[ RadSafe ] CT scans dangerous?

[John Jacobus]

Mr. Cheng
I am aware of the ICRP's recommendations.  My concern
is that risks must be weighted against benefits.  I
frequently respond to person's who are concerned about
the radiation exposures that they or their children
have received.  Often they cite articles they read or
heard about on the Internet or in the news media. 
Comments include "Am I going to get cancer?" "Why did
they (medical staff) not tell me it was so dangerous?"
 "I am scared because my child will get cancer for his
CT scan!" 

First, there is no proof that diagnostic medical x-ray
exams is leading to an increase in cancer or
sterility.  All of these reports are based on
extrapolation from the known effects from accute, high
doses to those in the infrequent low dose exposure.  

I think that it is important to differentiate patient
exposures from those of the medical staff. 
Nevertheless, there does not seem to be a statistical
increase effect on the workers either, which is
probable due in part to a dose, dose-rate effect.

Second, there is a presistent idea that medical exams
are so deadly, that medical staff must hide this from
patients.  "Why did not tell me how dangerous this
scan was!"

We should look at the improvement in public and
individual health.  Surgery to rule out appencitus and
its associated risks have been elimitated due to CT
scanning.  Intravascular radiology has made many
cardiac studies and treatment options safer and less
expensive.  Image guided radiation therapy has great
promise for treating cancers.

If given the choice of medical studies, I would not
hesitate to have a x-ray exams.  

In pasting, I think there is confusion between
optimizaton and ALARA.  IN the first you use the tool
you have, radiation, to provide the best outcome. In
medicine drugs, radiation exams, etc. may be
administered above the "recommend" guidelines to
benefit the patient.  In ALARA, you try to reduce the
exposures to radiation to workers.  Frequently,
nuclear operations are driven by ALARA, but on to
"optimize" the process. 


--- Cheng Kit-man <kmcheng1 at netvigator.com> wrote:

> The principles of justification of practice and
> optimization of
> protection also apply to the protection of patients
> in medical
> exposures.  Please refer to the following documents
> for details.
>  
> 1. IAEA Basic Safety Standards 115, 2000 (Appendix
> II Medical Exposure)
> 2. Radiation Protection in Medicine, Annals of ICRP,
> 26(2), 1996
> 3. Managing patient dose in CT, Annals of ICRP,
> 30(4), 2000
> 4. Radiation and your patient: A guide for medical
> practitioners, Annals
> of ICRP, 31(4), 2001
> 5. Recommendations of ICRP, Annals of ICRP, 37(2&3),
> 2007
>  
> According to ICRP, it is going to publish a report
> of title Managing
> Patient Dose in Multi-detector Computed Tomography
> as Annals of ICRP,
> 37(1) later this year.
>  
> Clement Cheng
> Radiation Health Unit
> Department of Health
> Hong Kong SAR, China
>  
> -----Original Message-----
> From: radsafe-bounces at radlab.nl
> [mailto:radsafe-bounces at radlab.nl] On
> Behalf Of John Jacobus
> Sent: Friday, November 02, 2007 10:09 AM
> To: radsafe at radlab.nl
> Subject: RE: [ RadSafe ] CT scans dangerous?
>  
> Ward,
> ALARA does not and should not apply to medical
> exposures. ALARA principles are used to reduce the
> risk of harmful effects associated with radiation
> exposures.  In medicine, the patient is frequently
> already at risk from harm due to disease or injury. 
> Radiation, surgery, prescribed drugs, etc., all have
> the potential to improve the patents' health and
> quality of life.  
>  
> While physicians are probably not trained in the
> risks
> of radiation exposure, drug interactions, etc. they
> assume total responsibility for the patient under
> their care.  
>  
>  

+++++++++++++++++++
"If you guard your toothbrushes and diamonds with equal zeal, you'll probably lose fewer toothbrushes and more diamonds."
- Former national security advised McGeorge Bundy
-- John
John Jacobus, MS
Certified Health Physicist
e-mail:  crispy_bird at yahoo.com

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