Ingrid B Boehm

Currently, the environment is being polluted by contrast media (CM). The contrast agent enters the water cycle in the following way. Following injection, both iodinated contrast media (ICM) and gadolinium-based contrast agents (GBCAs) are renally excreted unchanged. This means that ICM and GBCAs appear in the wastewater, and finally in the environment (e.g., rivers, lakes, sea) including in the groundwater [1, 2].

ADR adverse drug reaction CI confidence interval DPT drug provocation test ICM iodinated contrast medium IDT intradermal testing IR immediate reaction NIR non-immediate reaction NPV negative predictive value OR odds ratio PPV positive predictive value SD standard deviation 1 INTRODUCTION Although the exact number is unclear, several hundred million doses of iodinated contrast media (ICMs) are given worldwide per year [1].