Health Care and Radiation

Ever have to get an X-ray or diagnostic procedure where radiation is used? Have you had radiation treatment for cancer or know someone who has? Do you work in radiology as a professional or have been exposed to radiation therapy? Have you been to the dentist and had bitewings taken of your teeth? What about MRIs, CT scans, and other tests? If you have, you may have concerns over the safety of radiation, even in small doses. Often, people express concern about the risks of the radiation exposure(s) from these exams. According to the Health Physics Society (HPS), people are encouraged to become well informed about the risks and benefits of all uses of radiation; and in the case of medical exposures, it is good to be an active participant in the process. This includes an understanding of the procedures involved and the possible risks associated with them.

According to the EPA, in general, the amount and duration of radiation exposure affects the severity or type of health effect. There are two broad categories of health effects: stochastic and non-stochastic:
1). Stochastic Health Effects:
Stochastic effects are associated with long-term, low-level (chronic) exposure to radiation. ("Stochastic" refers to the likelihood that something will happen.) Increased levels of exposure make these health effects more likely to occur, but do not influence the type or severity of the effect. Cancer is considered by most people the primary health effect from radiation exposure. Simply put, cancer is the uncontrolled growth of cells. Ordinarily, natural processes control the rate at which cells grow and replace themselves. They also control the body's processes for repairing or replacing damaged tissue. Damage occurring at the cellular or molecular level, can disrupt the control processes, permitting the uncontrolled growth of cells--cancer. This is why ionizing radiation's ability to break chemical bonds in atoms and molecules makes it such a potent carcinogen. Other stochastic effects also occur. Radiation can cause changes in DNA, the "blueprints" that ensure cell repair and replacement produces a perfect copy of the original cell. Changes in DNA are called mutations. Sometimes the body fails to repair these mutations or even creates mutations during repair. The mutations can be teratogenic or genetic. Teratogenic mutations are caused by exposure of the fetus in the uterus and affect only the individual who was exposed. Genetic mutations are passed on to offspring.

2.) Non-Stochastic Health Effects:
Non-stochastic effects appear in cases of exposure to high levels of radiation, and become more severe as the exposure increases. Short-term, high-level exposure is referred to as 'acute' exposure. Many non-cancerous health effects of radiation are non-stochastic. Unlike cancer, health effects from 'acute' exposure to radiation usually appear quickly. Acute health effects include burns and radiation sickness. Radiation sickness is also called 'radiation poisoning.' It can cause premature aging or even death. If the dose is fatal, death usually occurs within two months. The symptoms of radiation sickness include: nausea, weakness, hair loss, skin burns or diminished organ function. Medical patients receiving radiation treatments often experience acute effects, because they are receiving relatively high "bursts" of radiation during treatment.

According to the EPA, there is no firm basis for setting a "safe" level of exposure above background for stochastic effects. Many sources emit radiation that is well below natural background levels. This makes it extremely difficult to isolate its stochastic effects. In setting limits, the EPA makes the conservative (cautious) assumption that any increase in radiation exposure is accompanied by an increased risk of stochastic effects. Some scientists assert that low levels of radiation are beneficial to health (this idea is known as hormesis). However, there do appear to be threshold exposures for the various non-stochastic effects. Because children are growing more rapidly, there are more cells dividing and a greater opportunity for radiation to disrupt the process. EPA's radiation protection standards take into account the differences in the sensitivity due to age and gender. Fetuses are also highly sensitive to radiation. The resulting effects depend on which systems are developing at the time of exposure. Health physicists generally agree on limiting a person's exposure beyond background radiation to about 100 mrem per year from all sources. Exceptions are occupational, medical or accidental exposures. (Medical X-rays generally deliver less than 10 mrem). The EPA and other regulatory agencies generally limit exposures from specific source to the public to levels well under 100 mrem. This is far below the exposure levels that cause acute health effects.

According to Medical News Today, though, based upon an evaluation of the peer-reviewed literature that details the improvements brought about by such technologies, it is reasonable to conclude that millions of lives have been saved and millions more dramatically improved as a result of these imaging technologies. Technological advances and innovations in medicine have produced significant benefits for society noted by healthier, longer lives. Early disease diagnosis and some disease treatments involve imaging exams that expose us to radiation. With radiation, physicians have the capability to see inside the human body, see if any organ is not functioning properly, determine if a growth is cancer, treat disease, and look to see if our disease is gone after treatment. Timely detection and treatment of disease is critical to improving outcomes. As with any medical imaging procedure, individuals need to discuss with their physician the need for the procedure and the potential benefit of having it performed. Imaging procedures must be justified based on a need for information to improve the patient's health condition.

Health physicists generally agree on limiting a person's exposure beyond background radiation to about 100 mrem per year from all sources, according to the EPA. Exceptions are occupational, medical or accidental exposures. (Medical X-rays generally deliver less than 10 mrem). EPA and other regulatory agencies generally limit exposures from specific source to the public to levels well under 100 mrem. This is far below the exposure levels that cause acute health effects. Both the type of radiation to which the person is exposed and the pathway by which they are exposed influence health effects. Different types of radiation vary in their ability to damage different kinds of tissue. Radiation and radiation emitters (radionuclides) can expose the whole body (direct exposure) or expose tissues inside the body when inhaled or ingested.

Other than cancer, the most prominent long-term health effects are teratogenic and genetic mutations, according to the EPA. Teratogenic mutations result from the exposure of fetuses (unborn children) to radiation. They can include smaller head or brain size, poorly formed eyes, abnormally slow growth, and mental retardation. Studies indicate that fetuses are most sensitive between about eight to fifteen weeks after conception. They remain somewhat less sensitive between six and twenty-five weeks old. The relationship between dose and mental retardation is not known exactly. However, scientists estimate that if 1,000 fetuses that were between eight and fifteen weeks old were exposed to one rem, four fetuses would become mentally retarded. If the fetuses were between sixteen and twenty-five weeks old, it is estimated that one of them would be mentally retarded. Genetic effects are those that can be passed from parent to child. Health physicists estimate that about fifty severe hereditary effects will occur in a group of one million live-born children whose parents were both exposed to one rem. About one hundred twenty severe hereditary effects would occur in all descendants. In comparison, all other causes of genetic effects result in as many as 100,000 severe hereditary effects in one million live-born children. These genetic effects include those that occur spontaneously ("just happen") as well as those that have non-radioactive causes.

Radiation sickness, according to RightHealth.com, is illness and symptoms resulting from excessive exposure to radiation. Exposure may be accidental or intentional (as in radiation therapy). Radiation sickness results when humans (or other animals) are exposed to very large doses of ionizing radiation. Radiation exposure can occur as a single large exposure (acute), or a series of small exposures spread over time (chronic). Radiation sickness is generally associated with acute exposure and has a characteristic set of symptoms that appear in an orderly fashion. Chronic exposure is usually associated with delayed medical problems such as cancer and premature aging, which may happen over a long period of time. The severity of symptoms and illness (acute radiation sickness) depends on the type and amount of radiation, how long you were exposed, and which part of the body was exposed. Symptoms of radiation sickness may occur immediately after exposure, or over the next few days, weeks, or months. Children who receive radiation treatments or who are accidentally exposed to radiation will be treated based on their symptoms and their blood cell counts. Frequent blood studies are necessary and require a small puncture through the skin into a vein to obtain blood samples. Symptoms include the following:
--Bleeding from the nose, mouth, gums, and rectum
--Bloody stool
--Bruising
--Dehydration
--Diarrhea
--Fainting
--Fatigue
--Hair loss
--Inflammation of exposed areas (redness, tenderness, swelling, bleeding)
--Mouth ulcers
--Nausea and vomiting
--Open sores on the skin
--Skin burns (redness, blistering)
--Sloughing of skin
--Ulcers in the esophagus, stomach or intestines
--Vomiting blood
--Weakness
Your doctor will advise you how best to treat these symptoms. Medications may be prescribed to help reduce nausea, vomiting, and pain. Blood transfusions may be given for anemia . And, antibiotics are used to prevent or fight infections.

Here is how to prevent radiation sickness, according to RightHealth.com:
1.) Avoid unnecessary exposure to radiation.
2.)Persons working in radiation hazard areas should wear badges to measure their exposure levels.
3.) Protective shields should always be placed over the parts of the body not being treated or studied during x-ray imaging tests or radiation therapy.

Radiation has proven to be an effective way to find and cure diseases and to help with controlling the growth of certain diseases like cancer. However, it must be used in moderation and with protected methods by health care providers and technicians.

Until next time. Let me know what you think.