[ RadSafe ] RE: Reasonable risk?

Flanigan, Floyd Floyd.Flanigan at nmcco.com
Thu Apr 20 08:32:53 CDT 2006

The idea is to keep the ALARA principal in the forefront of the minds of
those we are charged with watching over. As for dense ... hardly. If you
wish to defame those who would offer help in the regulation of public
and occupational exposure, you may first want to take into consideration
who you would call when things go sideways if we weren't around? We
provide a necessary function. We do not decide what the regulatory
limits will be. We make suggestions and leave the final decisions to the
political types. We enforce what they decide. Just like a police officer
may think a particular ordinance is absurd, he still has to enforce it.
As for the medical community and their record with radio-isotopes, one
has only to check into the headlines here and there about illegal
disposition of their waste. Something which would be far less likely to
happen if they had HP Pros mandated to each hospital staff. It must be
wonderful to be able to claim "ignorance" when caught with your
proverbial pants down. We, as HP Professionals, do not have that luxury.
We actually know what we're doing so we are held to a different
standard. Here's an idea ... I'll stick to my area of expertise, you
know, regulatory enforcement, and I promise not to diagnose any runny
noses or rashes, and I won't tell people not to eat there lunch too
close to a bathroom stall, I'll leave that important stuff up to the med
pros and IH types. In return, until you acquire some credentials in my
field, keep your unqualified professional opinions to yourself.

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

-----Original Message-----
From: jjcohen at prodigy.net [mailto:jjcohen at prodigy.net] 
Sent: Wednesday, April 19, 2006 8:34 PM
To: Flanigan, Floyd; Michael Bohan; radsafe at radlab.nl
Subject: Re:Reasonable risk?

It is certainly nice to know that  ALARA policy recommends that
safety actions be reasonable in nature. I personally believe that ALL
actions should be reasonable, but that's just my opinion.  I haven't run
across many advocates for unreasonableness, but if I do, I will cite the
Health Physics ALARA policy to show them how things should be done.
I wonder why Health Physicists are so dense, that they must be
reminded to be reasonable.
Jerry Cohen

----- Original Message ----- 
From: "Flanigan, Floyd" <Floyd.Flanigan at nmcco.com>
To: <jjcohen at prodigy.net>; "Michael Bohan" <mike.bohan at yale.edu>;
<radsafe at radlab.nl>
Sent: Wednesday, April 19, 2006 1:11 PM
Subject: RE: [ RadSafe ] In utero dose

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

    I am an Industrial Hygienist (CIH), and I resent your attempt to pin
ALARA nonsense on  Industrial Hygienists. ALARA is strictly a Health
invention, which IMHO was designed to justify the application of
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
> 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
> time and energy making sure that all hospital equipment provides the
> best diagnostic information for the smallest necessary dose.
> 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
> message in a secure and confidential manner. If you are not the
> intended recipient, please notify the sender immediately and destroy
> this message. Thank you.
> 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
> > be addressed. We cannot continue to let the medical world
> > They have proven time and time again that they are prone to leaning
> > 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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