Health Hazard

[DrArsenic]

Isn't it dangerous to be exposed to radiation even though it is monitored? Have there been cases of Radiologists dieing from the exposure of radiation?

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[eddieberetta]

The amount of radiation exposure experienced by radiologists is minimal. Diagnostic radiologists are usually not in the room during imaging examinations except in the setting of interventional procedures and supervising other work under fluoro. For routine imaging, techs are usually the only ones in the room. However, the use of proper precautions and advances in equipment (collimators etc.) have made exposure even during procedures minimal assuming proper techiniqes are followed.

When proper techniques are not used, the amount of radiation needed to exceed your allowance (monitor) is still not nearly enough to cause radiation burns or injuries that would cause death (unless you manage to do something crazy!!).

Also, as a radiologist, you have extensive training in radiation safety during residency. Some imaging modalities (MR, US) do not use ionizing rays and are very safe.

However, in the early years following the discovery of x-rays, many people were badly burned / got cancer due to radiation injuries!!

 

[oldandtired]

Remember that we are all exposed to radiation every day. The amount of excess radiation that a radiologist is exposed to is almost insignificant.

 

[Jumpu]

Have there been studies that indicate what you all are saying? I am interested in this field but God Forbid I bring it up in my household. My Mother In law swears she knew of a radiologist who died from exposure and Heaven help her, I will NOT become one.

 

[russellb]

Originally posted by Jumpu
Have there been studies that indicate what you all are saying? I am interested in this field but God Forbid I bring it up in my household. My Mother In law swears she knew of a radiologist who died from exposure and Heaven help her, I will NOT become one.

Check out any Radiologic Physics textbook. "Review of Radiologic Physics" by Huda and Slone should be available at your Med. School bookstore. I think that you have to go back to the 1950's to find a time when Radiologists were at a measureably greater risk than members of the general population.

 

[drstrangelove]

Hi all, I was going to post something similar to the original question by DrArsenic but found this thread and figured I would post here instead.

How much less or more dangerous is being a radiologist than being any other kind of doctor? Other types of doctors? What factors account for this difference?

Are there any good, recent studies with good design detailing this?

 

[fantasty]

I didn't look up the article, but I know I've read a study using medical licensing information and mortality follow-up data to show that radiologists were not at an increased risk of death compared to other specialities (but I do not remember how recent the study was, and whether they may also have looked at cancer registeries as well). But, as noted above, I don't think radiologists get that much exposure these days, especially compared to rad techs. I also imagine OSHA would be have fairly strict guidelines about acceptable levels of exposure.

 

[Whisker Barrel Cortex]

First of all, the current dose to radiologists except for interventionalists is minimal. Many cardiologists and orthopods get more radiation (and have little to no regard or knowledge of radiation safety).

The most complete study to date:

Berrington, A, Darby, SC, Weiss, HA, & Doll, R.
100 years of observation on British radiologists: mortality from cancer and other causes 1897-1997 Br J Radiol. 74, 507-519 (2001)

http://bjr.birjournals.org/cgi/cont...jkey=867b3762a4eaa99dd98bbefe7942148b0e655d41

Findings as discussed by Dr. John Cameron, medical physicist:

“There was no evidence of an effect of radiation on diseases other than cancer even in the earliest radiologists, despite the fact that doses of the size received by them have been associated with more than a doubling in the death rate.”


BRITISH RADIOLOGIST STUDY

Divided radiologists in to four groups:

1. 1897- 1921 huge doses;

2. 1921-1935 more careful.

3..1936-1954 better yet

4. 1955-1979 about 5mGy/y

Radiologists’ deaths from cancer and non-cancer were compared to that of all male MDs in England

Before 1921, radiologists had 75% more cancer deaths (P<0.001) but deaths from other causes were 14% lower (P<0.05) than for all male MDs. Deaths from all causes were 3% lower. (NS)

Large doses (~1 Gy/y) did not shorten longevity.

In 1920 British radiologists formed a x-ray safety committee to reduce occupational radiation. The results were beneficial as the following data indicate.

After 1920 no group of radiologists had a cancer death rate significantly greater than their medical colleagues.

The abrupt drop from p<0.001 to NS suggests that the radiation induction of cancer has a significant threshold as shown by Evans’ 1974 study of radium dial painters & the Rossi-Zaider’s 1997 study of lung cancer.

The1955-1979 British Radiologists had 29% lower cancer deaths (NS); 36% lower non-cancer deaths (P<0.001) and 32% lower deaths (P<0.001) from all causes than the controls

Their lower death rate from all causes increased their longevity by over three years! If all cancer were curable in the U.S., the longevity would only increase 3 years !

FOR THE 100 YEARS, THE RADIOLOGISTS’ DEATHS FROM NON-CANCER WAS 14% LOWER (P<0.001); THEIR DEATH RATE FROM ALL CAUSES WAS 8% LOWER (P<0.01) THAN FOR ALL MALE MDs IN ENGLAND AND WALES.

So overall, being a radiologist is better for your health than other medical fields.

There has been one study, however, that has shown increased incidence of cataracts in interventional radiologists:

http://www.pslgroup.com/dg/243bfe.htm

 

[dr-dre]

First of all, the current dose to radiologists except for interventionalists is minimal. Most cardiologists and orthopods get more radiation (and have little to no regard or knowledge of radiation safety).

So, are you basing your claim that orthopods and cardiologists have no regard for radiation safety on data or your own personal experiences? Ya, I know that they don't have the radiation physics background of a radiologist (no surprise there). But, show me a study after 1979 that demonstrates these guys care less about getting irradiated than a radiologist.

 

[Whisker Barrel Cortex]

So, are you basing your claim that orthopods and cardiologists have no regard for radiation safety on data or your own personal experiences? Ya, I know that they don't have the radiation physics background of a radiologist (no surprise there). But, show me a study after 1979 that demonstrates these guys care less about getting irradiated than a radiologist.

Of course its based on my personal experiences and observations. I doubt a good study could be done to prove that fact.

The fact is, their radiation safety training is minimal and based on my personal observations, their knowledge of how to reduce radation exposure and the very basics of how their fluoro machine works is minimal. Of course they care about getting irradiated, they just don't seem to have the respect for and knowledge of doses and radiation that radiologists have. Thus, they are not as adept or careful about exposure in my experience. I have had to teach some pretty basic stuff to senior cardiology fellows.

 

[f_w]

Realistically, the only area in radiology were you can get significant exposure is IR. Depending on the types of cases you do, there can be a considerable exposure to your body, lens and hands.

There has been a recent study out of Columbia that seems to show that there is an increased risk for the development of posterior subcapsular cataract in the left eye of full-time interventional radiologists. PSC is the type of cataract typically related to ionizing radiation, it is distinctively different from age related nuclear cataracts.

Here are some references, I am not sure whether it is available as a journal article yet. There were abstracts at SIR and some of the eye meetings.

http://www.diagnosticimaging.com/dinews/2004032801.shtml

http://www.escrs.org/eurotimes/04July/pdfs/Radiologistsmayb.pdf

However, 90+ percent of radiologists are NOT doing full time IR. If you are a diagnostic imager and only occasionably sling some barium in the fluoro suite, the risk from radiation exposure is minimal.

 

[dr-dre]

Of course its based on my personal experiences and observations. I doubt a good study could be done to prove that fact.

Exactly. Try to be objective and stop bashing other specialties that you know nothing about (unless you've also done an ortho residency / cards fellowship).

 

[Whisker Barrel Cortex]

Exactly. Try to be objective and stop bashing other specialties that you know nothing about (unless you've also done an ortho residency / cards fellowship).

I will bash all I want. I've heard enough anti-radiology crap from people many fields to last me a lifetime. I have friends that are cardiology fellows and I have worked with them. My personal impressions still confirm the above statements. If you don't want to read them, then don't. DO NOT come to the radiology board and try to tell me what I can and cannot post. As far as I can tell from your previous posts you are a new intern or still a medical student. So that would mean, if you take the "advice" you gave me above, that you should espouse no opinions at all since you have no real first hand knowledge of anything. Now go supplement some potassium like a good little intern.

 

[dr-dre]

I will bash all I want. I've heard enough anti-radiology crap from people many fields to last me a lifetime. I have friends that are cardiology fellows and I have worked with them. My personal impressions still confirm the above statements.

Listen up, tough guy. I may be a medical student, but it doesn't change my point: if you're going to make statements that other fields recklessly expose themselves to radiation, then show the data to prove it. That's all I'm saying.

Second, who the hell is anti-radiology? Radiology is great (and a field I'm considering as a career, which is why I'm on the radiology forum). I'm bashing YOU for being ingnorant and getting all riled up, but having NOTHING substantial to support your assertions beyond your own clearly subjective and emotional experiences.

I don't care how many cardiology fellows you are friends with. I don't care how many people you've given advice to about radiation safety. I don't care that you make fun of orthopods. I don't care that you imply medicine residents are only good for repleting K. Show me the data or shut up.

 

[Whisker Barrel Cortex]

Listen up, tough guy. I may be a medical student, but it doesn't change my point: if you're going to make statements that other fields recklessly expose themselves to radiation, then show the data to prove it. That's all I'm saying.

Second, who the hell is anti-radiology? Radiology is great (and a field I'm considering as a career, which is why I'm on the radiology forum). I'm bashing YOU for being ingnorant and getting all riled up, but having NOTHING substantial to support your assertions beyond your own clearly subjective and emotional experiences.

I don't care how many cardiology fellows you are friends with. I don't care how many people you've given advice to about radiation safety. I don't care that you make fun of orthopods. I don't care that you imply medicine residents are only good for repleting K. Show me the data or shut up.

I was not the one that got riled up, kiddo. I made a brief statement in a thread on another topic and YOU got all riled up.

This is not evidence based medicine I'm talking about, this is my opinion on an internet message board. If I wrote an article about it, then I'd have to have some data. If you can't differentiate the two, then I'm sorry. There nothing emotional about my impressions, but obviously they're subjective. If that's what you want me to admit, I admit it. In no way does that change my statement above.

And you obviously confused the word "intern" with "medicine resident". For educational purposes: an intern is a first year resident (in any specialty), who initially knows very little about the practical care of the patient and does a lot of patient management tasks such as repleting potassium (which I did a whole lot of in my medicine internship). So my implication had nothing to do with medicine residents, whom I respect greatly for the work they do (and who comprise the majority of my friends).

Good job taking this thread off topic.

I still recommend the article I posted above to the original poster and anyone interested in radiation exposure and mortality in radiologists. I apologize for the off topic discussion.

 

[f_w]

Kid, what you are looking for is a study to measure stupidity.

The experience of the radiation protection department at the hospital I did my residency at was, that most problems with dose overruns occured in the cardiac cath lab. As some of our IR techs cross-covered the cathlab at times, we had some insight into how that happened: Fluoroscopy running with nobody watching the monitor (lead-foot), cine-runs with staff in the room extending into the late venous phase, no use of articulated lead-glass shields etc. At this point in time, cardiolgy fellows receive only cursory training in radiation protection. They see what their attendings are doing and copy the poor practices.

 

[DrBowtie]

Without a doubt Radiologists are more informed about exposure since they have had formal education on it. Not to say that cardiologists or whoever else are careless around radiation but without a doubt they don't have as much knowledge and therefore I would say at a higher risk.

 

[dr-dre]

Thanks BrettBatchelor and f w for answering my question politely and succintly. I agree it would be a study to measure stupidity. However, if stupidity is the source of excessive radiation exposure for the patient and physician, eliminating the stupidity would be a good thing for everyone (and prove that radiologists do a good job of minimizing their exposure to radiation).

 

[Whisker Barrel Cortex]

Thanks BrettBatchelor and f w for answering my question politely and succintly. I agree it would be a study to measure stupidity. However, if stupidity is the source of excessive radiation exposure for the patient and physician, eliminating the stupidity would be a good thing for everyone (and prove that radiologists do a good job of minimizing their exposure to radiation).

Did you read my first post in answer to your question? Very polite and succinct. Only when you try to be a badass and tell me what I should and should not post did I reply in kind. So you're welcome.

And yes, eliminating the stupidity by better educating clinicians who use flouro would be a good thing. Thats the whole point.

 

[dr-dre]

Did you read my first post in answer to your question? Very polite and succinct.

Must you keep bringing this up? You've got to be kidding me (and yourself) if you believe statements such as these are polite:

1. I will bash all I want.

2. I've heard enough anti-radiology crap from people many fields to last me a lifetime.

3. DO NOT come to the radiology board and try to tell me what I can and cannot post.

4. Now go supplement some potassium like a good little intern.

I simply asked about data showing other fields expose themselves to greater amounts of radiation, and you go on an angry soap-box tirade. Hence, not succint. None of the other posters were rude in their responses.

Thanks for CONTINUING to take this thread off topic. Chill out.

 

[DrBowtie]

He said his first post which was the research on the topic.

 

[Whisker Barrel Cortex]

My first post after yours. Find something inflammatory in it and I'll give you a prize. Good night.

Of course its based on my personal experiences and observations. I doubt a good study could be done to prove that fact.

The fact is, their radiation safety training is minimal and based on my personal observations, their knowledge of how to reduce radation exposure and the very basics of how their fluoro machine works is minimal. Of course they care about getting irradiated, they just don't seem to have the respect for and knowledge of doses and radiation that radiologists have. Thus, they are not as adept or careful about exposure in my experience. I have had to teach some pretty basic stuff to senior cardiology fellows.

 

[hans19]

My first post after yours. Find something inflammatory in it and I'll give you a prize. Good night.