[ RadSafe ] Deadly embrace: NRC policy can exposechildrento radioactivity, by retired........

Dale Boyce daleboyce at charter.net
Tue Jan 6 20:39:38 CST 2009 

Patient compliance is all over the board. Sorry I don't have a reference, 
but I think the study was done a Sunnybrook. LDR brachytherapy patient's 
spouses were badged. The dosimetry results showed _NO_ correlation to the 
size of the implant.

As I remember no spouses came close to exceeding the 500 mrem limit, but 
many were very low. I do not remember if the implants were I-125 (60day) or 
Pd-103 (17 day). Unfortunately, I know they were not Cs-131 (9.7 day)(I may 
be biased). The shorter half-life makes compliance much easier on the 
patients as the restrictions only need to be followed for a short time.

Dale

----- Original Message ----- 
From: "Philip Egidi" <pvegidi at smtpgate.dphe.state.co.us>
To: "Daren Perrero" <Daren.Perrero at illinois.gov>; <radsafe at radlab.nl>; 
"Steven Dapra" <sjd at swcp.com>
Sent: Tuesday, January 06, 2009 9:48 AM
Subject: RE: [ RadSafe ] Deadly embrace: NRC policy can exposechildrento 
radioactivity, by retired........


I just wish the patients would follow the instructions when they are 
released from the hospital such that us State folks don't have to spend so 
much time at the landfill screening garbage at a putrescent landfill in the 
middle of July dressed out in Tyveks looking for the offending diaper or 
paper towel or whatever causes the gate alarm to go off. It gives me pause 
to wonder if the patients are following other instructions about limiting 
contact with others, especially children. Our experience is that some of 
these people are incontinent, not of sound mind, do not follow directions, 
and throw their diapers in the trash rather than decay in storage. We have 
also seen where the patient passed away soon after the treatment, and the 
personal belongings that were thrown out tripped the alarms at the landfill.

I also agree that if old people are swapping spit with little people there 
are bigger issues, but they do share living space, come in close contact, 
and if they sweat and touch things, leave their mark around the house for 
quite some time. Scenarios and pathways can be atypical and I am not 
convinced that there is not a health issue in some situations. If a couple 
has intimate relations after a treatment, would the pathway be injection??

Releasing the patients ASAP is in no small part a financial decision, and is 
reflected in many situations, such as minor and not so minor surgery - they 
kicked me out of the hospital less than 4 hours after double hernia surgery.

With respect to voiding of the I-131 in the first day, there were so many 
I-131 treatments in Grand Junction, CO that for a while the sludge from the 
wastewater treatment plant containing I-131 was tripping the alarms at the 
landfill. The landfill does not play nice with others and would not allow 
burial in the back 40 of the offending article(s) or sludge. It takes a 
couple days for the radioactivity to make it through the sewer system and 
into the plant, where residence time varies, nonetheless the alarms were 
going off when the sludge was hauled to the landfill. We actually set up an 
informal system where the hospital informed the State and the wastewater 
treatment plant when they performed an ablation. That gave the facility a 
couple of days to monitor. Things have dropped off enough now that the 
inventory in the sewers is reduced and sludge does not trip the alarm. It 
can also be noted that the wastewater treatment plant and the landfill are 
both owned by the County, nonetheless, the landfill would not accept the 
sludge until it had decayed below the alarm limit (usually 2 days later).

I recently had a Cardiolite diagnostic treadmill test, and I was lit up 
enough (Tc-99m) to peg my Model 19 (5 mR/h) for a couple days. My family 
keeps me at least at arms length anyway, so it was no big deal. Since I-131 
is around longer, there is a greater chance for contamination leading to 
inadvertent intake and uptake.
Thank you for letting me rant.
Phil Egidi
CDPHE

>>> On 1/6/2009 at 10:01 AM, in message 
>>> <730E743AFAA26146A2F74AC52A2BEAEA01E36A2C at BEAR.iema.state.il.us>, 
>>> "Perrero, Daren" <Daren.Perrero at illinois.gov> wrote:
If we are assuming a point source exposure to 400 mCi of I-131 than the
gamma constant and distance formula would tell us that the dose at 10
feet would go as follows:

Gamma Constant = 0.283 microR/h per microCi at 1 meter. For 400,000
microCi that comes to a dose rate of 113 milliR/h which then gives us
2,700 milliR for the 24 period at 1 meter (3.3 feet).

Unfortunately there are significant errors encountered by going with the
simplified assessment above.  Medical physicists will tell you that
treated patients are not point sources and that a treatment dosage of
400 milliCi does not equal a 400 milliCi source in the thyroid.  Thyroid
update is more likely to be between 10 percent and 35 percent (we're
talking about treating unhealthy thyroids after all) depending on the
disease being treated.  Also, occupancy factors vary widely but can
easily go from 1/8 to 1/3.  One quarter is used in most cases.
Biological excretion is a huge term reducing factor during the first 24
hours as well.  Many hospitals will ask the patient to 'hang around'
until the first urination when a great deal of the unincorporated source
term is 'disposed' in the very early phase (first 8 hrs).  The single
biggest source of exposure is sleeping with patient, so most precautions
are driven by reducing that factor to the maximum extent practicable. A
search for authors Jeffry Siegel and Mike Stabin will provide some well
documented analysis of the counter point to Peter Crane's argument if
you'd like to dive into the subject further.

Daren Perrero
The opinions expressed are mine, all mine....
I'm with the government, I'm here to help you.
Daren.Perrero(a)Illinois.gov

-----Original Message-----
From: radsafe-bounces at radlab.nl [mailto:radsafe-bounces at radlab.nl] On
Behalf Of Steven Dapra
Sent: Saturday, January 03, 2009 6:07 PM
To: radsafe at radlab.nl
Subject: Re: [ RadSafe ] Deadly embrace: NRC policy can expose
childrento radioactivity, by retired........

Jan. 3

         The PDF link posted by Celia is an article of approximately 600

words written by Peter Crane, a retired NRC counsel.  It was published
in
the New Hampshire Sentinel Source, the online edition of the Keene (NH)
Sentinel.

         Crane claims that the NRC instituted a "deregulation" of I-131,

and did so "at the behest of providers and insurers, eager to cut costs
and
increase profits."  (Presumably Crane means health care providers.)  He
says that (unspecified)  "international safety standards" call for
hospitalizing patients given more than 30 millicuries of I-131, but that
in
the US, patients are being sent home with "as much as 400 millicuries of

I-131 in their systems."

         Let us assume that a patient is sent home with 400 millicuries,

and that a family member is within 10 feet of this patient at all
times.  In 24 hours what will the exposure be to that family member?

Steven Dapra
sjd at swcp.com


At 03:50 PM 1/3/09 +0000, Celia wrote:
>In the news - FYI
>
>celia


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