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It is one of the ironies of medicine that radiation, as in x‐rays, CT scans, radiation therapy and nuclear
medicine can cause cancer yet can be used to detect and treat cancer. Perhaps because of this irony,
most of us know very little about radiation dangers. Often we simply trust our doctors and caregivers to
do what is right. In the majority of cases, this mutual trust system works well.
However, what happens when the system fails?
A recent study suggests that 15,000 people are projected to die within the coming years from the
radiation they received from x‐ray procedures!
How can we protect ourselves?
There have been reports of patients experiencing serious radiation overdose causing reddening of the
skin, hair loss, cataract formation, or burns that cannot heal.
A lack of knowledge will not protect you!
Radiation cannot be seen, felt, tasted or heard and organ and tissue damage from radiation, and
radiation‐induced cancer, may take years or even decades to manifest.
However, the dangers are real!
Last year 3000 patients were treated for serious radiation burns at a wound care facility.
Read how to protect yourself from medical radiation!
*****
ISBN: 978‐0‐9829774‐1‐5
Copyright © 2010 by Olive Peart
All right reserved.
No part of this book may be used or reproduced by any means, graphic, electronic, or mechanical, including scanning,
photocopying, recording, taping or by any information storage retrieval system without the written permission of the publisher
except in the case of brief quotations embodied in critical articles and reviews. Please do not encourage piracy or plagiarization
of copyrighted material in violation of the author’s rights. Purchase only authorized editions.
For purchase information contact email the author:
Peltrovijan Publishing
peltrovijan@yahoo.com
www.opeart.com
P.O. Box 13
Shrub Oak NY 10588
*****
Olive Peart has taught radiography students for over ten years. She writes regular columns for
radiologic journals and newsmagazines. Her published works include: Spanish for Professionals
in Radiology; Lange Mammography Examination; and Mammography and Breast Imaging‐Just
the Facts. She is also the author of two young adult novels The Intruders & Linked.
*****
Table of Contents
INTRODUCTION
WHAT IS RADIATION?
MIRACULOUS IMAGING OF THE HUMAN BODY
WHY IS RADIATION DANGEROUS?
EFFECTIVE DOSE LIMIT RECOMMENDATIONS
POSSIBLE RADIATION EFFECTS
WHAT ARE SOME SOURCES OF RADIATION?
HOW IS RADIATION USED IN MEDICINE?
WHY ARE WE AT RISK FROM MEDICAL RADIATION?
HOW IS MEDICAL RADIATION MONITORED?
INITIATIVES UNDERWAY TO REDUCE RADIATION DANGERS
WHAT CAN THE GENERAL PUBLIC DO?
ORGANIZATIONS MONITORING RADIATION SAFETY
REFERENCES
STATE STATUS
GLOSSARY OF TERMS
RADIATION CONTROL/STATE LICENSURE OFFICES:
INTRODUCTION
It is one of the ironies of medicine that radiation, as in x‐rays, can cause cancer yet can be used
to treat cancer. Perhaps because of this irony, most of us know very little about radiation
dangers. Often we simply trust our doctors and care givers to do what is right. In the majority of
cases this mutual trust system works well, but what happens when the system fails.
A recent study suggests that 15,000 people are projected to die within the coming years from
the radiation they received from x‐ray procedures!
There have been reports of patients experiencing acute radiation effects including reddening of
the skin, hair loss or cataract formation, all resulting from the overuse of medical radiation.
The amount of radiation patients are exposed to have dramatically increased over the past
twenty years. A new study by the National Council on Radiation Protection and Measurement
(NCRP) concluded that Americans were exposed to seven times more radiation from medical
procedures in 2006 than in the 1980s.
Organ and tissue damage from radiation and radiation‐induced cancer may take years, even
decades, to manifest. It is therefore seldom that a radiation mistake will result in a law suit. Yet,
in 2009 the nation’s largest wound care company treated 3000 patients with serious radiation
burns. Many required hyperbaric oxygen chambers to promote healing.
The problem is that in many states the people who operate radiation‐producing equipment do
not need a license. That means the person taking your x‐ray, CT scan (CAT scan), nuclear
medicine scan or giving you radiation therapy has little or no training. Even worse, often the
doctor or physician is unaware of the dangers of radiation and the medical physicist, who is
responsible for calibrating the radiation emitting equipment, has no license or no certification.
Many states do not require the reporting of errors and even if an error is reported the penalty
is nonexistent or not enforced. The American College of Radiology notes that only about 20
percent of radiotherapy units in the country are accredited.
We worry about radiation dose at airport security systems. We worry about electromagnetic
radiation from power lines and cell phones yet we are willing to tolerate the massive doses of
radiation given to us by our health care providers. Americans are getting the most medical
radiation in the world. The US accounts for half of the most advance procedures that use
radiation. A report documents a New Hampshire teen who was about to get a CT scan to check
for kidney stones. Fortunately, the radiologist discovered the child had already had 14 CT scans
for previous checks of kidney stones. This child is now a cancer risk!
It’s hard for us to conceive of the danger of something we cannot see, feel or hear. However,
the effects are real and unfortunately, radiation dose never goes away. For a patient age
seventy this may not be a significant factor but think of the 2‐year‐old or even the 10‐year‐old.
The effects of radiation will simply accumulate in their bodies showing up years later as
radiation induced cancer.
Excerpts from THE DANGERS OF MEDICAL RADIATION
In 2009, a Philadelphia hospital gave the wrong radiation doses to more than 90 patients with
prostate cancer and did not report it.
In 2005, a Florida Hospital reported that 77 brain cancer patients had received 50% more
radiation than prescribed because the linear accelerator of the radiation therapy machine had
been programmed incorrectly for nearly a year.
In the 1986 Chernobyl nuclear accident, 30 people received a high dose of radiation causing acute
radiation syndrome and death.
In a summary of radiation accidents published in The New York Times, a 14‐year‐old girl received double
her prescribed dose for 10 radiation therapy treatments because the facility made faulty calculations
and did not follow its policy to verify the dose.
During radiation therapy, another patient received 10 times the prescribed radiation in 1 spot and 1/10
of her dose in another. She later died.
In India, a worker died after being exposed to radioactive material at a scrap metal shop. He was one of
seven people exposed to high level of radiation from obsolete medical equipment hidden in abandoned
equipment.
According the American Heart Association, acute heart attack patients received an average radiation
dose that is 30% of the recommended annual limit, equal to 725 chest x‐rays–during an average hospital
admission.
Dally was the first person to die from radiation overdose in the United States. He died in 1904 after
suffering from severe radiation burns and the amputation of both arms.
Cardiac interventional procedures can potentially expose a patient to high radiation doses because
patients often undergo repeated cardiac interventional procedures.
One hour of fluoroscopy time can result in skin doses to the patient, which can include mild erythema,
equivalent of sunburn, to more serious burns.
On average, the cumulative radiation dose during a heart attack patient’s hospitalization was
approximately 14.5 mSv (1.45 rem). Radiation workers have an annual limit of 50 mSv (5 rem).
Interventional cardiology personnel in Malaysia developed cataracts five times more often than a control
group. Studies show that this is due to nonuse of radiation protection for the face and head during
interventional procedures.
A recent study found that 15,000 people were projected to eventually die from the radiation they
received from CT scans given in just a single year. The dangers are particular dangerous to children who
are more susceptible to radiation and more likely to develop cancer from it. The risk of radiation damage
to the body accumulates over a lifetime.
A study at Bridgman and Women’s Hospital, Boston and Washington University School of Medicine, St.
Louis Mo., followed 130 patients who had at least three emergency department visits within one year in
which they had a CT scan of the neck, chest, abdomen or pelvis. Over half of the patients had undergone
10 or more CT scan in the previous eight years, to a maximum of 70 scans. This means that using typical
dose values and standard risks estimation, half the group had accrued additional radiation‐induced
cancer risks above baseline, greater than 1 in 110 and up to a maximum of 1 in 17.
Of 500 patients in a study presented at RSNA in 2009, over half or 52.5% received un‐indicated
(unnecessary) CT exam.
Over 300 patients in four hospitals in California were over‐radiated by CT scans used to detect strokes.
The patients received over eight times the normal dose. Although the errors occurred over an 18‐month
period, they were not discovered until the patients lost their hair.
The Food and Drug Administration in the US says that more than 250 patients at Cedars‐Sinai Medical
Center in Los Angeles mistakenly received eight times the normal radiation dose during CT brain
perfusion scans. Some patient indicated that they have suffered hair loss or reddened skin after scanning.
At Mad River Community Hospital in Arcata, a technologist activated the CT scan over 100 times on a 2‐
year‐old boy. The examination, which should have taken just a few minutes, lasted over an hour. Since
the effects of radiation can take years to develop, the child’s prognosis is uncertain; however, the
prediction is that he will develop cataracts within three to five years.
Eight percent of the junior doctors in an Irish study believed ultrasound involves the use of ionizing
radiation, and 27% thought MRI involves radiation.
Fourteen states, even someone with absolutely no training, can take you into a room a deliver a lethal
dose of radiation to you, the patient.
In 2009, only 33 States required radiation therapists to be licensed by a State accrediting board.
In a radiation oncology study nearly 30% of hospital seeking admission into the National Cancer Institute
trial had failed to accurately irradiate an object, called a phantom, that mimicked the human neck and
head.
The New York Times recently reported the death of a 43‐year‐old patient. He died after receiving a huge
overdose–seven times his prescribed dose−on three separate occasions during radiation therapy
treatment. The multileaf collimator on the linear accelerator of an IMRT unit was left open during his
treatment. The resulting error exposed his entire neck, from the base of his skull to the larynx, to seven
times the prescribed dose.
Another patient developed a sore on her chest during radiation treatment. After her 28th treatment, her
skin started peeling and the hospital decided to investigate the reason for her injury. They discovered
that the linear accelerator was missing a wedge, a beam‐modifying device used to filter the radiation.
Without the wedge, the patient received three and a half times the prescribed radiation dose during each
treatment. The overdose resulted in a wound that would not heal, or even close. Doctors even tried
reconstruction using muscle from her back and skin from her legs. A year later, she was dead.
In documentation of radiation errors, researchers found that on 284 occasions, radiation missed all or
part of its intended target or treated the wrong body part entirely. In one case, radioactive seeds
intended for a man’s cancerous prostate were instead implanted in the base of his penis. Another patient
with stomach cancer was treated for prostate cancer. Fifty patients received radiation intended for
someone else, including one brain cancer patient who received radiation intended for breast cancer.
A number of government experts have been warning about the risks of routinely using powerful CT (CAT)
scans to screen patients for colon cancer, lung cancer and other cancers. Instead of a CT scan screen for
colon cancer, the American College of Gastroenterology recommend the doctor use a flexible tube
(colonoscopy) to view the insides of the colon.
The average lifetime dose of diagnostic radiation has increased sevenfold since 1980.
The top sources of radiation used to be normal background radiation from things like radon in the soil
and cosmic energy from the sun. In United States today, medical radiation now accounts for more than
50% of the populations’ total exposure; it used to just 16.5%.
A single CT scan can deliver the equivalent of 400 chest x‐rays.
An estimated 70 million CT scans are performed in the United States every year, up from three million in
the early 1980s.
Studies suggest that about 33 percent of all diagnostic tests are unnecessary. That means that 20 million
adults and more than one million children get CT scans that are needless and are putting themselves at
risks.
In eight states, x‐ray technologists are not licensed. Radiation therapists are not regulated in seventeen
states, and medical physicists have no oversight in thirty‐one states. There are also no state licenses for
medical dosimetrists.
An AP chest x‐ray on infants gives a skin entrance exposure of 5 mR. A PA or AP chest x‐ray on adult
gives a skin entrance exposure of 12−26 mR
*****
ISBN: 978‐0‐9829774‐1‐5