Re: MEDHP-SEC: Article: High Security Trips Up Some Irradiated Patients, Doctors Say

[Carol Marcus <csmarcus@ucla.edu>]

At 08:50 AM 12/4/02 -0500, Jacobus, John (NIH/OD/ORS) wrote:

>Thought this would be of interest.

>

>-- John

>John P. Jacobus, MS

>Certified Health Physicist

>3050 Traymore Lane

>Bowie, MD 20715-2024

>

>e-mail:  jenday1@msn.com

>

>-----Original Message-----

>

>High Security Trips Up Some Irradiated Patients, Doctors Say

>

>December 4, 2002

>By AL BAKER

>

>In one case last spring, a man being treated for an

>overactive thyroid gland was stopped by the authorities on

>two occasions while at a subway stop at Pennsylvania

>Station. In another case about a month ago, a woman who had

>undergone a diagnostic heart study was stopped while trying

>to drive out of Manhattan through a tunnel.

>

>In both cases, the people involved had been treated with

>radioactive materials. And in both cases, doctors said,

>they were stopped by law enforcement officers armed with

>radiation detectors used to track possible terrorists.

>

>Such reports are flowing into doctors' offices, physicians

>in the metropolitan region and elsewhere say.

>

>The expanded use of radiation and metal detectors to guard

>against potential terrorism after Sept. 11, 2001, has

>prompted many unintended security stops, whether of cancer

>patients undergoing radiation treatment or of travelers

>with prosthetic limbs or pacemakers passing through airport

>metal detectors. Drug dealers have been known to mark their

>goods with radioactive material as a way of tracing it, and

>one doctor said he had heard of shipments being stopped at

>border crossings in Europe.

>

>"This is all along the law of unintended consequences,"

>Fred Mettler, the chairman of radiology and nuclear

>medicine at the University of New Mexico, said yesterday.

>"The question is, `How does the poor patient convince the

>law enforcement authorities that they are truly patients

>and not terrorists?' "

>

>To better prepare their patients for security episodes

>relating to their radioactive treatment, and to keep them

>from being mistaken for those who would do harm, doctors in

>New York are drawing up guidelines telling patients how

>they should react. Doctors say Police Department officials

>have recommended that patients carry letters from their

>doctors to avoid confusion, but the police said that they

>had issued no broad recommendations and that such letters

>would not suffice to resolve the matter.

>

>Countless patients being treated for a variety of ailments

>may have had radioactive isotopes injected into their

>bodies and can therefore set off alarms at borders, bridge

>crossings or transportation hubs, or trigger the attention

>of authorities who have portable radiation detectors.

>

>The woman stopped recently near the tunnel contacted her

>physician, Dr. Chaitanya Divgi, an expert in nuclear

>medicine in the radiology department at Memorial

>Sloan-Kettering Cancer Center. "She called me from the

>cellphone," said Dr. Divgi, who could not identify the

>tunnel but added that he spoke with the officer and that

>the woman was later able to pass through. "Doctors are

>talking about patients being stopped, about security alarms

>going off after patients are being administered radio

>pharmaceuticals."

>

>Doctors say they have not criticized law enforcement

>officers for their efforts, under which patients may be

>questioned intensely and subjected to body searches.

>Rather, most interviewed yesterday said the recent

>incidents pointed out one of the sometimes odd byproducts

>of the nation's heightened state of alert and gave them

>confidence that the authorities' detection equipment was

>working.

>

>Dr. Christoph Buettner, an endocrinologist treating the man

>with the overactive thyroid who was stopped at Penn

>Station, said: "They did not treat him badly. They just

>detected radioactivity and they had to pursue that, and

>that is obviously the right thing to do in these

>circumstances, in these times. We just want the cops to

>have a way to identify patients who have been treated with

>radioactive isotopes."

>

>As part of the Police Department's new measures to guard

>against potential terrorism, radiation detectors have been

>installed outside several city buildings. Also, about 250

>radiation detectors, worn on the belt, have been

>distributed to officers. The devices are intended to form a

>sort of moving detection curtain so that police officers

>can interact with the public as they look for radioactive

>material.

>

>When the Police Department installed radiation detection

>devices outside Police Headquarters in Lower Manhattan in

>June, a police inspector who had been injected with

>radioactive dye for a stress test reportedly set them off.

>

>The man with the overactive thyroid gland was stopped

>after authorities somehow detected gamma rays emitting from

>him and detained him for questioning, said Dr. Martin I.

>Surks, the director of endocrinology at Montefiore Medical

>Center who oversaw the man's treatment, which was

>administered by Dr. Buettner. The doctors could not say

>which law enforcement agency was involved.

>

>A Police Department official said last night that the

>department could find no records to confirm that incident.

>Tom Kelly, a spokesman for the Metropolitan Transportation

>Authority, said he had no record of it, either. Cliff

>Black, an Amtrak spokesman, said yesterday that he was

>still researching the matter.

>

>According to his doctors, the patient, a 34-year-old

>fitness instructor from the Bronx, was being treated for

>Graves' disease, a thyroid condition, with radioactive

>iodine (iodine-131). Sixty-three percent of it was

>concentrated into his thyroid gland, in the front of his

>windpipe in his lower neck, the doctors said.

>

>"Three weeks after treatment, he returned to our clinic

>complaining that he had been strip-searched twice at major

>Manhattan subway stations," Dr. Surks and Dr. Buettner

>wrote in a letter to be published today in The Journal of

>the American Medical Association. "Police had identified

>him as emitting radiation and had detained him for further

>questioning."

>

>The doctors said that the patient had requested that he not

>be identified publicly and that they were unable to reach

>him by phone yesterday. In their letter to the the journal

>and in interviews yesterday, Dr. Surks and Dr. Buettner

>said a police official had recommended that physicians who

>treat patients with radioactive material give them letters

>describing the isotope and dose, its biological half-life

>and the date and time of treatment. The doctors also said

>the police had recommended that patients be given a

>telephone number where they can reach the physician 24

>hours a day.

>

>But a police official said last night that the department

>had made no such broad recommendation. The official said

>police officers would not treat a letter from a doctor as

>sole proof that someone was above suspicion, but would

>conduct an investigation first.

>

>http://www.nytimes.com/2002/12/04/nyregion/04PATI.html?ex=1040008786&ei=1&en

>=bef596269b32ea9c

>

>Copyright 2002 The New York Times Company

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Dear Radsafers:



This is an old problem with a simple solution.  It's called 

"spectrometry".  The radionuclides used in Nuclear Medicine and permanent 

brachytherapy are not good candidates for nuclear terrorism.  They can be 

identified by their gamma/x-ray spectra, and law enforcement personnel who 

carry radiation detectors should carry spectrometers with simple programs 

that give a green light if it's nuclear medicine or brachytherapy 

radionuclides, and a red light if it's not.  Or, pick other colors because 

of color-blind men.  But, the technology is here and it's time it was 

used.  The same technology should be used at landfills.



Ciao, Carol



Carol S. Marcus, Ph.D., M.D.

<csmarcus@ucla.edu>



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