Re: incontinent patient dosed with ~100 mCi of I-131

[William V Lipton <liptonw@dteenergy.com>]

Many thanx for you thoughtful response.  However, I do not see valid regulatory
basis.  It is important to keep in mind that DOT and NRC regulations, although they
interface in many areas, are separate.  Often, material which is exempt from
licensing requirements is still considered "radioactive material" for
transportation.  Likewise, waste material that is below the DOT threshold for
"radioactive material" (i.e., < 2 nCi/g) may still be considered "radioactive waste"
by the NRC.  Thus, I'd have to disagree with the reasoning in your statement:

"Once the patient is released from confinement, the radioactive material is
unregulated.  The patient does not need a "license", and while counseled to
take certain precautions, cannot be forced to do so.  The patient can carry
contaminated diapers in their car without a DOT license, and can carry
themselves in their car without a DOT license as well."

You're correct in stating that a patient does not need an NRC license to possess his
contaminated diaper.  However, the diaper may still be within the DOT definition of
"radioactive material," and, hence subject to DOT regulation.  BTW, there is no such
thing as a "DOT license."

In addition, the licensee, under 10CFR35.75, is required to: "... provide the
released individual with instructions, including written instructions, on actions
recommended to maintain doses to other individuals as low as reasonably achievable
if the total effective dose equivalent to any other individual is likely to exceed 1
millisievert (0.1 rem)...."  These instructions must:  (1) be effective, and (2) not
instruct to patient to violate any regulations.

The opinions expressed are strictly mine.
It's not about dose, it's about trust.

Bill Lipton
liptonw@dteenergy.com



>
> >carol marcus wrote:
> >
> >> Dear Radsafers:
> >
> Dear Radsafers:
>
> Once the patient is released from confinement, the radioactive material is
> unregulated.  The patient does not need a "license", and while counseled to
> take certain precautions, cannot be forced to do so.  The patient can carry
> contaminated diapers in their car without a DOT license, and can carry
> themselves in their car without a DOT license as well.  They can throw
> contaminated kleenexes in any garbage can or waste basket they like.  Once
> the material is deregulated, it is no longer labeled "radioactive", and I
> believe that it is illogical to assume that if it touches that hands of
> someone on a license that it is suddenly reregulated.  This point was raised
> with some radiation control program directors a couple of years ago, who
> agreed that once patients are released from confinement, their contaminated
> articles are permanently deregulated in terms of NRC or Agreement State
> radiation requirements.
>
> I have always treated it as such, with no directive from anyone otherwise
> (e.g. a radiation regulator or my RSO).  The point is that no member of the
> public can get more than 500 mrem from the patient or his/her diapers
> because if someone reasonably could, the physician should have kept the
> patient in the hospital in the first place.  Why make a big deal about an
> insignificant hazard?
>
> If you can show that a physician is letting someone out of the hospital in a
> situation where it is reasonable to expect a member of the public to get
> more than 500 mrem, I would (1) like to see your analysis and (2) suggest
> that you should get that physician off the license.
>
> Ciao, Carol
>

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