Results are normalized relative to the 50 mL glass bottle (100%).

Page 13 of 16
Conclusion

The study results suggest that using polymer rather than glass can lower the
environmental impact of contrast media packaging and reduce operational expenses
related to disposal of contrast media packaging waste.

The lower environmental impacts of polymer bottles compared with glass bottles can be
attributed to:

• lower material and manufacturing impacts partly due to their lower mass
• lower distribution impacts due to their lower mass
• lower end-of-life disposal impacts due to lower mass and lower disposal
impacts

The operational advantages of polymer bottles compared to traditional glass packaging

include decreased cost of waste disposal and improved workplace safety and efficiency
for healthcare workers who administer contrast media to patients.

Personal information

William P. Flanagan, PhD, LCACP

Director - Ecoassessment Center of Excellence

General Electric Company

Niskayuna, NY/US

flanagan@ge.com

Harnoor Dhaliwal

EarthShift LLC

Huntington, VT/US

harnoor@earthshift.com

Martin Browne

Page 14 of 16
Senior Scientist

GE Healthcare Life Sciences

Oslo/NO

Martin.Browne@ge.com

References

1. ISO 14040:2006 - Environmental management - life cycle assessment

- Principles and framework, 2006, International Organisation for
Standardization.
2. ISO 14044:2006 - Environmental management - life cycle assessment
- Requirements and guidelines, 2006, International Organisation for
Standardization.
3. Goedkoop, M., et al., "ReCiPe 2008: A life cycle impact assessment method
which comprises harmonised category indicators at the midpoint and the
endpoint level." VROM-Ruimte en Milieu, Ministerie van Volkshuisvesting,
Ruimtelijke Ordening en Milieubeheer, 2009. Available from: http://www.lcia-
recipe.net
4. Frischknecht R, Jungbluth N, Althaus H, Doka G, Dones R, Heck T, Hellweg
S, Hischier R, Nemecek T, Rebitzer G, Spielmann M, Wernet G, (2007),
Overview and methodology, ecoinvent report No. 1, Swiss Centre for Life
Cycle Inventories, Dübendorf, CH. Available from http://www.ecoinvent.org
5. Climate Change 2007: The Physical Science Basis. Contribution of Working
Group I to the Fourth Assessment Report of the Intergovernmental Panel
on Climate Change. Solomon S, Qin D, Manning M et al. (eds). Cambridge
University Press, Cambridge, UK, and New York, USA.
6. Plisko, J., Stewart, V., "The Financials of Going Green: University of Maryland
Medical Center Case Study," pp 21 and 24, Healthcare Financial Management
Association (HFMA) Annual National Institute (ANI) Conference, Seattle, WA,
June 17, 2009.
7. "Waste Categories & Types", Practice Greenhealth, Web, September 2012.
Available from https://practicegreenhealth.org/topics/waste/waste-categories-
types
8. Dhaliwal, H., M. Browne, W. Flanagan, L. Laurin, M. Hamilton, "A
life cycle assessment of packaging options for contrast media delivery:
comparing polymer bottle vs. glass bottle," International Journal of Life Cycle
Assessment, 19(12): 1965-1973, 2014. Available from:
http://rd.springer.com/article/10.1007%2Fs11367-014-0795-1
9. Marshall, G., "Sharps injuries among radiographers: dangers associated
with opening bottles of contrast agent," Radiography 14(2), 128-134, 2008.

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