[ RadSafe ] In utero dose

[Michael Bohan]

Hello Floyd and RadSafer's:

In medicine, the conservative approach (of ALARA for radiation) is 
usually NOT advisable.  ALARA is specifically an industrial hygiene 
practice that has been bastardized by some to apply to realms it was 
never intended for.

If there is a pregnant mother, who's been in a serious car accident, 
the risk of having an undiagnosed condition that results in immediate 
death to the mother and/or fetus, is real.   The theoretical risk of 
even a 10 rad dose to her and the fetus are a very small concern in 
comparison.  Even with a dose of 10 rad, the theoretical risk to the 
fetus is about 1 in a thousand, and it might only be expressed many 
years later.  However, the mortality of mothers and fetuses from 
serious car accidents and undiagnosed trauma, is immediate and probably 
would lead to 10's if not 100's of deaths/thousand, if modern 
diagnostic tests are withheld due to radiophobia.  It should be 
remembered that ALARA is meant to keep occupational workers well away 
from any risk at all, even theoretical ones.  When reality strikes, we 
need to use a different set of standards.

ALARA does have a place in medicine.  Medical Physicists spend a lot of 
time and energy making sure that all hospital equipment provides the 
best diagnostic information for the smallest necessary dose.   However, 
ALARA should never be used to deny a patient a necessary diagnostic 
procedure.

Regards,

Mike Bohan, RSO
Yale-New Haven Hospital
Radiological Physics
20 York St. - WWW 204
New Haven, CT 06510
Tele: (203) 688-2950
Fax: (203) 688-8682
Email: mike.bohan at yale.edu

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On Apr 18, 2006, at 2:32 PM, radsafe-request at radlab.nl wrote:

> I realize this. But taking the conservative approach is always
> advisable. Hence ALARA. The lack of set limits is an issue which should
> be addressed. We cannot continue to let the medical world self-police.
> They have proven time and time again that they are prone to leaning to
> one extreme or the other. The limit should mirror occupational dose
> except, of course in the case of limits hindering treatment. All of 
> this
> falls into the principals of ALARA in one way or another.