Re: radiopharmaceutical patient release

[isurveyor@vianet.net.au (Ivor Suveyor)]

>Stephane Jeanfrancois wrote:
>
>Stephane, thanks for your thoughts.  I respond, not to you directly, but
>to all radsafers.  You have enunciated ideas that, in my mind, need
>further discussion.
>
 Al Tschaeche  xat@inel.gov
>
>> You are right, we should not be too worry about this issue. But I try,
>> as much as possible, to think ALARA and if there is a way to educate a
>> patient to wait for a while after a Thyroid treatment (ablation or
>> you wrote:

If I can be allowed a comment on this issue, which comes in several forms
after treatment with iodine-131.  I have  been much involved in these
decisions in the past.    In Australia the legal limit for OP treatment is
set at 555MBq.  There seems to me to be several levels of argument that a
practicing physician has to consider when discharging a patient back to the
community after OP radionuclide treatment. 

1). That the exposure to any fellow passengers, airline, bus etc., or fellow
worker, spouse  is harmless,  is a matter on which I  would have no
difficulty in supporting. 

2). I can easily explain this matter to the patient.  But how do I deal with
the fellow passenger, worker, employer etc.   The patient has only to let it
be known that  radioactive treatment was given,  for  irrational reactions
to be  generated.  

3). No matter what private opinions I may or may not  hold as to the safety
of these procedures.  As a radiation worker I  believed that I  was
obligated to follow ICRP guidelines.  In the case in  of potential radiation
exposure to the patients   spouse,  immediate family and unknown members of
the public,  excess exposure is defined as greater then 1mSv/y  above
background.   Prior to 1990 when recommendations for dose to the public was
5 mSv/y,  there was little  difficulty in complying with regulations. 

4). As a Citizen, I would have to conform with any lawful directive from the
State Health Authority, Employing  Authority etc.    I presume too that an
Airline has the authority to make its own bye-laws and state a company
policy on   these issues. 

5). In practice most of these issues are of a theoretical nature, some are
easily foreseen and dealt with or covered by local  rules and precedence.
Such as discharge to a  Nursing home.      I have known in the distant past
of Airline Captains refusing to  fly radioactive containers on passenger
craft, but never a radioactive passenger. 

6). I can state that in some thirty years of experience in this area,  I
have found  real problems in this area to be very rare indeed

Ivor Surveyor
Emeritus Consultant Physician, Nuclear Medicine. 
E-mail:    isurveyor@vianet.net.a
Ivor Surveyor
Emeritus Consultant Physician, Nuclear Medicine. 
E-mail:    isurveyor@vianet.net.au