[ RadSafe ] In utero dose

[jjcohen at prodigy.net]

Michael,
    I am an Industrial Hygienist (CIH), and I resent your attempt to pin the
ALARA nonsense on  Industrial Hygienists. ALARA is strictly a Health Physics
invention, which IMHO was designed to justify the application of absurdly
restrictive controls to operations involving ionizing radiation.
Jerry Cohen


----- Original Message ----- 
From: "Michael Bohan" <mike.bohan at yale.edu>
To: <radsafe at radlab.nl>
Sent: Tuesday, April 18, 2006 3:13 PM
Subject: RE: [ RadSafe ] In utero dose


> 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.
>
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