[ RadSafe ] In utero dose

[Flanigan, Floyd]

I beg to differ. ALARA is now a relatively universal concept used by
industry. It is applied to all forms of risk whether radiological or
not. Safety professionals and PRA engineers use it on a regular basis as
well as OSHA in a manner. Any time risk can be reduced without causing a
detriment it should be done. In the case of emergency x-ray, of course
it is necessary to take the x-ray in order to provide proper, possibly
life-saving treatment. That should be a "no-brainer". A good analogy
would be that a man has a heart attack while crossing a busy street.
Should you move him or perform CPR in the middle of traffic? The answer,
of course, depends on the severity of the attack and the logistics
involved in controlling traffic safely as well as other factors such as
time of day/traffic flow, distance to nearest hospital, etc. etc. etc.
Each case will have differing variables which will make the decision
making process unique. It seems as though we are trying to paint this
one in black and white and in the process are creating dissention.
Conservative decision making takes into account all of these things and
should be used by all in positions of responsibility. Right and wrong
are not really applicable in many instances.

Floyd W. Flanigan B.S.Nuc.H.P.

-----Original Message-----
From: radsafe-bounces at radlab.nl [mailto:radsafe-bounces at radlab.nl] On
Behalf Of jjcohen at prodigy.net
Sent: Tuesday, April 18, 2006 10:25 PM
To: Michael Bohan; radsafe at radlab.nl
Subject: Re: [ RadSafe ] In utero dose

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
>
> This message originates from Yale New Haven Health System. The
> information contained in this message may be privileged and
> confidential. If you are the intended recipient, you must maintain
this
> message in a secure and confidential manner. If you are not the
> intended recipient, please notify the sender immediately and destroy
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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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