Voluntary guidelines suggest that after radioactive treatment, patients avoid close proximity to others, sleep alone for a week, and avoid close proximity (i.e., hugs) with infants and children, and avoid pregnant women. And yet, these guidelines are not being followed, and many of these patients, while still "radioactive" so to speak, end up in public, riding public transportation, or, to avoid exposing their own families, frequently stay in hotel rooms which then become contaminated by radiation.
According to some scientists, even the second-hand exposure to someone who has has had a radioactive medical treatment can provide a single dose of radiation that exceeds the typical annual dose from all sources received by a typical American, and may be as much as four times higher than the level considered safe for a pregnant woman.
Take our poll to share your thoughts about whether radioactive thyroid patients should be quarantined, go to hotels, and more.
This is not a new issue, and we've been talking about it for years actually. Back in 2006, I blogged, Radioactive Treatments Can Trigger Airport Security...Even Weeks After Treatment, and in 2007, USA Today did a series that I profiled: Radioactive Iodine (RAI) Treatment for Thyroid Disease: Is Secondhand Exposure Safe?.
In 2008, I reported on the "New Guidelines Issued to Protect Babies and Children from Thyroid Patients Receiving Radioactive Iodine." These guidelines were released by the Nuclear Regulatory Commission (NRC), and recommended back then that the procedures to protect infants and young children from radiation exposure be strengthened.
In Rep. Markey's Congressional investigation, a number of problems were identified, including patients who set off radiation detectors at airports and in tunnels, rode public buses, shared a bathroom and/or bedroom with a pregnant woman or child, and their house trash has triggered radiation detectors at landfills. Hotels are a particular concern, because, according to the report, 7 percent of the patients surveyed had radioactive iodine treatment, and then checked in to a hotel "where they contaminate sheets, bedspreads, and other common room surfaces and could also potentially expose pregnant hotel workers or children of guests - who are the most susceptible for developing cancer as a result of radiation exposure. In 2007, a patient was discovered to have contaminated two individuals as well as the sheets and towels used in almost an entire hotel in Illinois."
According to Rep. Markey's statement, the Nuclear Regulatory Commission (NRC) is ignoring the problem. "My investigation has led me to conclude that the levels of unintentional radiation received by members of the public who have been exposed to patients that have received 'drive through' radiation treatments may well exceed international safe levels established for pregnant women and children...This has occurred because of weak NRC regulations, ineffective oversight of those who administer these medical treatments, and the absence of clear guidance to patients and to physicians."
You can read Rep. Markey's letter to the Nuclear Regulatory Commission here in PDF format.
While the specific risk from exposure is not clear, hopefully, this new investigation will propose some better solutions. It's hard enough for patients to deal with the stress of thyroid cancer and its treatment -- but to be considered a public health hazard, or referred to as "human dirty bombs" -- when they have no other options -- seems to be an additional and unfair burden on patients. At the same time, the public needs to be protected.