[ RadSafe ] CT scans dangerous? -ALARA

Tue Nov 13 19:13:13 CST 2007

"There is NO other source of excess useless radiation exposure to the US
public than what Dr. Villforth cites."

Except radon.  While I completely agree that unnecessary medical
exposures should be discouraged, there is at least (usually) some
potential benefit, even if only to rule out something.  With radon
exposure there is no demonstrated benefit (Yes, I know there are some
hormesis fans out there, but I think you still have a ways to go to
prove your case).  I suspect that if one looked at the costs of
increased regulation to decrease medical dose vs. programs to reduce
radon dose you would find the radon programs more productive on a $ per
rem avoided rate. If you included costs avoided by not having the
procedure then reducing medical dose might be more cost effective. 

-----Original Message-----
From: radsafe-bounces at radlab.nl [mailto:radsafe-bounces at radlab.nl] On
Behalf Of stewart farber
Sent: Thursday, November 08, 2007 9:55 AM
To: John Jacobus; radsafe at radlab.nl
Subject: Re: [ RadSafe ] CT scans dangerous? -ALARA

Hi all,

I have not been following this thread carefully, and do not know if my
point below has been made in some manner. 

While ALARA, per se is not applied to the dose delivered in a given
radiation diagnostic procedure, there is a real issue if there is
significant total excess dose delivered to the US public due to the
issue raised below.

In 1979, Dr.. John Villforth, then head of the FDA Bureau of
Radiological Health [BRH], testified before Congress that by the FDA BRH
estimate one-third of all medical radiation exposure was "unnecessary".
Dr. Villforth was considering the problem with retakes due to use of
improper technique, tests being ordered without proper indications for a
given procedure,  etc., etc. 

If Dr. Villforth's rough estimate still holds, fully one-third of all
medical diagnostic radiation integrated dose yields no useful diagnostic
information. This sum amounts to very approximately 2 million person-rem
per year of "unnecessary" radiation dose in the US alone. 

Does anyone have any information that Dr. Villforth's one-third
"unnecessary" diagnostic radiation exposure is no longer applicable??

There is NO other source of excess useless radiation exposure to the US
public than what Dr. Villforth cites. Is this excess radiation dose due
to poor practice in medical applications in a broad sense ALARA? Should
something be done or set as a goal to reduce "unneccessary" radiation
exposure in diagnostic radiology?

As a simple comparison, the TMI accident caused about 1,000 person-rem
of total integrated population exposure. Thus the excess wasted dose in
routine medical testing per year cited by Dr. Villforth is equal to
2,000 TMI scale accidents per year in the US --year in year out. 

Stewart Farber, MS Public Health

Farber Medical Solutions, LLC
Linac & Medical Instrumentation Brokerage
1285 Wood Ave.
Bridgeport, CT 06604
[203] 441-8433 [Office]
[203] 522-2817 [Cell]
[203] 367-0791 [Fax]
email: radproject at sbcglobal.net
website: http://www.farber-medical.com

====================================

----- Original Message -----
From: "John Jacobus" <crispy_bird at yahoo.com>
To: <radsafe at radlab.nl>
Sent: Thursday, November 01, 2007 9:09 PM
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.  
> 
> 
> --- "Brunkow, Ward" <ward.brunkow at wipp.ws> wrote:
> 
>> 
>> Good issue to bring up. I think the answer is as it
>> has been for
>> decades:
>> >ALARA principal is not observed well within the
>> medical community
>> >Dr.s aren't trained well in radiation safety and
>> therefore prescribe
>> diagnostic use freely
>> >I think the older CT scanners were giving 12 -20
>> Rem  acute exposure at
>> times, especially upper and lower GI
>> >Not enough consideration given to rapidly dividing
>> cells, young people
>> >$$$$$$$$$$$$$$$$$$$$$$$$$$$, money driven yet, not
>> ethical to give
>> someone this exposure if there isn't significant
>> benefit, especially
>> younger person, but have to keep those bucks coming
>> in
>> >Too much "cook book" diagnosis in medical community
>> yet, diagnostic
>> (therapeutic for that matter also) radiation
>> exposure used too freely.
>> The Prescribe and move on to the next one....
>> premise....
>> 
>> 
>> 
>> W. G. (Ward) Brunkow
>> DOE Contractor (former Medical School RSO)
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