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

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

I agree almost completely with one unfortunate point of contest: The expenditure of resources to identify the isotope once the alarm at the dump goes off. I'm sure there is a way of addressing it efficiently ... but who picks up the tab?



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



-----Original Message-----

From: John Jacobus [mailto:crispy_bird@yahoo.com]

Sent: Friday, August 20, 2004 11:17 AM

To: Gerald Nicholls; kb1ipd@HOTMAIL.COM;

owner-radsafe@list.Vanderbilt.Edu; radsafe@list.Vanderbilt.Edu;

Flanigan, Floyd; phil.egidi@state.co.us; crispy_bird@YAHOO.COM

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





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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