Re: any problems releasing radionuclide therapy patients?

[carol marcus <csmarcus@ucla.edu>]

At 08:00 AM 2/11/98 -0600, you wrote:
>>Date:         Tue, 10 Feb 1998 19:52:42 EST
>>Reply-To: Medical Physics Mailing List <MEDPHYS@LISTS.WAYNE.EDU>
>>Sender: Medical Physics Listserver <medphys@lists.wayne.edu>
>>From: Ray Kaczur <Raymonator@AOL.COM>
>>Subject:      Re: any problems releasing radionuclide therapy patients?
>>To: Multiple recipients of list MEDPHYS <MEDPHYS@LISTS.WAYNE.EDU>
>>
>>
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>>In a message dated 98-02-10 10:09:31 EST, you write:
>>
>><< What about
>> the business of I-131-contaminated patient trash being caught at the
>> landfill? Who's responsible? >>
>>
>>This exact situation happened to me. Turns out it is in the public domain and
>>not under NRC control anymore nor the licensee (as long as it was released
>>within regulatory limits)  but is a matter for the EPA. Turns out the EPA
>>referred it to the state department of health to handle.
>>
>>Ray Kaczur, M.S., D.A.B.R.
>>Cleveland, Ohio
>>
>
>This is an interesting problem caused by lack of regulatory continuity
between entities who run sanitary landfills and those who decide whether
certain radioactive waste streams are to be controlled or not. The best way
I know of to avoid the garbage dump hysteria problem is to instruct a
patient receiving therapy doses of NaI-131 carefully.  Explain that all body
fluids contain I-131, and that whatever cannot go down the sewer, via the
toilet, sink, dishwasher, or clotheswasher, should be saved for a week in a
double plastic shopping bag and returned to the physician who administered
the dose.  The physician will throw it into the garbage when it has decayed
enough not to trigger detectors in the dumps.  Some helpful hints are
available in the following 1 page commentary:Marcus CS and Aldrich R:
Avoiding Solid Waste Contamination Problems from Iodine-131 Patients. Jour.
Nucl. Med. vol. 38 no. 9 (Sept., 1997):26N.

In addition, the adoption of the 1996 IAEA standards for levels of
radionuclides that may be dumped in the garbage may also help.  NRC won't
touch this issue after being clobbered by Congress for their really dumb
"BRC" fiasco some years ago, but Agreement States are considering adoption
of the IAEA standards.  This is really a logical extension to what Texas
began years ago.

The whole contamination issue should be based on radiation absorbed dose,
not on activity.  What could be more stupid than running around a nuclear
medicine department surveying and wipe-testing for nanocurie levels of
Tc-99m, when hundreds of millicuries of Tc-99m leaves the department each
day, uncontained and uncontrolled, because it leaves inside patents?  The
patients are free to urinate, defecate, sweat, spit, cough, sneeze, bleed,
and cry wherever they want, and contaminate everything, and so what?  The
radiation absorbed doses from this contamination is absolutely insignificant.