Why is there a Barium Shortage?

For the last few months, our hospital has had trouble acquiring barium for our GI studies.  When I asked our suppliers why there has been such an issue, they told me that all barium was on back-order.  "Yeah right," I thought... when the heck has there ever been a problem getting barium?  I thought they might have forgotten to order some and they didn't want to own up to it.  The problem was that it kept happening!  We got to the point where we had scheduled patients, but not enough barium to complete the studies for the day.  There were several times that we used a courier to deliver supplies from one of our other hospitals within the organization, but eventually, they stopped allowing us to do that after some time because they had also run out.  Why is this happening now, and what is causing it?

Well, yesterday, I was speaking to one of our radiologists, and he informed me that there was a depletion of barite from the world's largest mines... the earth is simply running out!  I thought he was joking at first, but he encouraged me to "google" it.  I found some interesting things:

Most of my first search included headlines from news articles across the world stating things like "hospital forced to stop barium studies."  I guess I'm not the only one experiencing this.  I also ran across this letter from Bracco, the largest supplier of barium sulfate for radiology exam purposes. It goes on to list all of the produces which there is a shortage of, and also explains that they are attempting to fulfill back ordered products as soon as possible.  Among the list of products happens to be every single one my hospital uses for GI studies.  I also ran across a list of current drug shortages from the American Society of Health System Pharmacists which confirms the significance of the shortages.

Then I ran across this article, which explains that due to increased safety regulations in barite mines in China, the volume of barite production has fallen to about 25% of what it once was.  China is responsible for over 51% of the barite mining in the world.  India is the next largest supplier at about 14% The U.S. is responsible for about 9% while Morocco mines about 7%.  The rest of the world together supplies about 19% of the global supply.

The barite reduction is said to mainly be caused by increased safety regulations in China's mines.  There's also the fact that as the mines get deeper and drilling sites expand, there is increased cost for getting the barite to export ports.  If you dig deep (no pun intended) into some of the articles on google, you can find comments from people who claim to be associated with these mining companies (mainly from China and India) who are also stating that the world's supply of barite is being rapidly depleted, and propose that this is another reason for the reduction in barium sulfate production.  It is difficult, however, to find concrete sources for that information with the amount of searching I have done, but it's interesting nonetheless.  Other comments advise the world to begin looking for other materials that can perform the same job that barium sulfate currently does, which would lend some credibility to the notion that it is being depleted.

Could we be entering an era of no barium studies?  It's quite possible, although we will simply have to use another form of contrast media for the current exams we are performing with barium.  There's always water soluble contrast... and there's potentially a lot of money to be made for any manufacturer out there that can come up with a cheap and plentiful alternative to barium (I'll accept a 2% credit on all profits for giving you the idea).  I would love to hear what everyone is using as their barium runs out, along with the pros and cons of each.  Feel free to let me know in the comments!