{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:43:22Z","timestamp":1788263002505,"version":"build-2803163510"},"reference-count":42,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008069","name":"University of California, San Francisco","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006477","name":"Connecticut Breast Health Initiative","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006477","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100024099","name":"Philips Medical Systems","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100024099","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007208","name":"Vanderbilt Cancer Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007208","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004343","name":"3M","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004343","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009825","name":"American College of Radiology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009825","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016667","name":"Sean N. Parker Center for Allergy and Asthma Research, Stanford University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016667","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010174","name":"University of Colorado","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010174","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005492","name":"Stanford University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005492","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jacr.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of the American College of Radiology"],"published-print":{"date-parts":[[2026,4]]},"DOI":"10.1016\/j.jacr.2025.09.031","type":"journal-article","created":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T02:35:30Z","timestamp":1759631730000},"page":"522-531","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":6,"title":["Harmonizing Diagnostic Ultrasound Practice with Environmental Sustainability: A Life Cycle Assessment of Diagnostic Ultrasound in a Single Adult University Hospital"],"prefix":"10.1016","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3281-1452","authenticated-orcid":false,"given":"Katherine","family":"Frederick-Dyer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra L.","family":"Thiel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica R.","family":"Leschied","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1921-0182","authenticated-orcid":false,"given":"Olesya","family":"Struk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5528-9670","authenticated-orcid":false,"given":"Marta","family":"Vigil-Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8660-6706","authenticated-orcid":false,"given":"Cecilia","family":"Meijer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3270-6130","authenticated-orcid":false,"given":"Josephine","family":"Gehrels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2404-8688","authenticated-orcid":false,"given":"Reed A.","family":"Omary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0998-0098","authenticated-orcid":false,"given":"John R.","family":"Scheel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9517-2849","authenticated-orcid":false,"given":"Diana E.","family":"Carver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jacr.2025.09.031_bib1","doi-asserted-by":"crossref","first-page":"2346","DOI":"10.1016\/S0140-6736(23)01859-7","article-title":"The 2023 report of the Lancet Countdown on health and climate change: the imperative for a health-centred response in a world facing irreversible harms","volume":"402","author":"Romanello","year":"2023","journal-title":"Lancet"},{"key":"10.1016\/j.jacr.2025.09.031_bib2","series-title":"Health care\u2019s climate footprint: how the health sector contributes to the global climate crisis and opportunities for action","first-page":"48","author":"Karliner","year":"2019"},{"key":"10.1016\/j.jacr.2025.09.031_bib3","doi-asserted-by":"crossref","first-page":"2071","DOI":"10.1377\/hlthaff.2020.01247","article-title":"Health care pollution and public health damage in the United States: an update: study examines health care pollution and public health damage in the United States","volume":"39","author":"Eckelman","year":"2020","journal-title":"Health Aff (Millwood)"},{"key":"10.1016\/j.jacr.2025.09.031_bib4","doi-asserted-by":"crossref","first-page":"215","DOI":"10.3390\/jcm12010215","article-title":"Climate change, carbon dioxide emissions, and medical imaging contribution","volume":"12","author":"Picano","year":"2022","journal-title":"J Clin Med"},{"key":"10.1016\/j.jacr.2025.09.031_bib6","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/j.jacr.2018.07.015","article-title":"Environmental impacts of abdominal imaging: a pilot investigation","volume":"15","author":"Martin","year":"2018","journal-title":"J Am Coll Radiol"},{"key":"10.1016\/j.jacr.2025.09.031_bib7","doi-asserted-by":"crossref","first-page":"103","DOI":"10.21106\/ijma.294","article-title":"Trends in ultrasound use in low and middle income countries: a systematic review","volume":"9","author":"Stewart","year":"2020","journal-title":"Int J MCH AIDS"},{"key":"10.1016\/j.jacr.2025.09.031_bib8","doi-asserted-by":"crossref","DOI":"10.1148\/radiol.240398","article-title":"Environmental life cycle assessment of a U.S. hospital-based radiology practice","volume":"313","author":"Thiel","year":"2024","journal-title":"Radiology"},{"key":"10.1016\/j.jacr.2025.09.031_bib9","author":"Drew"},{"key":"10.1016\/j.jacr.2025.09.031_bib10","doi-asserted-by":"crossref","DOI":"10.1289\/EHP8666","article-title":"Operating in a climate crisis: a state-of-the-science review of life cycle assessment within surgical and anesthetic care","volume":"129","author":"Drew","year":"2021","journal-title":"Environ Health Perspect"},{"key":"10.1016\/j.jacr.2025.09.031_bib11","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1001\/jama.2019.10823","article-title":"Reducing pollution from the health care industry","volume":"322","author":"Sherman","year":"2019","journal-title":"JAMA"},{"key":"10.1016\/j.jacr.2025.09.031_bib12","unstructured":"International Organization for Standardization. ISO Standard 14040: Environmental management: Life cycle assessment; Principles and Framework. ISO: Geneva, Switzerland; 2006."},{"key":"10.1016\/j.jacr.2025.09.031_bib14","unstructured":"PR\u00e9 Consultants, SimaPro 9.3.0.2. 2022, LCA software. Amersfoort, Netherlands: PR\u00e9 Consultants."},{"key":"10.1016\/j.jacr.2025.09.031_bib15","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1065\/lca2004.10.181.1","article-title":"The ecoinvent database: overview and methodological framework","volume":"10","author":"Frischknecht","year":"2005","journal-title":"Int J Life Cycle Assess"},{"key":"10.1016\/j.jacr.2025.09.031_bib16","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/s10098-010-0338-9","article-title":"TRACI 2.0: the tool for the reduction and assessment of chemical and other environmental impacts 2.0","volume":"13","author":"Bare","year":"2011","journal-title":"Clean Technol Environ Policy"},{"key":"10.1016\/j.jacr.2025.09.031_bib46","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1007\/s10098-013-0629-z","article-title":"Updated US and Canadian normalization factors for TRACI 2.1","volume":"16","author":"Ryberg","year":"2014","journal-title":"Clean Technol Environ Policy"},{"key":"10.1016\/j.jacr.2025.09.031_bib18","first-page":"204","article-title":"Eliminating the routine use of examination table paper in outpatient oncology clinics","volume":"66","author":"Mariano","year":"2024","journal-title":"B C Med J"},{"key":"10.1016\/j.jacr.2025.09.031_bib47","first-page":"1","article-title":"Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC)","volume":"52","author":"Sehulster","year":"2003","journal-title":"MMWR Recomm Rep"},{"key":"10.1016\/j.jacr.2025.09.031_bib19","doi-asserted-by":"crossref","first-page":"11589","DOI":"10.3390\/su151511589","article-title":"A review of sustainability standards and ecolabeling in the textile industry","volume":"15","author":"Plakantonaki","year":"2023","journal-title":"Sustainability"},{"key":"10.1016\/j.jacr.2025.09.031_bib20","first-page":"E13","article-title":"Guidelines for cleaning and preparing external- and internal-use ultrasound transducers and equipment between patients as well as safe handling and use of ultrasound coupling gel","volume":"42","year":"2023","journal-title":"J Ultrasound Med"},{"key":"10.1016\/j.jacr.2025.09.031_bib21","first-page":"551","article-title":"Outbreak of catheter-related Burkholderia cepacia sepsis acquired from contaminated ultrasonography gel: the importance of strengthening hospital infection control measures in low resourced settings","volume":"28","author":"Viderman","year":"2020","journal-title":"Infez Med"},{"key":"10.1016\/j.jacr.2025.09.031_bib22","doi-asserted-by":"crossref","first-page":"263","DOI":"10.4103\/ijmm.IJMM_19_249","article-title":"Ultrasound gel as a source of hospital outbreaks: Indian experience and literature review","volume":"37","author":"Solaimalai","year":"2019","journal-title":"Indian J Med Microbiol"},{"key":"10.1016\/j.jacr.2025.09.031_bib23","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.jhin.2017.09.010","article-title":"Outbreak of Burkholderia cepacia bacteraemia in a tertiary care centre due to contaminated ultrasound probe gel","volume":"98","author":"Abdelfattah","year":"2018","journal-title":"J Hosp Infect"},{"key":"10.1016\/j.jacr.2025.09.031_bib24","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1016\/j.ajic.2017.06.025","article-title":"Outbreak of health care-associated Burkholderia cenocepacia bacteremia and infection attributed to contaminated sterile gel used for central line insertion under ultrasound guidance and other procedures","volume":"45","author":"Shaban","year":"2017","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.jacr.2025.09.031_bib25","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.bjid.2015.06.009","article-title":"Polyclonal outbreak of bacteremia caused by Burkholderia cepacia complex and the presumptive role of ultrasound gel","volume":"19","author":"Nannini","year":"2015","journal-title":"Braz J Infect Dis"},{"key":"10.1016\/j.jacr.2025.09.031_bib27","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.15585\/mmwr.mm7148a3","article-title":"Outbreak of Burkholderia stabilis infections associated with contaminated nonsterile, multiuse ultrasound gel\u201410 states, May\u2013September 2021","volume":"71","author":"Hudson","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"10.1016\/j.jacr.2025.09.031_bib28","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1086\/671268","article-title":"An outbreak of Pseudomonas aeruginosa respiratory tract infections associated with intrinsically contaminated ultrasound transmission gel","volume":"34","author":"Chittick","year":"2013","journal-title":"Infect Control Hosp Epidemiol"},{"key":"10.1016\/j.jacr.2025.09.031_bib29","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.juro.2010.08.093","article-title":"An outbreak of Achromobacter xylosoxidans associated with ultrasound gel used during transrectal ultrasound guided prostate biopsy","volume":"185","author":"Olshtain-Pops","year":"2011","journal-title":"J Uurol"},{"key":"10.1016\/j.jacr.2025.09.031_bib30","series-title":"BMC Proceedings","first-page":"O75","article-title":"Burkholderia cepacia\u2013outbreak in obstetric patients due to intrinsic contamination of non-sterile ultrasound gel","volume":"5","author":"Hell","year":"2011"},{"key":"10.1016\/j.jacr.2025.09.031_bib31","doi-asserted-by":"crossref","first-page":"100009","DOI":"10.1016\/j.infpip.2019.100009","article-title":"Outbreak of Acinetobacter baumannii associated with extrinsic contamination of ultrasound gel in a tertiary centre burn unit","volume":"1","author":"Yagnik","year":"2019","journal-title":"Infect Prev Pract"},{"key":"10.1016\/j.jacr.2025.09.031_bib32","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.ultrasmedbio.2016.09.004","article-title":"Potential infection control risks associated with ultrasound equipment\u2014a bacterial perspective","volume":"43","author":"Westerway","year":"2017","journal-title":"Ultrasound Med Biol"},{"key":"10.1016\/j.jacr.2025.09.031_bib33","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1002\/jum.14788","article-title":"Shake no bake: a homemade ultrasound gel recipe for low-resource settings","volume":"38","author":"Cherukuri","year":"2019","journal-title":"J Ultrasound Med"},{"key":"10.1016\/j.jacr.2025.09.031_bib34","series-title":"Open Forum Infectious Diseases","article-title":"Greening infection prevention and control: multifaceted approaches to a sustainable future","volume":"12","author":"Lee","year":"2025"},{"key":"10.1016\/j.jacr.2025.09.031_bib35","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1007\/s11367-021-01998-8","article-title":"Environmental footprint of regular and intensive inpatient care in a large US hospital","volume":"27","author":"Prasad","year":"2022","journal-title":"Int J Life Cycle Assess"},{"key":"10.1016\/j.jacr.2025.09.031_bib36","first-page":"33","article-title":"The impact of glove misuse on patient safety during the COVID-19 pandemic","volume":"118","author":"Hafeez","year":"2022","journal-title":"Nurs Times"},{"key":"10.1016\/j.jacr.2025.09.031_bib37","doi-asserted-by":"crossref","first-page":"S126","DOI":"10.1016\/j.annemergmed.2020.09.340","article-title":"325 Do sterile probe covers confer less infection than an alcohol-cleaned probe? A pilot study","volume":"76","author":"Brodak","year":"2020","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.jacr.2025.09.031_bib38","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s13089-023-00347-0","article-title":"Comparing contamination rates of sterile-covered and uncovered transducers for ultrasound-guided peripheral intravenous lines","volume":"16","author":"Estrella","year":"2024","journal-title":"Ultrasound J"},{"key":"10.1016\/j.jacr.2025.09.031_bib39","doi-asserted-by":"crossref","first-page":"6759","DOI":"10.1007\/s00330-022-08849-6","article-title":"Incidence of infectious complications following ultrasound-guided percutaneous musculoskeletal interventions with the use of an uncovered transducer footprint","volume":"32","author":"Gorelik","year":"2022","journal-title":"Eur Radiol"},{"key":"10.1016\/j.jacr.2025.09.031_bib40","series-title":"The essential physics of medical imaging","author":"Bushberg","year":"2011"},{"key":"10.1016\/j.jacr.2025.09.031_bib41","author":"Brown","year":"2014"},{"key":"10.1016\/j.jacr.2025.09.031_bib42","series-title":"Assessing trends over time in performance, costs, and energy use for servers","author":"Koomey","year":"2009"},{"key":"10.1016\/j.jacr.2025.09.031_bib44","first-page":"100459","article-title":"The carbon footprint of hospital diagnostic imaging in Australia","volume":"24","author":"McAlister","year":"2022","journal-title":"Lancet Reg Health West Pac"},{"key":"10.1016\/j.jacr.2025.09.031_bib45","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.jacr.2023.11.020","article-title":"A CT scan of our earth: the radiology department\u2019s how-to guide for addressing planetary health","volume":"21","author":"Lee","year":"2024","journal-title":"J Am Coll Radiol"}],"container-title":["Journal of the American College of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1546144025005770?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1546144025005770?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T07:28:49Z","timestamp":1781076529000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1546144025005770"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":42,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["S1546144025005770"],"URL":"https:\/\/doi.org\/10.1016\/j.jacr.2025.09.031","relation":{},"ISSN":["1546-1440"],"issn-type":[{"value":"1546-1440","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Harmonizing Diagnostic Ultrasound Practice with Environmental Sustainability: A Life Cycle Assessment of Diagnostic Ultrasound in a Single Adult University Hospital","name":"articletitle","label":"Article Title"},{"value":"Journal of the American College of Radiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jacr.2025.09.031","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier Inc. on behalf of American College of Radiology.","name":"copyright","label":"Copyright"}]}}