This may be a stupid question...but has anyone been concerned about the level of radiation that they are exposed to in radiology? I get the impression that it is not too big of a factor if you take appropriate precautions, and every field comes w/ its risks, but any insight into this would be great, thanks!
radiation exposure?
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Seconds of sleep lost over this = zero. The only people that even have the potential to have any problems are interventionalists, and even then the risks are negligible.
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Just to add to colb's post, you're not exposed to radiation in the reading room, so that's not a big deal. Generally, the techs are the ones who may get exposed to the most radiation, but even then it's not beyond a negligible amount provided they actually take the appropriate precautions. Also, radiation exposure is generally very carefully regulated; everyone in the department gets a batch that records the amount of radiation each individual is exposed to. If at any point you are exposed beyond the very conservative legal limit, you are essentially put on vacation for a certain period of time until it is safe for you to return back to work. The only time radiation is even an issue to a radiologist is, like colb said, if they are doing a fluoroscopic procedure, and even then, as long as you suit up appropriately (good vest, thyroid shield, glasses, cap), your exposure is essentially negligible.
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Hi Student X,
I am actually interested in the occupational exposure of radiologists to radiation myself, and have talked to many people at a couple of institutions about it, and in addition done my own research
I first became interested in in this topic after my parents told me not to go into Radiology because of the occupational exposure to radiation. Then, I heard about a doctor at our institution that used a lot of fluoro and got cancer in his leg (where the source of the C-arm is), and he thought it was b/c of the radiation. I wasn't certain how danerous radiation was, so I decided to conduct some research. It made me pretty concerned.
Obviously interventional radiologists get a lot of exposure, but do diagnostic radiologists get anything? I asked several diagnosticians this question, and they said that they all had to do diagnostic procedures which involve fluorscopy, like upper GI series, small bowel series, barium enema, IV pyelography, venogram, and so on. Plus even for Diagnostic Radiology residency you have to do a couple of months of interventional, I think, so it's very difficult to avoid radiation exposure. But most of them said they weren't sure that the radiation would necessarily shorten their life.
SO, then I decided to search the literature for this topic. We have to be evidence based right??? I found a ton of stuff, and I'll just summarize some of the more signifficant articles.
So when radiation was first discovered, by Roentgen in 1895 (well there was another guy who discovered it simultaneously but Roentgen gets all of the credit) most of the people that worked with it died from radiation poisoning. Dozens of the first radiologists died b/c they didn't know about it's dangers. Thomas Eddison's assistant, Clararance Dally, died a horrible death from radiodermatitis, which convinced Eddison to get out of work w/ X-rays.
So then ppl improved shielding and realized it was dangerous, so that most radiologists got low doses. Low dose radiation has an effect on DNA which is not immediately apparent. It wont burn your skin or GI tract, but it's been shown to damage DNA (there's a lot of articles about this, you can do a PubMed search if youre interested). This is reffered to in the literature as a "stochastic" effect.
Radiation causes cancer in tissues, and cataracs in the eyes (b/c the cells that die due to the radiation get clumped up and become opaque in the lenses). Bone marrow is pretty sensitive to radiation, b/c of the high turnover rate, and when you wear an apron, you still leave 18% of the active marrow exposed: .. Ellis RE. The distribution of active bone marrow in the adult. Phys Med Biol 1961; 5: 255–258.
The actual effects of low dose radiation on humans are difficult to examine, because they happen a lot later down the line. Also, 42% of ppl (a little more men than women) get cancer. So it's hard to say what's due to radiation and what's not. A lot of what's been known comes from Atomic Bomb survivors. ( .NAS/NRC (National Academy of Sciences/National Research Council), Health Risks From Exposure to Low Levels of Ionizing Radiation, BEIR VII, Phase 2, National Academy Press, Washington DC 2006..)
You need a very large sample size to determine the effects of low dose radiation. Recently, a study conducted in 15 countries, in about 400,000 radiation workers found that workers that got about 20mSv total exposure, had about a 2% increase in all cancer mortality. This was higher, but proportional, to A-bomb studies. The dose limit for most US hospitals is 50 mSv total body exposure PER YEAR, and to the skin and eyes (where it causes cataracs) it's like 200 - 500 mSv per year. So I would expect people that reach the limit frequently to have more problems. Here's the study: Cardis E, Vrijheid M, Blettner M, et al., The 15-Country Collaborative Study of Cancer Risk among Radiation Workers in the Nuclear Industry: Estimates of radiation-related cancer risks, Radiat Res 2007; 167: 396–416.
In Februrary, 2009 this article was published in 4 radiology/vasc. surgery journals simultaneously due to it's perceived importance:
Klein LW, Miller DL, et al. Occupational Health Hazards in the Interventional Laboratory: Time for a Safer Environment.
It talks about a lot of the risks that people that work w/ radiation are exposed to, but what I remember the most is that it talks about several small studies that found a 3.5 to 6.0 Odds Ratio of having brain cancer if youre a physician that works w/ fluoroscopy.
Recently, an article came out in the NEJM which said that in the near future about 2% of all cancers will be caused by CT scanners (if I remember correctly.) But this is for patients. Why am I mentioning it? B/c I thought it was signifficant 🙂 (.D.J. Brenner and E.J. Hall, Computed tomography—an increasing source of radiation exposure, N Engl J Med 357 (2007), pp. 2277–2284.). A CT scan gives you aroun 10 mSv of radiation, and according to the FDA it increases risk of cancer (if done in the pelvis, abdomen, or chest) by about 1 in 1000 to 1 in 2000.
Anyways, I could go on, but this post is getting too long. To me it seems that it's not completely safe. It's my main concern with Radiology. But that's just my humble oppinoin.
I am actually interested in the occupational exposure of radiologists to radiation myself, and have talked to many people at a couple of institutions about it, and in addition done my own research
I first became interested in in this topic after my parents told me not to go into Radiology because of the occupational exposure to radiation. Then, I heard about a doctor at our institution that used a lot of fluoro and got cancer in his leg (where the source of the C-arm is), and he thought it was b/c of the radiation. I wasn't certain how danerous radiation was, so I decided to conduct some research. It made me pretty concerned.
Obviously interventional radiologists get a lot of exposure, but do diagnostic radiologists get anything? I asked several diagnosticians this question, and they said that they all had to do diagnostic procedures which involve fluorscopy, like upper GI series, small bowel series, barium enema, IV pyelography, venogram, and so on. Plus even for Diagnostic Radiology residency you have to do a couple of months of interventional, I think, so it's very difficult to avoid radiation exposure. But most of them said they weren't sure that the radiation would necessarily shorten their life.
SO, then I decided to search the literature for this topic. We have to be evidence based right??? I found a ton of stuff, and I'll just summarize some of the more signifficant articles.
So when radiation was first discovered, by Roentgen in 1895 (well there was another guy who discovered it simultaneously but Roentgen gets all of the credit) most of the people that worked with it died from radiation poisoning. Dozens of the first radiologists died b/c they didn't know about it's dangers. Thomas Eddison's assistant, Clararance Dally, died a horrible death from radiodermatitis, which convinced Eddison to get out of work w/ X-rays.
So then ppl improved shielding and realized it was dangerous, so that most radiologists got low doses. Low dose radiation has an effect on DNA which is not immediately apparent. It wont burn your skin or GI tract, but it's been shown to damage DNA (there's a lot of articles about this, you can do a PubMed search if youre interested). This is reffered to in the literature as a "stochastic" effect.
Radiation causes cancer in tissues, and cataracs in the eyes (b/c the cells that die due to the radiation get clumped up and become opaque in the lenses). Bone marrow is pretty sensitive to radiation, b/c of the high turnover rate, and when you wear an apron, you still leave 18% of the active marrow exposed: .. Ellis RE. The distribution of active bone marrow in the adult. Phys Med Biol 1961; 5: 255–258.
The actual effects of low dose radiation on humans are difficult to examine, because they happen a lot later down the line. Also, 42% of ppl (a little more men than women) get cancer. So it's hard to say what's due to radiation and what's not. A lot of what's been known comes from Atomic Bomb survivors. ( .NAS/NRC (National Academy of Sciences/National Research Council), Health Risks From Exposure to Low Levels of Ionizing Radiation, BEIR VII, Phase 2, National Academy Press, Washington DC 2006..)
You need a very large sample size to determine the effects of low dose radiation. Recently, a study conducted in 15 countries, in about 400,000 radiation workers found that workers that got about 20mSv total exposure, had about a 2% increase in all cancer mortality. This was higher, but proportional, to A-bomb studies. The dose limit for most US hospitals is 50 mSv total body exposure PER YEAR, and to the skin and eyes (where it causes cataracs) it's like 200 - 500 mSv per year. So I would expect people that reach the limit frequently to have more problems. Here's the study: Cardis E, Vrijheid M, Blettner M, et al., The 15-Country Collaborative Study of Cancer Risk among Radiation Workers in the Nuclear Industry: Estimates of radiation-related cancer risks, Radiat Res 2007; 167: 396–416.
In Februrary, 2009 this article was published in 4 radiology/vasc. surgery journals simultaneously due to it's perceived importance:
Klein LW, Miller DL, et al. Occupational Health Hazards in the Interventional Laboratory: Time for a Safer Environment.
It talks about a lot of the risks that people that work w/ radiation are exposed to, but what I remember the most is that it talks about several small studies that found a 3.5 to 6.0 Odds Ratio of having brain cancer if youre a physician that works w/ fluoroscopy.
Recently, an article came out in the NEJM which said that in the near future about 2% of all cancers will be caused by CT scanners (if I remember correctly.) But this is for patients. Why am I mentioning it? B/c I thought it was signifficant 🙂 (.D.J. Brenner and E.J. Hall, Computed tomography—an increasing source of radiation exposure, N Engl J Med 357 (2007), pp. 2277–2284.). A CT scan gives you aroun 10 mSv of radiation, and according to the FDA it increases risk of cancer (if done in the pelvis, abdomen, or chest) by about 1 in 1000 to 1 in 2000.
Anyways, I could go on, but this post is getting too long. To me it seems that it's not completely safe. It's my main concern with Radiology. But that's just my humble oppinoin.
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So I had this detailed response regarding the above post, but it got erased. The short version is this...
There's a lot of fear-mongering regarding radiation, even among physicians who presumably have a better grasp on its nature and effects than Joe Sixpack. If someone were legitimately interested in radiology but didn't pursue it because they were concerned about radiation exposure, then I would say categorically that it would be the worst decision of their professional life.
There's a lot of fear-mongering regarding radiation, even among physicians who presumably have a better grasp on its nature and effects than Joe Sixpack. If someone were legitimately interested in radiology but didn't pursue it because they were concerned about radiation exposure, then I would say categorically that it would be the worst decision of their professional life.
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I think that radiation exposure is a concern for a good amount of people at my level, and especially if they are female and want to have children during residency. I think it's important to pick the specialty that youre most comfortable with, whatever that is, but from talking to a guy from the "hazard protection agency" at our institution it's when ppl get cavalier about radiation exposure when they have problems.