[ RadSafe ] Re: I131 patient during intercontinental flight

Wed Feb 11 12:07:57 CST 2009

I think this is an important point.  While I agree with Clayton that
there are many members of the public who would not want to travel with
someone who had received treatment and was "radioactive", regardless of
how low the risks, I am not at all sure that it right to cater to
unreasonable fears.  Would it be appropriate restrict the travel of
members of certain ethnic groups because some other people might not
want to get "contaminated" by using the same seats, restrooms, drinking
fountains, etc.?  Or to allow the beliefs of some religions that
menstruating women are "unclean" to dictate when and how women could
travel?  

This has, in my opinion, parallels to the discussion over whether
irradiated food should be marked as such, so that non-evidence-based
fears can be used to stir up the public against the process.  I
recognize that outrage is part of the risk communication equation, but I
don't think it should be allowed to outweigh the actual hazard.

-----Original Message-----
From: radsafe-bounces at radlab.nl [mailto:radsafe-bounces at radlab.nl] On
Behalf Of Richardson David (RDE) Colchester Hospital University NHS
FoundationTr
Sent: Wednesday, February 11, 2009 8:54 AM
Cc: radsafe at radlab.nl
Subject: RE: [ RadSafe ] Re: I131 patient during intercontinental flight

Why do I keep thinking about the Litvinenko case for this scenario.

If you are not familiar with the case, do a google search for
"litvinenko contamination" (Yes, that was Po210 but the point is
contamination was found on aircraft). Now ask yourself - what would the
(not necessarily your) response be from Joe Public to being asked to fly
on aircraft with radioactive contamination?

No matter how low the contamination was, would the (uninformed) public
still want to fly on these aircraft? What would the operators of these
aircraft (want to/have to) do to get the public to use these planes?
(risk assessment on an individual basis, radiation monitoring, cleaning,
crew/maintenance exposure) etc. etc. etc.

If the I131 patient used the loo on the flight, what about the dose to
the guy who has to unblock the toilet if it gets blocked - will he know
he's dealing with radioactive material.

Would the "patient" have a "duty of care" to inform the airline they
will be contaminating their vehicle?

There are many worms in this can.

Best regards

David Richardson
MTO Radiation Protection
Medical Physics
Essex County Hospital
Lexden Road
COLCHESTER
CO3 3NB

01206 744579

david.richardson at colchesterhospital.nhs.uk

-----Original Message-----
From: radsafe-bounces at radlab.nl [mailto:radsafe-bounces at radlab.nl] On
Behalf Of Clayton J Bradt
Sent: 11 February 2009 15:37
To: Moshe Levita
Cc: Clayton J Bradt; radsafe at radlab.nl
Subject: [ RadSafe ] Re: I131 patient during intercontinental flight

I don't think that there is a public health issue here. No one is going
to be hurt by releasing such patients. But there is an ethical issue
raised by the creation of a public nuisance.  There will be
contamination all over the plane.  If passengers and crew knew about it
they would be furious.
Is
it OK to subject them to this contamination as long as they don't know
about it?  I think not.

Clayton J. Bradt
Principal Radiophysicist
BERP
518-402-7550

             "Moshe Levita"

             <mlevita at tasmc.he

             alth.gov.il>
To 
                                       <radsafe at radlab.nl>, "Clayton J

             02/11/2009 10:26          Bradt" <cjb01 at health.state.ny.us>

             AM
cc 

Subject 
                                       Re: I131 patient during

                                       intercontinental flight

If the patient on the flight has only 7 mc of I-131 in his body, he
might discharge some 1500 microcuries into the toilet during the flight.
While contamination of 1 microcurie '
has
'  Effective Dose Equivalent
of about 0.4 mSv, It seems that contamination is an issue....

External exposure of his neighbor during the flight can be some 0.3 mSv
...

Is this justified ?

----- Original Message -----
From: "Clayton J Bradt" <cjb01 at health.state.ny.us>
To: <radsafe at radlab.nl>
Cc: <mlevita at tasmc.health.gov.il>
Sent: Wednesday, February 11, 2009 4:34 PM
Subject: Re: I131 patient during intercontinental flight

>
>
> It might be easier to resolve this problem if we ignore that fact that
the
> patients' excretions are radioactive. Most readers on this list will
agree
> that after a fairly short time, the I-131 levels within the patient
will
> be
> low enough such that he/she poses no actual danger to others. So why
not
> suppose that these patients instead of excreting small amounts of
I-131,
> are rather excreting skunk scent. Not dangerous, but offensive to
others.
> What would be the ethically defensible protocol for releasing these 
> patients for mass transit?
>
> If we can answer this, I think we have answered the original question 
> posed.
>
>
> **************************************************
>
> Message: 2
> Date: Mon, 9 Feb 2009 10:21:52 +0200
> From: "Moshe Levita" <mlevita at tasmc.health.gov.il>
> Subject: [ RadSafe ] I131 patient during intercontinental flight
> To: <radsafe at radlab.nl>
> Message-ID: <002601c98a8f$764b1bc0$df83640a at tasmc.corp>
> Content-Type: text/plain;            charset="windows-1255"
>
> Dear Colleagues,
>
>
>
> Many Iodine 131 patients arrives in Israel to be treated and then fly
back
> home.
>
> The patient stays in the award until the residual dose is below
certain
> level.
>
> (Residual activity is calculated by the measurement of dose rate at 1
m)
>
>
>
> I wonder at what residual activity it will be reasonable to allow the 
> patient to fly back to his country.
>
>
>
> One have to take into considerations :
>
>
>
> 1.  Five hours flight of sitting beside another passenger (who might
be a
> child or pregnant women)
>
> 2.  Definite contamination of the airplane toilet, toilet cleaning,
toilet
> disposal etc.
>
> 3.  Possible triggering of airport radiation alarm monitors.
>
>
>
>
>
>
>
> Any suggestion will be welcomed.
>
>
>
> Moshe Levita
>
> Chief Radiation Executive
>
> Ministry of Health
>
> Israel
> *************************************************************
>
>
> Clayton J. Bradt
> Principal Radiophysicist
> BERP
> 518-402-7550
>
>
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