[ RadSafe ] IAEA urges scheme to track radiation in patients

[Wes Van Pelt]

Radsafers,
Quoting from the article on IAEA:
	"The IAEA is working on a smart card which would record radiation
levels in patients in developed countries and which it hopes could be
launched in the next three to five years as more medical records are
digitized. This would help doctors weigh up whether scanning procedures were
medically advisable."

If you apply the linear non-threshold (LNT) theory, this scheme makes no
sense at all. For example, a doctor considers giving a patient a CT
procedure and first consults the smart card and finds the patient has
accumulated 0.1 Sv. The doctor considers the medical benefit versus the
cancer risk. Under LNT, the benefit and incremental risk are EXACTLY the
same whatever the smart card shows as a prior radiation dose. In other
words, the doctor's choice is totally independent of prior dose and the data
on the smart card is superfluous. 

There is a more cynical reason, however. If the patient has been heavily
dosed already, he/she already has an increased cancer risk (under LNT) and
the doctor will be more likely blamed for the cancer. So by choosing to not
give a CT procedure, the doctor eliminates the chance he will be blamed for
any future cancer.

Of course, if cancer risk is actually not linear, and/or if there actually
is a threshold, then a smart card might be useful.

So, IAEA, the choice is yours: if you support the smart card you must
abandon LNT.

Best regards,  Wes
Wesley R. Van Pelt, PhD, CIH, CHP 
Wesley R. Van Pelt Associates, Inc.  
 


-----Original Message-----
From: radsafe-bounces at radlab.nl [mailto:radsafe-bounces at radlab.nl] On Behalf
Of Boby Mathew
Sent: Monday, May 11, 2009 10:20 AM
To: radsafe
Subject: [SPAM][ RadSafe ] IAEA urges scheme to track radiation in patients

http://www.reuters.com/article/healthNews/idUSTRE53S7TY20090429 
 
By Sylvia Westall
VIENNA (Reuters) - A scheme to track the amount of radiation patients are
exposed to from scans is urgently needed to help guard them against the risk
of cancer, the United Nations nuclear body said on Wednesday.
The International Atomic Energy Agency said that although technical advances
in medical scans had improved diagnoses, overuse could expose patients to
excessive radiation.
The IAEA is working on a smart card which would record radiation levels in
patients in developed countries and which it hopes could be launched in the
next three to five years as more medical records are digitized. This would
help doctors weigh up whether scanning procedures were medically advisable.
"Some of (the patients) are reaching a level where the effects of radiation
are well known from the data which we have from Hiroshima and Nagasaki
survivors," radiation safety specialist Madan Rehani told journalists,
referring to the U.S. nuclear bombing of Japan at the end of World War Two.
While individual X-rays, mammograms and scans present relatively low levels
of exposure, if the procedures are repeated many times, the radiation levels
become a cause for concern, he said.
"If we do not take action now, we are going to be blamed and asked why we
did not. With the very fast pace at which things are increasing and with the
doses of the patients getting to a level that is arguably alarming, some
action needs to be taken."
Experts have been reviewing the issue at a conference at the Vienna-based
IAEA this week. Some four billion radiological scans are carried out
worldwide every year, representing a 17 percent rise in the dose given to
the population in the past decade. The IAEA said there was concern about
computed tomography (CT) scans because they deliver especially high doses of
radiation. One CT scan has around the same radiation dose as 500 X-rays.
But such procedures can save lives and the experts said the smart card
scheme was not supposed to discourage doctors and patients from using scans
if medically justified.
"If the examination is necessary and health care demands repeated
examinations then there is never too much radiation. Medical imaging was one
of the greatest advances in medicine (of) all time," radiation expert Donald
Frush said.
He said the radiation tracker would help inform medical decisions, helping
to highlight an issue instead of ignoring it.