Re: release of patient based on NRCREG 35.75

[Andrew Karam <akaram@safety.rochester.edu>]

I can't speak to many of the issues raised by Dr. Marcus and others.
However, while working for the Ohio Department of Health, I answered
several cases of landfill alarms caused by radiopharmaceuticals.
Specifically, at least three were due to I-131 (diagnostic dose) and one
due to Ga-67.  All doses were traced back to incontinent patients.  In some
cases, we could trace the dumpster to the hospital and requested hospital
personnel take possession of the materials.  In other cases this could not
be done.  

I think a few things are reasonable to expect in similar cases:

- If a load of waste can be traced back to a hospital, it is reasonable for
the landfill to ask the hospital to investigate because the landfill
doesn't know if they've got innocuous material or a teletherapy source.

- If the hospital sends people to the landfill and ID the waste as trace
amounts of I-131, the landfill is unlikely to say "Oh, then go ahead and
leave it with us."

- If state or federal regulators are contacted, they may understand the
health physics and public health concerns, but may still be obligated to
accede to the landfill's wishes.

That being said and done, I have not had any direct experience at either in
the past two years in which I or any of my immediate colleagues have had to
go to a landfill to retrieve patient waste.  It could be that portal
monitors are more common and more effective at the hospitals, waste
segregation practices are better, patient education is improved, or that
the number of patients who give us landfill alarms is small on an
institutional scale but large on a state scale.

Andy

Andrew Karam, CHP
Radiation Safety Officer, University of Rochester
(716) 275-1473 (phone)
(716) 256-0365 (fax)

"The mind is not a vessel to be filled but a fire to be lighted"
Plutarch
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