RE: saftey of being in the proximity of someone on RAI therapy

[John Jacobus <crispy_bird@yahoo.com>]

Maybe it is about time that the regulators consider

the cost outweigh the risk, and consider allowing

landfills to receive and dispose of short-lived

radioactive waste from medical treatments.



--- Gerald Nicholls <Gerald.Nicholls@dep.state.nj.us>

wrote:



> The analogy with cheese isn't really applicable. 

> Some patients now

> leave hositals following nuclear medicine procedures

> with millicurie

> levels of iodine.  This is excreted in urine, feces

> and perspiration. 

> Many of these patients are elderly and suffer from

> incontinence and/or

> bowel problems.  Most home care givers aren't

> equipped or trained to

> hold wound dressing, diapers, etc. in the patient's

> home for decay and

> hence the materials wind up in municipal trash.

> 

> Many landfills and incinerators now have radiation

> monitors installed

> and a soiled diaper contains more than enough

> activity to activate the

> alarm, even inside a filled garbage truck.  The

> alarms are typically set

> at 2X to 3X background (20 to 50 microR/hour).  Most

> of these facilities

> do not have gamma spectrometry equipment available

> on site or staff

> trained in its use.  Hence, when the monitor alarms,

> a visit from a

> state regulatory program representative or a

> consultant is necessary to

> indentify the material and assure the landfill or

> incerator operator

> that the waste can be safely held for decay or

> disposed of immediately. 

> As Phil Egidi pointed out, sometimes it is necessary

> to dump a truckfull

> of municipal waste and search through it to find and

> identify the item

> that triggered the alarm.  That can be truly

> problematic for a fully

> loaded truck that has sat in the sun for several

> days awaiting

> evaluation.

> 

> New Jersey's regulatory program typically receives

> 80 to 100 calls per

> year regarding radioactive materials and about one

> half of them involve

> I-131.  Responding to these calls takes resources

> away from more

> important and relevant work.  Also, the loss of the

> truck (sometimes for

> up to a week) and staff time to deal with the

> problem are signifcant

> costs to the waste hauler.

> 

> It would be far better for the hospital or physician

> to provide

> instructions to the patient and home care givers on

> how to deal properly

> with contaminated materials, even if that ultimately

> leads to the

> materials being returned to the hospital and held

> for decay.

> 

> As far as a homeowner being billed for the costs of

> this work, I'm not

> aware of that ever happening but I know that it has

> been threatened by

> municipal waste haulers.  I think the primary reason

> it hasn't occurred

> is the difficulty in identifying the source of the

> contaminated waste.

> 

> Gerald Nicholls

> NJDEP

> 

> >>> "Flanigan, Floyd" <Floyd.Flanigan@nmcco.com>

> 08/20/04 09:52AM >>>

> The radiological half life of I-131 is only about 8

> days. It should be

> at unnoticeable levels in a relatively short period

> of time. Isotopes of

> this nature are used for medical applications on a

> regular basis and to

> my knowledge, once a patient is released from the

> hospital, there are no

> regulations which place controls on the disposition

> of the resultant

> contaminated waste which the patient generates. As

> an example of the low

> level of concern for this particular isotope, cheese

> made from milk

> contaminated with I-131 may be sold at market

> theoretically since the

> aging process for cheese is longer than the time it

> takes for the Iodine

> to decay to a low enough level to fly under the

> proverbial radar. I

> would not be concerned in this case.

> 

> Floyd W. Flanigan B.S.Nuc.H.P.

> 

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

> From: owner-radsafe@list.vanderbilt.edu 

> [mailto:owner-radsafe@list.vanderbilt.edu]On Behalf

> Of John Jacobus

> Sent: Friday, August 20, 2004 7:29 AM

> To: Philip Egidi; kb1ipd@HOTMAIL.COM;

> owner-radsafe@list.vanderbilt.edu;

> radsafe@list.vanderbilt.edu; crispy_bird@YAHOO.COM 

> Subject: Re: saftey of being in the proximity of

> someone on RAI

> therapy

> 

> 

> Philip,

> Unless there is a regulatory state requirement,

> which

> I doubt, there is no requirement to isolate

> household

> trash.  It is a nice idea, but unless the hospital

> or

> local authorities are willing to pick it up,

> patients

> should not be required to do so.  Does Colorado have

> such a provision?  

> 

> I have never heard of a private citizen being asked

> to

> pay charges for contaminated waste. 

> 

> --- Philip Egidi <phil.egidi@state.co.us> wrote:

> 

> > And PLEASE have your friend follow the

> instructions

> > given (hopefully) by

> > the doctor/clinic/hospital as to disposal of

> wastes

> > that may contain the

> > I-131 after she is released from patient care.  Do

> > NOT just throw paper

> > towels or anything that may contain body fluid

> > (feces, urine, sweat,

> > vomit, etc), in the trash - it may set off alarms

> at

> > the local landfill.

> > Your friendly state regulator (or less friendly

> > hazmat response team)

> > may end up dumping the load looking for the

> > offending trash in order to

> > deal with it appropriately/  If the responders can

> > trace the radioactive

> > trash back to your friend, she may get a visit

> from

> > the suits, and

> > perhaps a bill for the effort.

> > 

> > Thanks,

> > Phil Egidi

> > Colorado

> > 

> > >>> John Jacobus <crispy_bird@YAHOO.COM> 08/19/04

> > 07:42 AM >>>

> > Steve,

> > Your friend is being treated with I-131 to ablate

> > any

> > remaining thyroid tissue.  I-123 is an imaging

> > agent,

> > which was probably used during a diagnostic scan

> to

> > assess her the extent of the cancerous thyroid and

> > uptake of iodine.

> > 

> > Because she no longer has a functioning thyroid,

> > various hormonal and physiological problems will

> > develop.  Eventually, she will be put on a

> synthetic

> > hormone that will have to be adjusted over time. 

> > Too

> > little, and the patient is lethargic.  Too much,

> and

> > the patient is too hyper.  I assume they have not

> > started her on replacement therapy because the

> want

> > to

> > ensure that all of the cancerous thyroid tissue

> has

> > been destroyed.

> > 

> > Your friends sinus problem may be a side effect of

> > the

> > removal of the thyroid, or a totally unrelated

> > effect.

> > 

> > There are a number of Web sites dealing with

> thyroid

> > cancer try

> >

> http://www.cancer.org/docroot/CRI/CRI_2_3x.asp?dt=43

> 

> > and

> >

> 

=== message truncated ===





=====

+++++++++++++++++++

"Everyone is ignorant, only on different subjects."

Will Rogers



-- John

John Jacobus, MS

Certified Health Physicist

e-mail:  crispy_bird@yahoo.com





	

		

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