Are Americans Getting too Much Medical Radiation?
March 5th, 2009
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Probably not…
An item which has been making the rounds in the press in the past few days is a report which came out from the National Council on Radiation Protection and Measurement. The press has been going wild with it, as the report states that Americans are being exposed to an average of seven times more radiation from medical imaging than they were almost thirty years ago.
By the way, if you’re not an American, this still applies to you. The trend is not just a US thing. Medical imagine is becoming more available and more frequently used in modern medicine in general, not just in the US.
Here’s a typical report from Reuters:
Overexposed: Imaging tests boost U.S. radiation dose
CHICAGO (Reuters) – Americans are exposed to seven times more radiation from diagnostic scans than in 1980, a report found on Tuesday as experts said doctors are overusing the tests for profit and raising health risks for patients.
The findings, issued by National Council on Radiation Protection and Measurement, add to already mounting evidence that doctors are ordering too many diagnostic tests, driving up the cost of healthcare in the United States and potentially harming patients.
While diagnostic scans give doctors valuable information and many times are necessary, doctors fear too much radiation exposure can cause cancer, especially in younger people.
“Imaging has literally become the guiding hand of medical practice,” said Dr. James Thrall, chair of the American College of Radiology’s Board of Chancellors, who was not part of the study.
“Unfortunately, one of the things we have seen in the imaging world is that many physicians look at imaging as the solution to their financial problems,” Thrall, head of radiology at Massachusetts General Hospital in Boston, said in a telephone interview.
He said imaging technology has created a financial incentive for some doctors to cash in by referring patients to get imaging tests on equipment in their own practices. This is one place the federal government and Congress can look in enacting healthcare reform, Thrall added.
Not surprisingly the whole issue of evil profit-driven doctors exposing their patients to radiation has come up, even more explicitly in this report:
Recent research revealed that Americans are seven times more exposed to radiation than in 1980. The possible reason behind this increase is overuse of a diagnostic scans by doctors for profit.
First let me just point out something: This study has only determined that the average dose from medical imaging has gone up, it has not revealed any kind of increase in cancer or other health issues from this trend. There is no evidence that this is causing net harm to anyone. In fact, the radiation may very well be causing a net improvement in health.
Certainly there are plenty of reports which are talking about cancer, infertility and the other scary aspects of radiation. And of course, artistic, glowing, ominous looking trefoils. There is no empirical data to support the claims that this has caused any rise in cancer. That’s just based on applying the linear non-threshold hypothesis to the issue, a hypothesis which has been shown to be flawed and generally not supported by data.
Here’s an example of what a typical informational graphic on a news media site might look like:
The real reason for the increase:
The reason for the increase in average dose is not necessarily because a large portion of the American public are being exposed to radiation frequently, but because a few people are getting more medical imaging and thus the average is driven up. CT scans are one example of a procedure which has a higher radiation dose than most others and which has become far more common since 1980. CT scans were first used in the 1970’s and at the time, the amount of computing power necessary to produce a good image relegated them to only a few cutting edge facilities. By the early 1980’s, the CT scan was still state of the art and not something the average hospital was likely to have on the premises. However, today CT scans can be done at most major hospitals and even a modest desktop computer has ample power for producing 2D and even 3D CT-scan images.
Modern technology has also made realtime C-arm flouroscopy during surgery an affordable option for guiding non-invasive surgery. This kind of technology does expose the patient to radiation, but it is generally regarded as a much smaller risk than the alternative. (Believe me, given the choice between getting a couple millirems of radiation while a doctor guides a stent into my chest through a vein in my arm or having my chest cracked open so it can be done directly, without radiation exposure, I’ll take the fluoroscope.)
In addition to this, there has been an increase in the use of mammograms, x-ray densitometry and other diagnostic tests which have become more avaliable and which studies have confirmed the life saving value of. Imaging is now cheaper, more available and more is utilized more than ever before.
This is simply a case of doctors being able to reduce the guesswork, improve diagnosis and increase early detection by using more imaging and better quality methods than ever before. Prior to 1980, X-rays were used primarily for evaluating broken bones and were limited to film-based two dimensional images. CT scans were too expensive and uncommon for use on all but the most high priority patients. If you had a brain tumor, you might get a CT scan, but if it was just a dislocated shoulder, you wouldn’t have the benefit of such imaging.
MSNBC is one of the few news outlets that has a more sane take on this report.
“Huge Increase,” “Overexposed,” and “Higher Than Ever” are some of the terms in headlines yesterday reporting that the average American’s exposure to radiation from medical procedures has risen over the last 30 years.
The reports are true, though the hype may be unwarranted. The bulk of the increase is among certain individuals undergoing valuable and sometimes life-saving medical procedures or tests.
Yes, Americans are now exposed to about six times more radiation from medical procedures than they were in 1980, according to a report released by the National Council on Radiation Protection and Measurements. However, the numbers can be misleading, some scientists say.
Story continues below ↓advertisement | your ad here“Adding up all the doses and then spreading out the total over the entire population, no matter a person’s age, occupation, location, or health status is not appropriate for assessing risk to the general population,” said Cynthia McCollough, a professor of radiological physics at the Mayo Clinic in Rochester, Minn.
If nothing else, the big danger here is confusing patients, creating even more rehtoric to be exploited by quacks (who love to talk about how untrustworthy doctors are) and just confusing patients in general. If your doctor tells you that diagnostic imaging will improve his or her ability to assess your condition and provide approperate treatment, then you get those tests done. Don’t worry about the radiation becasue it is almost certainly less of a concern than the condition you are being evaluated for. And be sure to get all the approperate cancer and disease screenings recomended for your demographic!
This entry was posted on Thursday, March 5th, 2009 at 1:05 am and is filed under Bad Science, Culture, Obfuscation, Politics, Quackery. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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March 5th, 2009 at 1:28 am
This kind of scare journalism combined with groups like the radiation council putting out obviously inflammatory reports does nobody any good. The last thing we need is more ammo being used in the idiocy of quacks telling people not to listen to their doctor and do it the “natural” way, omitting that there’s nothing more natural than death.
Even though the study is of Americans, I agree with you that this surely applies to any country with modern medicine. In terms of percent increase it probably applies even more in developing countries like China, where in 1980 hardly anyone in the population had access to x-rays of even the basic kind and now it’s more avaliable. So clearly in that kind of a society the average medical radiation exposure would be much higher now than in the past. Bad thing? I would have to say no.
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March 5th, 2009 at 1:32 am
Aside from the words about radiation being evil and needing to panic, that graphic is not that far off the mark of what you see in news media reports. When it’s a radiation related story and they don’;t have any photos they just pick up some scary clipart with radiation symbols.
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March 5th, 2009 at 2:01 am
The hype machine strikes again spreading hysterical technophobia masquerading as journalism. Scaremongering is no trivial offense, as the outbreaks of preventable diseases, caused by the vaccination misinformation is proving. This sort of pandering to the latent angstlust of a public wallowing in scientific ignorance must stop. There is freedom of the press and then there is seditious libel, which in the broader sense of the term is to promote discontent among or hostility between peoples in a society by uttering lies. This is the same reasoning that doesn’t grant an individual the right to shout ‘FIRE’ in a crowded theater under freedom of speech.
The concept of a rational citizen responsibly dealing with risks comes with the expectation that the general media will give the public accurate information. A radio station that embellished traffic reports to satisfy the passion for excitement and fear of drivers during rush hour, would swiftly lose their license, especially if their reports were causing more snarl-ups due to misdirection. It is beyond me why this same logic doesn’t apply here and to similar instances.
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March 5th, 2009 at 3:17 am
Yes too much radiation and too much toxic drugs from chemicals. More natural medicine is better. Health stays good to begin with and that means you do not have illness to treat. Radiation is part of the polution we see today. Electronic items are full of toxins and radiation makes things worse.
Yes, avoid radiation. It degrades your healthy balance. It is a bigger danger today. If the doctor wants you to go inside something big and electronic then use your mind and know how bad it is. Do not let them. Natural alternatives exist.
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March 5th, 2009 at 4:09 am
Juan said:
Do you even know what the words ‘chemical’ and ‘radiation’ mean?
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March 5th, 2009 at 4:11 am
I worked in development for a fluoroscopy imager (from what I can see, the successor of the gear in your photo), and not only it is radiologically very safe (the X-rays used are taylored to pass trough soft tissues and only be stopped by the iodine solution injected in the targetted veins that then expel that energy as heat), but it also reduces eart and vascular surgery mortality by a good order of magnitude.
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March 5th, 2009 at 4:49 am
Finrod said:
No he doesn’t and he hasn’t actually read any of the posts he’s commented on because he wouldn’t understand those, nor any of the following remarks by others.
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March 5th, 2009 at 9:45 am
Excellent writeup. The author touched on something that is important to stress involving screening x-rays especially mammograms. In the past few years there have been groups putting out information about how mammography is dangerous because of the radiation exposure and some have gone so far as to say women should not get annual mammograms. This is really something that needs to be opposed because it is confusing patients and can lead to forgoing of mammogram out of fear of radiation or confusion of what to do.
A mammogram exposes a woman to very minimal radiation doses and does not present any significant danger. However, it has been proven time and time again to be a simple, inexpensive and effective way of saving lives through early detection. This is why they are so highly recommended now, because the more data we have the better we can see how valuable a tool it is.
Of course, medical imaging has saved many lives and improved many more in other areas, because it is so important that doctors are able to understand exactly what the problem in a patient is and see what is going on inside the body.
If anyone is ever worried that their doctor is sending them for unnecessary diagnostic imaging or they are receiving more x-ray imaging tests or CT scans, they should seek a second opinion or even a third opinion. It’s always good to seek more opinions when in doubt about ones care. However, they should seek the second opinion from a qualified practitioner and not from an fear mongering internet site or a homeopathic quack.
Please get the tests you need.
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March 5th, 2009 at 10:05 am
But today,
warmedicine is too important to be left topoliticiansdoctors. They have neither the time, the training, nor the inclination for strategic thought. I can no longer sit back and allowCommunistmedical infiltration,Communistmedical indoctrination,Communistmedical subversion and the internationalCommunistmedical conspiracy to sap and impurify all of our precious bodily fluids.Quote Comment
March 5th, 2009 at 11:06 am
Interesting side note: one of the things which has led to medical imaging being able to save more people’s lives, especially in emergency situations, is high-speed Internet access and digital imaging. CT scans and the like need to be interpreted by an expert radiologist, and it’s expensive to keep one of those on staff 24/7. This can be prohibitive for small hospitals.
However, with digital imaging, now all a hospital needs is an imaging device and a trained technician who can operate the machine. If no radiologist is present (say, if someone shows up at 3 am with a head injury), the hospital can send the digital images to a hospital in another country where it’s daytime, the radiologists there who are on duty during their normal hours interpret the results, and they send back their report.
In my experience it took about twenty minutes. I’m very grateful to the radiologists in Australia who determined that my middle-of-the-night concussion last year was not life-threatening.
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March 5th, 2009 at 11:27 am
franck said:
While I am sure that the x-ray intensity is low and the safety margin is very good, any system like that will expose the patient to some x-rays. I mean, you are exposed to some just watching an old CRT television. It’s an issue of risk to benefit. I’m not surprised at all that it would increase survival by a good order of magnitude. It sure beats flying blind! It also beats the more invasive options.
Medical imaging has come a long way and it’s really an exciting field. It’s great to see how this equipment is becoming more avaliable even as it is being continuously improved to provide better imaging and new functions. Some of the new 3D radiology systems are really really cool.
Be assured that the work you do on these systems does not go unappreciated around here.
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March 5th, 2009 at 12:43 pm
All is relative. There may be more exposure [on average] today than say ten years ago, but…
How about the 1950’s where it was common to have a fluoroscope in a shoe store, operated by the salesman. He would show you on the screen just how the shoe fit your foot.
Now that’s [steampunk era] high technology! None of your wimpy image intensifiers, digital signal processing or other fancy electronics.
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March 5th, 2009 at 6:16 pm
This is the sort of scaremongering hyperbole that should not be permitted in my opinion:
American’s Radiation Exposure Greater Than Being In Atomic Bomb Blast Zone
“Alarmingly, radiation levels caused by CT scans are so high that receiving just two or three CT scans bombards your body with as much radiation as surviving an atomic bomb blast (no kidding).”
“Read this shocking story to learn the truth about the incredible harm being caused by CT scans, mammograms and cancer radiation “therapy”.”
From here
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March 6th, 2009 at 4:14 am
drbuzz0 said:
Yes, patients are exposed to x-rays, but these particular devices are designed to see the shape of veins or heart cavities, which means they use only high energy x-ray photons, above ~100keV (the beam has to pass trough a cooper or alluminium plate before reaching the patient that filters out the dangerous energy levels) and these photons have too much energy to interact with the ligh atoms forming organic chemistery (it’s quantum physics, an atom can only absorb an ionizing radiation if it can have a corresponding electron state transition, and each atom has a very limited list of such possible transition).
On the image, soft tissues are invisible (so, there is no significant absorbtion), bones are transparent with visible outlines (their mineral coating absorbs a small proportion of the beam) and the iodine solution-filled veins or cavities are plain (high absorbtion by the iodine).
Of course, that doesn’t mean that these devices come with strict safety rules, in particular at the factory, where tests and calibrations sometimes need the generation of a full power unfiltered beam.
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