RE: Patient Release - A Related Question

["Tonry, Louie L MAJ" <Louie.Tonry@se.amedd.army.mil>]

The 500 mrem is not to any member of the general public, it is to a select
member of the public, namely the family member.  At least this is the
intent.

When the patient is released, they are given specific instuctions on where
they can go, how to minimize doses to those around them, etc.

As far as the contamination, realistically, the potential dose from uptake
of their contamination is minimal.  I think it is routinely agreed that we
have the contamination levels not because they are necessary for dose
minimization but rather because we can and therefore it's ALARA.

Louie Tonry, CHP
Eisenhower Army Medical Center, Ft. Gordon, GA
louie.tonry@se.amedd.army.mil

-----Original Message-----
From: steve.rima@DOEGJPO.COM [mailto:steve.rima@DOEGJPO.COM]
Sent: Thursday, October 28, 1999 3:13 PM
To: Multiple recipients of list
Subject: Patient Release - A Related Question


     RADSAFERs,
     
     In my last post on this topic, I asked a question that has bugged me 
     for quite a while. Maybe someone out there can attempt to answer it.
     
     Most NRC and Agreement State licensees are subject to the 100 mrem/y 
     limit for members of the public from their activities. In addition, 
     there are some pretty strict public information requirements for many 
     licensees, especially nuclear power plants, whereby they have to 
     provide information on the calculated _theoretical_ dose, and the 
     measured dose, that their plant is giving local residents. DOE sites 
     have similar requirements. There are also _very_ strict limits on how 
     much surface contamination is allowed to be released to the public on 
     material released from their sites.
     
     Medical licensees, on the other hand, can now release a patient to the 
     public so long as the _calculated_ dose to a member of the public is 
     less than 500 mrem, and there is obviously no way to ever measure or 
     confirm whether this was exceeded. There is also no requirement, nor 
     attempts I've heard of, from hospitals to alert the local public that 
     they may be randomly exposed to up to 500 mrem from their patients. We 
     also know that a person with tens to hundreds of I-131 will 
     contaminate everything they touch, usually to a level above what is 
     releasable from other licensees, with no monitoring or public notice 
     required.
     
     QUESTION: Why is there/should there be such a double standard??? I-131 
     is I-131, whether from a hospital or power plant, and a mrem is a 
     mrem, no matter the source, so why can hospitals do things that would 
     get other licensees cited, fined, or even shut down? An argument can 
     be made that residents near a power plant benefit from its operation, 
     but I don't believe that the random member of the public exposed to a 
     radioactive patient receives any benefit whatsoever.
     
     I'm NOT addressing patient care issues here. Dr. Marcus asserts that 
     the NRC should stay completely out of that arena, and I totally agree 
     with her on that point. However, this question has absolutely nothing 
     to do with patient care and everything to do with consistency, or the 
     lack thereof, in regulations regarding public dose limits and 
     notification.
     
     Anybody care to take a stab at an answer to this?
     
     Steven D. Rima, CHP, CSP
     Manager, Health Physics and Industrial Hygiene
     MACTEC-ERS, LLC
     steven.rima@doegjpo.com
     
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