Journal of Building Engineering 41 (2021) 102387

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Journal of Building Engineering

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A life cycle analysis of ionizing radiation shielding construction systems in

healthcare buildings
Gonzalo Sánchez-Barroso a, Manuel Botejara-Antúnez a, Justo García-Sanz-Calcedo a, *,
Francisco Zamora-Polo b
a
Engineering Projects Area, School of Industrial Engineering, University of Extremadura, Badajoz, Spain
b
Design Engineering Department, Higher Polytechnic School, University of Seville, Seville, Spain

A R T I C L E I N F O A B S T R A C T

Keywords: Optimization of material resources, energy efficiency and reduction of environmental impact are basic aspects in
Healthcare design selection of a construction system. The aim of this study is to evaluate the environmental impact generated by
Building materials different shielding systems for walls of an X-ray room in healthcare buildings. Eight commercial construction
Healthcare buildings
systems for anti-X shielding were analysed. A Life Cycle Assessment (LCA) was performed by SimaPro using the
Sustainable radioactive shielding systems
Ecoinvent database, and a single-score damage category analysis was performed for midpoint and endpoint
Healthcare engineering
levels. Prices of installation and working time employed in the construction of a functional unit of each system
were obtained. Solutions with clay brick, cast-in-place reinforced concrete and sprayed concrete were the most
favourable for the different categories. Sprayed concrete obtained 6.739 points/m2 of against 165.12 points/m2
of rolled steel option. The damage to human health occupies between 41% and 87% of the total impact in the
protection areas. The impact category of human toxicity is also the broadest in the midpoint approach.
Considering time and cost of implementation, clay brick solutions proved to be the most favourable, along with
cast-in-place reinforced concrete and barite concrete. System #6 is the most environmentally friendly, 1.6 times
less than the next one (which is #4), although its unit price is 1.94 times the cheapest (which is #2) and its
execution time is 1.89 times the lowest (which is #2 again). The knowledge generated in this study will improve
investment decision making for the planning departments of the Sanitary Systems, obtaining an economic, social
and environmental benefit. The main novelty of the work lies in the object of the study (X-ray room) as well as in
the integration of LCA and economic aspects.

1. Introduction can cause harmful effects on people’s health [3,4] and on the environ­
ment [5].
The design and construction of an X-ray facility for medical diag­ Conventional radiography equipment emits X-rays that cause
nostic purposes must be safe for people. The radiation-equivalent doses adverse effects on workers in the room itself and other people in adja­
that may be received by exposed personnel, patients, and accompanying cent wards [6]. X-ray technicians at these facilities must carry individual
persons should be as low as reasonably achievable [1]. Therefore, the protection equipment (IPE), personal radiation monitoring dosimeter
armour of an X-ray room plays a critical role in absorbing as much ra­ and they must adjust their workload to minimize their exposure [3].
diation produced by these equipment as possible, to avoid it from being Other workers and users outside the room do not carry IPE, so the ver­
transmitted perimetrically [2]. In order to provide this mitigation of tical walls enclosing the diagnostic X-ray machine must have radiolog­
radioactivity, different materials are used: lead, steel, concrete, ce­ ical isolation characteristics that attenuate X-ray transmission to the
ramics, among others. Each of these materials offers different advan­ outside of the room [2].
tages and disadvantages from a point of view of placement, costs, The doses emitted by diagnostic X-ray machines vary considerably
thickness, etc. In addition, these materials have a different impact on the depending on the angle of incidence of the beam [7] and its diagnostic
environment. Lead is commonly used for anti-X shield. However, its use application [8]. Radiopacity is achieved by superimposing layers of

* Corresponding author.
E-mail addresses: [email protected] (G. Sánchez-Barroso), [email protected] (M. Botejara-Antúnez), [email protected], [email protected] (J. García-Sanz-Calcedo),
[email protected] (F. Zamora-Polo).

https://doi.org/10.1016/j.jobe.2021.102387
Received 20 December 2020; Received in revised form 1 March 2021; Accepted 7 March 2021
Available online 17 March 2021
2352-7102/© 2021 Elsevier Ltd. All rights reserved.
G. Sánchez-Barroso et al. Journal of Building Engineering 41 (2021) 102387

materials with anti-radiation properties of a certain thickness, so that a in the three areas of protection: climate change, human health and
lead equivalent is achieved according to test IEC 6133–1:2014 [9]. ecosystem quality. Ingrao et al. [30] identified the most sustainable
Consequently, designing construction systems for protection against solution for exterior walls according to the midpoint and endpoint
ionizing radiation is one of the complex problems faced by Healthcare approach. There are extensive reviews of LCA in the construction sector
Engineering [10]. In Spain, Nuclear Safety Council is the competent [31], on residential and commercial buildings [32], applied to renova­
authority in this area, which has published various technical guides for tion work [33] and even in the demolition process [34,35].
the protection of exposure of people [11] applying commonly accepted LCA has been proven as the right tool for analysing the environ­
experience-based design methods [12,13]. mental impact associated with the life cycle of buildings [36]. In hospital
Research in this area of work has been focused on demonstrating the environment it has been used to measure environmental impact gener­
radiation attenuation capabilities of different materials. In this way, ated by different products and processes. For example, McGain et al.
concrete can achieve anti-radiation properties by increasing its density studied the environmental impact associated with the life cycle of an
through the incorporation of heavy aggregates and metal reinforcement anaesthesia equipment. [37], of a catheter insertion kit [38] and of a
(reinforced concrete) or incorporating additives such as barite sulphate plastic anaesthetic drug trays [39]. Igos et al. analysed the environ­
(BaSO4) [14]. Other equally valid materials can be drywall [15], barite mental impact of wastewater from sanitary buildings [40] y studied the
plasterboard [16] and steel [17]. There are even ceramic materials that elimination of pharmaceuticals [41]. Furthermore, García-Sanz-Calcedo
have anti-radiation properties [18]. et al. demonstrated the high potential for global warming associated
In order to achieve sustainability, the environmental dimension must with the construction of health centres [42] and the influence of the
be incorporated into the choice of construction materials and con­ management of the energy consumption of a hospital with the reduction
struction systems for radiological shields [19]. Life Cycle Assessment of its environmental impact [43].
(LCA) is a quantitative method to evaluate the environmental and Different databases are available to perform Life Cycle Inventory
human health impact over the lifetime of a product, taking into account (LCI) in building industry. Lasvaux et al. [44] compared the generic
extraction and processing of raw materials, manufacturing, distribution, (such as Ecoinvent, GaBi, DEAM, US-LC, etc.) and product-specific (i.e.,
use, maintenance and repair, and disposal [20]. Product Category Rules) databases in construction sector and listed the
Notwithstanding, the evaluation of hospital infrastructures con­ benefits of Ecoinvent database in France. Martínez-Rocamora et al. [45]
struction has not yet been widely addressed in the literature from an found that Ecoinvent and GaBi databases showed the best features
environmental perspective. Hui Li et al. [21] proved that hospital (scope, completeness, transparency, comprehensiveness, update and li­
buildings have the highest environmental impact compared to residen­ cense) in construction sector among European, American, national,
tial, commercial and educational buildings. Regarding conventional input-output and other databases. Althaus et al. [46] also noted that
radiology rooms, Lopresti et al. [22] investigated new epoxy-based Ecoinvent database is suitable for building materials. Ecoinvent is one of
lead-metal substitute materials with similar radiopacity properties. the most widely used databases for LCI. In fact, a comprehensive review
Despite the current knowledge, the study of radiology room shielding of LCA between 1995 and 2008 indicated that 59% of authors employed
systems in healthcare buildings from an environmental perspective this data repository [47].
using LCA tools has not been carried out. In order to develop the Life Cycle Impact Assessment (LCIA), ReCiPe
The main objective of this study is to evaluate the environmental is a method frequently used. Data from LIC is converted into impacts
impact generated over the cradle-to-grave life cycle of different wall through this method by using 18 midpoints indicators and 3 endpoints
shielding systems used in healthcare buildings’ X-ray rooms, and to indicators [48]. Bories et al. [49] evaluated the environmental impact of
analyse their feasibility from an environmental perspective. In this way, porous fired clay bricks with bio-based additives; Pushkar and Verbitsky
architects, engineers and infrastructure managers will have a tool to [50] analysed environmental damage of four wall technologies; and
select the construction system considering sustainability. Kono et al. [51] evaluated different thermal insulation materials using
This work is aligned with the achievement of the Sustainable ReCiPe.
Development Goals (SDG), the work agenda set by the United Nations Output of ReCiPe method is the valuation of metrics (points) called
for the period 2015–2030 [23]. Building hospitals in a sustainable way is eco-indicators midpoint (problem oriented) and endpoint (damage ori­
clearly within SDG no. 3: “ensuring healthy and safe living for all ages,” ented) [20]. Problem-oriented approach is associated with a low level of
but it is also related to SDG no. 9: “building resilient infrastructure,” SDG uncertainty but implies greater difficulty of interpretation due to the
no. 11, about more inclusive, safe, resilient and sustainable cities, SDG high number of impact categories. The opposite is true for
no. 12 sustainable consumption and production, combating climate damage-oriented approach. Controversy exists among experts. Never­
change (SDG no. 13) [24]. theless, Bare et al. [52] suggested that both methods could be used
together to provide more information to decision-makers.
2. Literature review This paper aims to address a gap in the scientific literature of hospital
engineering. To the best of our knowledge, life cycle analysis of X-ray
In environmental management, internationally accepted standards rooms has not been carried out. In the paper the different solutions are
describing the LCA process are ISO 14040 [25], which sets out principles analysed both from an economic and environmental point of view. The
and framework, and ISO 14044 [26], which describes requirements and paper addresses two issues of great interest to the scientific community,
guidelines for carrying it out. on the one hand environmental concerns, one of the main challenges
Uncertainty management of knowledge about environmental facing mankind, as well as health care. The current pandemic situation
mechanisms revolves around Cultural Theory [27]. Individualist, Hier­ caused by the COVID19 crisis requires resilient health systems with low
archist and Egalitarian archetypes assume a short-, medium- and environmental impact.
long-term perspective on the atmospheric lifetime scale of substances.
The environmental damages identified by LCA are congruent with an 3. Material and methods
egalitarian worldview [28]. Cradle-to-grave approach follows the linear
economic model of product use from raw material extraction to product 3.1. General method
use and disposal [20].
Applying LCA to construction, Maria de Souza et al. [29] conducted The multi-case LCA analysis followed a bottom-up methodology
an LCA-based evaluation to compare ceramic brick exterior wall with based on processes in accordance with ISO 14040 [25] and ISO 14044
concrete bricks and cast-in-place reinforced concrete. They found that [26] as shown in Fig. 1.
environmental impact of the first one is 50–70% lower than the third one

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G. Sánchez-Barroso et al. Journal of Building Engineering 41 (2021) 102387

Fig. 1. Life Cycle Analysis framework. Adapted from Ref. [25].

3.1.1. Goal and scope definition results by damage routes and check individual contributions to the
Firstly, a comparative evaluation of the environmental impact of impact on each protection area. ReCiPe proposes 18 impact categories,
eight X-ray room shielding systems in hospitals was defined as an but SimaPro v8.1 includes marine eutrophication within freshwater
objective of the analysis. The functional unit chosen was 1 m2 of shield eutrophication.
for a radiology room in a hospital, being the most widely used parameter An outline of both approaches to impact assessment methodology
according to published scientific research [47]. The scope of the study followed in this work is shown in Fig. 3, which is a summary of the
(system boundary) in terms of life cycle stages covered raw materials method and ReCiPe’s own characterisation, normalization and weight­
extraction, manufacture of the materials to build the wall, transport to ing factors [48].
the hospital, implementation, useful life (25 years) and finally demoli­ For the selection of impact categories (midpoint), the RECIPE
tion, as shown in Fig. 2. LCI will be defined in Description cases section. methodology points out the following aspects [55]:

3.1.2. Life Cycle Impact Assessment - Impact categories must have direct environmental relevance.
Once the LCI was established, the ReCiPe method for characterizing - Impact categories are names, and category indicators are measurable
environmental impact in the life cycle was used as this method is aspects. Thus, characterization models are required.
representative on a global scale [48]. The impact assessment was - Impact categories capture the common mechanisms involved in the
quantified using SimaPro v8.1 [53] software and the egalitarian effect of various substances.
perspective was chosen to take into account an infinite time horizon in
the most pessimistic development framework [54]. Double weighting For the selection of the final level categories (endpoint), those that
indicators (midpoint and endpoint) were chosen to disaggregate the influence on policy and sustainable development are chosen. In the case

Fig. 2. System boundary under cradle-to-grave approach.

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G. Sánchez-Barroso et al. Journal of Building Engineering 41 (2021) 102387

Fig. 3. Single score calculation process according to midpoint and endpoint approach.

of the methodology used: human health, environmental quality, and 3.2. Description cases
resource availability.
The characterization factors of each protection area were expressed An equipment with pipe power between 20 and 40 kW, maximum
in different metrics. For those referred to the human health, DALY 125 kV, focal points of 1–2 m/m and filtration of 3 mm (Al), with a
(disability adjusted life years) was used, which represents the years lost weekly load of 80 mA min per week, with a maximum field size of 40 ×
by a person due to a disease; ecosystems quality, in species lost per unit 40 cm was considered. The dose limits considered were 0.12 mSv/week
of time; and, finally, for resource scarcity, as the extra cost of extracting for the radiologist work area and 0.02 mSv/week for the walkable area
resources in the future. The standardization of characterization factors for patients and non-radiographic medical staff.
was done with global scale references to ensure the extrapolation of The dimensions of the X-ray room considered were 3.60 m wide and
results. Midpoint approach does not weight the normalization to achieve 5.40 m long, with a free height of 2.70 m. Fig. 4 shows the floor plan of
the final score. However, unique score was obtained by an endpoint this room.
approach through the damage and weighting route after normalization. Eight possible construction systems were considered for armouring
To complement the environmental impact analysis, other key di­ (Table 1). The radioprotective walls are those that enclose the radiology
mensions for the decision to choose shielding systems were incorpo­ machine and that separate the controlled zone from the monitored zone.
rated. For a given functional unit, cost and material execution time were The thickness of the wall varied according to the construction ma­
obtained from unit prices of the necessary materials and the work per­ terial. The horizontal faces were not taken into account because they are
formance of the necessary labour. These values were calculated from structural elements and the isodoses curves in a vertical plane to the
specialized databases of construction in Spain elaborated from infor­ machine are of less intensity [57]. These systems were designed to
mation provided by manufacturers [56]. ensure an individual dose cap on the other side of the shield by esti­
mating the attenuation factor (A) of Equation (1)
Г ⋅W⋅U⋅T
A= (1)
d2 ⋅Hw

Fig. 4. Floor plan of an X-ray room.

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G. Sánchez-Barroso et al. Journal of Building Engineering 41 (2021) 102387

Table 1
Description of the proposed shielding systems analysed.
Case Shielding material Description of layers Amount (kg) Constructive detail

#1 Lead (EN 12588:2006) A) External hollow brick wall. 126.01

B) Lead sheet. 17.01
C) Support system made up of wooden battens. 1.84
D) Internal hollow brick wall. 72.01
E) Gypsum plaster. 10.00
F) Epoxy paint coat. 0.05

#2 Clay brick [11] A) Hollow brick wall. 353,70

B) Gypsum plaster. 10.00
C) Epoxy paint coat. 0.05

#3 Rolled Steel [11] A) External hollow brick wall. 126.01

B) Steel sheet. 183.09
C) Support system made up of wooden battens. 1.84
D) Internal hollow brick wall. 72.01
E) Gypsum plaster. 10.00
F) Epoxy paint coat. 0.05

#4 Reinforced concrete [11] A) Reinforced concrete wall. 365.10

B) Gypsum plaster. 10.00
C) Epoxy paint coat. 0.05

#5 Barite concrete [11] A) Barite concrete wall. 365.10

B) Gypsum plaster. 10.00
C) Epoxy paint coat. 0.05

#6 Sprayed concrete (EN 14487–1:2005) A) Hollow brick wall. 126.01

B) Reinforced concrete wall. 17.01
C) Gypsum plaster. 10.00
D) Epoxy paint coat. 0.05

#7 Barite plasterboard (EN 520:2004 + A1:2009) A) Hollow brick wall. 72.01

B) Support system made up of metallic steel profiles. 10.27
C) Barite plaster double panel system. 80
D) Epoxy paint coat. 0.05

#8 Leaded plasterboard (EN 520:2004 + A1:2009) A) Hollow brick wall. 72.01

B) Support system made up of metallic steel profiles. 10.27
C) Rock wool. 9.84
D) Leaded plasterboard 26.82
(continued on next page)

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G. Sánchez-Barroso et al. E) Epoxy paint coat. Journal of Building Engineering 41 (2021) 102387

Table 1 (continued )
Case Shielding material Description of layers Amount (kg) Constructive detail

0.05

*(Measurements expressed in mm)

where Г is the equivalent radiation dose (in mSv) produced by a beam at after the internal normalization process is shown in Fig. 6. An internal
1 m, W is workload (mAs⋅min/week), U is the barrier use factor, T is the normalization process was carried out whereby 100% was assigned to
occupancy factor, d is the distance between the focus of the tube and the the system with the highest score in a category. Based on this re-scaling,
area to be protected, y Hw is the weekly dose limit on the other side of the proportion of the impact on the rest of the systems is established.
the armour (in mSv/week). Analysing by impact categories, design #3 presents the maximum
Although lower values were calculated, 1.5 mm thick lead was values in all impact categories except ionizing radiation and agricultural
considered as a minimum shield since a safety factor of 1.5 was applied. land occupation, where the maximum values are obtained by systems
Due to the suitability for the thickness and mechanical characteristics of #5 and #2, respectively. In general, all systems present similar values of
the floor and ceiling, these were excluded from the study. relative importance in each impact category. However, the second most
Following life cycle stages of each armour system, for each functional important is #5 in ozone depletion category, #8 in human toxicity and
unit an inventory of materials and machinery involved in the processes in terrestrial acidification. In terrestrial ecotoxicity, system #2 is rela­
of the scope was made using the Ecoinvent 3.1 database [58]. The tively important, and in this and in agricultural land occupation systems
transport of the material from the factory to a hospital using EURO3 #1, #2 and #3 stand out.
trucks that travel the distances of Table 2 was considered. According to
the cradle-to-grave approach, the energy consumed on-site construction 4.2. Results according to midpoint approach
activities for placing each system in the radiology room itself and the
electrical energy for lifting construction materials using a 1.6 kW hoist Single score results for different systems are reflected in Fig. 7 for
according to the manufacturer’s datasheet were considered. At the end midpoint categories. For all the designs analysed, human toxicity cate­
of their useful life, it was estimated that machines would be used to gory has the highest values.
dismantle the walls and transport 25 km to a waste disposal point using Solution #3 stands out as the most harmful to the environment
16–32 metric ton EURO3 lorry. considering all categories. The most important categories are, in order:
metal depletion (22.47 pt), climate change human health (11.38 pt),
4. Results climate change ecosystems (9.08 pt), fossil depletion (8.6 pt) and finally,
natural land transformation (6.17 pt).
4.1. General results
4.3. Results according to endpoint approach
Fig. 5 shows the characterization of the impact categories. The most
unfavourable impact category of the DALY set is human toxicity, in Fig. 8 shows the damage assessment by protection areas as an in­
which systems #1, #3 and #8 stand out, with shield #3 being the one termediate step to obtain the single score in the endpoint approach. With
with the greatest impact (0.001 DALY). In the ecosystems quality set, respect to damage to people’s health, system #3 (0.012 DALY) is 3.5
system #3 is again the most undesirable, generating greater impacts in times higher than the average (2.2⋅10− 3) of the other seven designs. It is
the categories climate change ecosystems (6⋅10− 6 species⋅yr), marine followed by system #8 with 5.9⋅10− 3 DALY and thirdly by system #1
ecotoxicity (2.6⋅10− 6 species⋅yr) and natural land transformation with 4.8⋅10-3 DALY. In the ecosystem quality damage path, case #3
(4.2⋅10− 6 species⋅yr). Finally, for resources scarcity characterization, (1.4⋅10− 5 species⋅yr) is 3.8 times higher than the average of the
system #3 is again the most unwanted, presenting the highest score in remaining cases (2.2⋅10− 6). The other systems have a very similar value.
the metal depletion category (34.6 $). Finally, shield #3 (48.0 $) has the most serious impact on resource
The characterization of impact categories of the shielding systems scarcity, being 4.6 times higher than the average of the other systems
(5.1 ± 2.0 $). As in the previous protection area, the other designs have a
Table 2 similar impact.
Building materials inventory. After normalizing and weighting the characterization factors, Fig. 9
Materials Density (kg/m3) Distance (km) shows the results of the unique endpoint score of each protection system.
Lead sheet 11,000 600
In this way, it is possible to compare the systems by aggregating the
Wooden batten 500 200 impacts on the protection areas. The most unfavourable shield system is
Epoxy paint 1000 600 that corresponding to steel, since it has an impact of 165.12 points/m2 of
Clay brick 1600 200 X-ray room shielding, of which 113.99 are attributed to human health
Gypsum plaster 1000 200
(69%), 20.07 to ecosystems (12.2%) and 31.06 to resources scarcity
Rolled steel 7800 600
Concrete 2400 200 (18.8%). System #6 yields the most desirable data on environmental
Barite concrete 3200 200 impact with 6.739 points/m2 of X-ray room shielding, of which 49.3%
Barite plasterboard 1440 200 are human health, 27.0% ecosystems, and 23.7% resources. According
Leaded plasterboard 784 + 11,000 600 Fig. 5, the endpoint’s single score result makes sense, since for the
Rock wool 160 200
midpoint the human toxicity value is much higher than the other impact

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G. Sánchez-Barroso et al. Journal of Building Engineering 41 (2021) 102387

Fig. 5. Characterization of impact categories.

categories. midpoints, the construction cost, and the labor required for the con­
struction of the shielding systems analysed. For this purpose, the most
unfavourable reference value has been marked as the benchmark, so
4.4. Unit cost and working time
that the values obtained indicate how much more favourable a system is
with respect to the reference value.
Fig. 10 shows the unit price and working time per functional unit
Thus, from Table 3 it can be inferred, for example, that the shielding
considered. With respect to cost, on the one hand, design #8 presents the
system 3 is the one with the worst values from an environmental point of
highest unit price (260.68 €/m2), which is 1.88 times the following:
view, although the construction price is 47% lower than that of type #8.
system #1 of 138.16 €/m2. On the other hand, system #2 has the lowest
The ceramic brick system (#2) shows the best environmental results.
installation cost (37.90 €/m2) and then there is system #4. With respect
A compact surface must be guaranteed to ensure radiopacity. This im­
to execution time, system #2 (1.12 h/m2) is the fastest in execution and
plies that grooves in the direction of the x-ray towards the outside
systems #1 and #3 are the slowest (3.44 h/m2). System #2 minimizes
cannot exist and a mortar of the same density must be used. The main
both dimensions (cost and time) with 37.90 €/m2 and 1.12 h/m2.
disadvantage of this construction material in the possible generation of
cracks [59], particularly in areas with possible seismic movement.
5. Discussion Another added problem is that this system takes up more useable space
in the building, due to its thickness (18 cm versus 11 cm of the solution
The above results demonstrate that a correct choice of anti-X that takes up less space). Notwithstanding the above, the time and cost
shielding systems can significantly decrease the overall environmental of execution is the lowest of all those analysed.
impact embedded in a healthcare building, thus increasing its sustain­ The reinforced concrete design (#4), a thickness of 15 cm is required
ability. On the other hand, Life Cycle Analysis is a suitable tool, which to achieve similarity to its lead equivalent and, consequently, the high
should be integrated into your design process. amount of material penalizes its environmental assessment. It is a viable
The results obtained allow the selection of the system that generates solution for new construction projects. However, the placement of the
the least environmental impact. To facilitate the understanding of the formwork makes it difficult for renovation projects. As with the brick
results, Table 3 shows the relative values of the endpoints, the main

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G. Sánchez-Barroso et al. Journal of Building Engineering 41 (2021) 102387

Fig. 6. Internally standardized characterization of intermediate impact categories

Fig. 7. Impact analysis - unique midpoint score.

system, X-ray leakage through the setting joint must be avoided, as well construction system is the sprayed concrete system (#6). Shotcrete
as air occlusion. This solution has the second lowest cost, 84% less than solves problems of both useful surface occupation (less thickness is
#8 and installation time, 58% less than #1 and #3. required) and on-site execution (no formwork is necessary). A disad­
An alternative solution to the cast-in-place reinforced concrete vantage during execution is related to quality control, so the evaluation

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G. Sánchez-Barroso et al. Journal of Building Engineering 41 (2021) 102387

Fig. 8. Damage assessment by protection areas.

than the most expensive (system #8).

The next least desirable system according to sustainability criteria is
leaded plasterboard (#8). Its low environmental rating is compounded
by its high installation cost, although installation time is among the
lowest. The toxicity of lead is a determining factor in the assessment of
this proposal. Analysing together systems #1 (lead based), #7 (barite
plasterboard) and #5 (barite concrete) it can be inferred that lead is the
culprit of the high environmental impact of system #8. The presence of
barite in the systems (#7 and #8) increases the environmental impact
since it is a heavy metal additive [61], concluding that plasterboard is
not so harmful. Previous studies published about the environmental
impact of barite show that this material as one of the least harmful to
people, ecosystems and resources and, furthermore, it has adequate
shielding properties [62]. When barite is used together with another
material, the wall thickness required, and the execution time are very
similar whether it is used with concrete (#5) or mixed with plasterboard
(#7). However, its use as an additive to plasterboard presents an
Fig. 9. Impact analysis - unique endpoint score.
execution cost almost double that of barite concrete. In this sense, the
mechanical and radiation protection properties of concrete reinforced
with Boron and Basalt fibres are being characterized [63].
Lead (#1) ranks as the third least planet friendly. It is the most
common system in these constructions; however, other options present a
better ecological performance. In this sense, special-purpose lead-free
shielding materials are emerging [64]. There is even the possibility of
transparent shielding without this element for X-ray rooms [65]. Even
so, for ceiling and floor shielding of rooms it is a very suitable material
due to its low thickness. In any case, lead sheets should overlap at least
twice their thickness to avoid leaks [11].
On the other hand, it should be noted that due to its high malleability
and high density, lead has been found to be the most suitable material
for anti-radiation shielding of doors and windows. Therefore, its use is
recommended. However, to ensure operational safety, periodic in­
spections should be carried out to check the correct arrangement,
especially of the door seals and door closures, which suffer a high degree
of deterioration due to accidental impacts with wheelchairs and litters.
Whatever the system chosen, the shielding of the radio-diagnostic
Fig. 10. Unit price and working time for the installation of the shielding
functional unit. rooms must be constructed in such a way that the protection is not
weakened by joints, ducts, pipes, etc., passing through the barriers, or
different service elements embedded in the barriers. Moreover, obser­
of the thickness achieved requires specialized equipment (layer thick­
vation doors and windows require special consideration to ensure
ness measurement) to ensure radiopacity [60]. Unit both execution time
adequate protection without impairing operational efficiency.
and cost are higher than the previous two (clay brick and reinforced
Direct access to a radiology room should be through a door with a
concrete). Nevertheless, these values are among the lowest of the pro­
plumb line. When the door is being opened, the sheet should protect the
posed systems. In this case, the setting joint takes on special importance
person opening it from exposure to radiation and give operating
to avoid radiation leaks.
personnel time to warn them. The opening should be located on a sec­
The rolled steel system (#3) reaches the worst environmental in­
ondary barrier, where the required shielding thicknesses are less.
dicators. This statement appears to be unintuitive, because the toxicity
Manufacturers tend to design diagnostic radiography equipment
of lead is greater than that of steel. However, it takes 9.7 times the
with less aggressive technologies for patients, which with lower radia­
amount of steel (system #3) compared to the amount of lead (system
tion dose generate images with equivalent quality; and thus, lower
#1). In addition, the steel making process demands a much higher
shielding will be necessary in the future. The appearance of new diag­
amount of energy compared to lead rolling. Lastly, execution time is the
nostic equipment and the replacement of obsolete ones require that it is
highest with the lead-based system, although the unit price is 47% lower

9
G. Sánchez-Barroso et al. Journal of Building Engineering 41 (2021) 102387

Table 3
Comparison of the shielding systems analysed.
#1 #2 #3 #4 #5 #6 #7 #8

Constructability Unit Price Classification M L M L L L M H

Weight 47,00% 85,46% 47,00% 83,91% 80,20% 71,77% 64,00% 0,00%
Working Time Classification H L H L L M L L
Weight 0,00% 67,44% 0,00% 57,85% 57,85% 38,37% 54,65% 52,03%
Endpoints Resources availability Classification L L H L L L L L
Weight 89,35% 93,34% 0,00% 89,86% 90,54% 94,85% 87,25% 80,69%
Ecosystems quality Classification L L H L L L L L
Weight 81,61% 85,50% 0,00% 86,30% 80,67% 90,93% 85,00% 78,53%
Human Health Classification M L H L L L L M
Weight 58,81% 94,83% 0,00% 96,31% 86,73% 97,09% 86,81% 49,78%
Midpoints Climate Change Human Health Classification L L H L L L L L
Weight 83,83% 85,24% 0,00% 74,17% 75,40% 87,79% 84,01% 76,54%
Human Toxicity Classification M L H L L L L M
Weight 55,23% 96,04% 0,00% 99,00% 87,97% 98,24% 87,13% 46,00%
Climate Change Ecosystems Classification L L H L L L L L
Weight 83,81% 85,35% 0,00% 74,23% 75,33% 87,78% 84,03% 76,32%
Metal Depletion Classification L L H L L L L L
Weight 92,75% 98,93% 0,00% 99,15% 98,89% 99,38% 89,05% 82,47%
Fossil Depletion Classification L L H M L L L L
Weight 80,47% 78,60% 0,00% 65,58% 68,72% 83,02% 82,56% 76,16%

*H: high; M: medium; L: low.

usual to carry out reform works in this type of rooms to adapt them to considering the perspective of sustainability taking into account the
new needs; therefore, it is necessary to take into account at the time of importance of passive elements [67].
choosing the materials the impact that the reform generates in the This work is framed within the healthcare engineering discipline.
environmental biosafety of hospitals [66]. In this sense, solutions that Fig. 11 shows an outline of the main subjects of this discipline according
generate little dust and/or noise are usually recommended. to Chu et al. [68]. The work contributes to the green design of hospital
On the other hand, all materials to be used in the healthcare build­ facilities, which is within the design of healthcare infrastructures.
ings construction process should be labeled to facilitate the determina­ This work contributes to the achievement of the Sustainable Devel­
tion of their environmental impact. This environmental labeling should opment Goals. The use of Life Cycle Analysis tools contributes to the
include at least the greenhouse gas emissions and embodied energy per sustainability of the construction sector and thus to the fulfilment of the
unit. SDGs in the field of engineering projects [69]. More broadly, research is
In any case, the characteristics of an X-ray installation and avail­ also needed to determine the environmental impact of electromedical
ability of resources and space will condition the type of shielding equipment due to its intense technological load one the road towards
required. This work will help architects, engineers and infrastructure infrastructure resilience [70]. Obviously, that equipment will be chosen
managers to select the most appropriate construction system, mainly considering the technical specifications required by medical

Fig. 11. Framing of the work within the discipline of health engineering. Source: Own elaboration based on [68]. Iconcredtis: www.onlinewebfonts/icon CC BY 3.0

10
G. Sánchez-Barroso et al. Journal of Building Engineering 41 (2021) 102387

procedures. Besides, the environmental variable must also be incorpo­ CRediT authorship contribution statement
rated in the decision-making process for equipment acquisition, which
contributes to improve the overall performance of hospitals [71]. Gonzalo Sánchez-Barroso: Data curation, Formal analysis, Inves­
The main limitation of this study is that is focused on medical tigation, Project administration, Writing – original draft, Writing – re­
diagnostic imaging equipment using X-type ionizing radiation. Howev­ view & editing. Manuel Botejara-Antúnez: Formal analysis,
er, it is perfectly applicable to equipment of similar technology applied Investigation, Resources, Software, Visualization. Justo García-Sanz-
in veterinary medicine, materials analysis, quality control in in­ Calcedo: Conceptualization, Formal analysis, Funding acquisition,
frastructures, among others. Investigation, Methodology, Supervision, Validation. Francisco
Future works should be directed, on the one hand, towards the Zamora-Polo: Investigation, Methodology, Software, Supervision,
environmental evaluation of shielding of equipment that generates Validation.
alpha, beta and/or gamma radiation emissions (i.e. linear particle ac­
celerators) and, on the other hand, towards the modelling of these Declaration of competing interest
shielding systems using Building Information Modelling (BIM) tech­
nology, leveraging the connection between BIM, LCA and Life Cycle Cost The authors declare that they have no known competing financial
(LCC). interests or personal relationships that could have appeared to influence
the work reported in this paper.
6. Conclusions
Acknowledgements
A multi-case LCA analysis followed a bottom-up methodology based
on main standards within cradle-to-grave perspective applying ReCiPe This research has been supported by the European Regional Devel­
method was carried out for assessing environmental impact of various opment Fund provided through Research Projects GR18029 linked to
shielding systems for X-ray room in a hospital. Furthermore, a unit es­ the VI Regional Plan for Research, Technical Development and Inno­
timate of both execution time and cost based on specialized databases of vation from the Regional Government of Extremadura (2017–2020).
construction complemented the information for decision making.
The findings of this study suggest that LCA is a suitable tool for
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