[ RadSafe ] I131 patient during intercontinental flight

Fri Feb 20 10:57:19 CST 2009

Glenn and Ed,

I was not promoting that a recent I-131 patient get on a plane. I was trying 
to show that the consequences are minimal. Also, that after about a week it 
isn't going to continue to be less of a risk as fast. Glenn, I may have been 
a little facitious about taking the I-131 right before boarding a flight. 
Take the more realistic case where a patient is packed for vacation, goes to 
the hospital, gets the dose, goes through the bureaucracy of getting 
released, drives to the airport, checks in with the hour or so preflight 
required, etc. They would be at about the maximum excretion rate during the 
flight.

As Ed points out governments may have the ability through public safety laws 
to intervene in a specific case, but they will seldom have the information 
necessary to do so. Also, with the speed at which courts move by the time a 
government could act the risk would be over.

Again, I am not advocating patients doing this. It is just not very 
practical to prevent it. I know of at least one country that requires 
hospitalization for nuclear medical procedures, and even prostate 
brachytherapy. Can you imagine how much that would cost in the U.S.?

Dale
----- Original Message ----- 
From: "McClung, Danny" <danny.k.mcclung at va.gov>
To: "Franz Schönhofer" <franz.schoenhofer at chello.at>; "Moshe Levita" 
<mlevita at tasmc.health.gov.il>; <radsafe at radlab.nl>
Sent: Thursday, February 12, 2009 9:33 AM
Subject: RE: [ RadSafe ] I131 patient during intercontinental flight

Franz,

The regulations in the U.S. are clear. Once you give the patient 
instructions (after evaluating their living arrangements, etc), they can be 
dosed, and then released into the public, providing you meet regulatory 
criteria for dose to others (500 mrem). What happens after that is the 
question here. Do the patients always follow instructions? Probably not...

It happens this way all the time. Hospitalization of I-131 ablation therapy 
patients is infrequent.

Dan

-----Original Message-----
From: radsafe-bounces at radlab.nl [mailto:radsafe-bounces at radlab.nl] On Behalf 
Of Franz Schönhofer
Sent: Thursday, February 12, 2009 9:57 AM
To: 'Moshe Levita'; radsafe at radlab.nl
Subject: AW: [ RadSafe ] I131 patient during intercontinental flight

Dear Moshe and all the RADSAFErs, who engaged in this thread,

In my home country Austria this question is well regulated. Anybody released
from hospital after a I-131 thyroid treatment receives a paper stating that
any close contact with other people, especially family members should be
restricted for at least one week, in some cases for 6 weeks or even three
nonths. This prohibits any overseas flights within this time scale, sitting
close to passengers - even children or pregnant women. The contamination of
not only lavatories, but also the whole aeroplane space is absolutely
unacceptable. I am far from being afraid of any radiation exposure, I have
been exposed already to some Sv (earlier to rems), but I still adhere to the
ALARA principle, which in this given case would require patients to stay a
few more days at the hospital or somewhere else.

Starting from the beginning: Why do have patients to come to Israel for such
a therapy? I hardly believe that there is any country, where such therapy is
not available! And I wonder, why there is at RADSAFE such a number of "hear
say" and "I believe " and "I think" messages; in developed countries the
regulations should be clear!

Best regards

Franz

Franz Schoenhofer, PhD
MinRat i.R.
Habicherg. 31/7
A-1160 Wien/Vienna
AUSTRIA

-----Ursprüngliche Nachricht-----
Von: radsafe-bounces at radlab.nl [mailto:radsafe-bounces at radlab.nl] Im Auftrag
von Moshe Levita
Gesendet: Montag, 09. Februar 2009 09:22
An: radsafe at radlab.nl
Betreff: [ RadSafe ] I131 patient during intercontinental flight

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
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