Gadolinium Pollution-A Future Forward Perspective on Human and Environmental Impact.

The widespread use of gadolinium-based contrast agents (GBCAs) in magnetic resonance imaging (MRI) has been instrumental in enhancing diagnostic capabilities. However, the potential environmental and human health impacts of gadolinium pollution have become a growing concern. Despite the stability of GBCAs when bound to organic ligands, gadolinium retention in animals after GBCA administration has been well documented, though the biological impact has been uncertain. GBCAs can degrade and release gadolinium. The degree of dechelation is dependent on the GBCA. The chemical form of the retained gadolinium is likely in the form of a salt. This review presents the current known information about gadolinium pollution as it pertains to both human and environmental health. The long-term effects of GBCA accumulation in humans most dramatically have been seen in patients with renal insufficiency through the association with nephrogenic systemic fibrosis (NSF), an iatrogenic disease that was not recognized until after more than 15 years of GBCA utilization. Neural deposition in people after repeated exposures has yet to have proven association with neurotoxicity, but it is widely agreed that exposure should be limited to clinical necessity. Environmentally there is concern for gadolinium runoff, contamination of water systems, bioaccumulation, and compounding ecological harm. We propose strategies for mitigating gadolinium pollution, including reducing the use of contrast agents, improving waste disposal/recovery techniques, and advancing research on microbial remediation methods. Addressing gadolinium pollution will be a collaborative, interdisciplinary effort that begins with improving awareness of the problem, which is what this review intends to accomplish here.