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Fwd: Iodine therapy patients (again) -Reply




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Forwarded message:
From:	Steve_Cartwright@KETTHEALTH.COM (Steve Cartwright)
Sender:	medphys@LISTS.WAYNE.EDU (Medical Physics Listserver)
Reply-to:	MEDPHYS@LISTS.WAYNE.EDU (Medical Physics Mailing List)
To:	MEDPHYS@LISTS.WAYNE.EDU (Multiple recipients of list MEDPHYS)
Date: 97-10-17 17:22:42 EDT

You've got the gist of it.  Using the government's figures, we can
administer about 220 mCi (8GBq) of I-131 for thyroid cancer (although
it is possible to justify more).  If more than 1.2 GBq (33 mCi) is
admistered the patient must be given instructions including
information on "maintaining distance from other persons, including
separate sleeping arrangements; minimizing time in public places
(e.g., public transportation, grocery stores, shopping centers,
theaters, restaurants, sporting events); precautions to reduce the
spread of radioactive contamination; the length of time each of the
precautions should be in effect."  (From USNRC Regulatory Guide 8.39)
 The kicker, though, is in the footnote:  "The NRC does not intend to
enforce patient compliance with the instructions nor is it the
licensee's responsibility to do so."  In short, we have to address
all the concerns you mentioned, but only to the extent we make the
patient aware of them.  Neither we nor the patient have a legal
obligation to follow them.  Please note, if we kept the patient
in-house we would have to follow all the standard precautions for
I-131 patients or face legal sanctions (and the wrath of the Nursing
department) for failing to do so.

As far as this situation never being allowed in the UK.  Well,
perhaps not, but you still have to deal with steak and kidney pie.