Stakeholder Support for Regulatory Harmonization and Expanded Nuclear Power: Outcomes of HPS/NCRP Open Forums.

Risk of medical imaging

Americans were exposed to more than seven times as much ionizing radiation from diagnostic medical procedures in 2006 than they were in the early 1980s.

This paper broadly examines the historical development of radiation protection in medical practice through an examination of the interactions of those concerned with radiation protection and medical practice with emphasis on the last half century and on the role played by health physicists and the Health Physics Society. Included is a brief discussion of the relevant activities of various federal agencies and other organizations including the Atomic Energy Commission and successors and the U.S. Public Health Service; the National Council on Radiation Protection and Measurements and International Commission on Radiological Protection; and the Health Physics Society, American Board of Health Physics, American Association of Physicists in Medicine, Society of Nuclear Medicine, and Conference of Radiation Control Program Directors and related scientific and professional bodies.

The use of low dose x‐ray scanners for passenger screening at public transportation terminals should require documentation of the “informed consent” of passengers

Over the past few years papers have appeared in the scientific literature that predict thousands of cancers and cancer deaths each year in populations of patients receiving medical imaging procedures (primarily computed tomography) employing ionizing radiation. The predictions in these papers are computed by estimating very small and hypothetical risks at low radiation doses and multiplying these speculative estimates by large numbers of patients experiencing medical imaging. The public media use these papers to develop print and electronic news releases that raise anxiety in parents, families and patients, at times causing them to delay or defer needed imaging procedures. Decisions to delay or defer examinations constitute real risks to patients, as contrasted with the hypothetical risks presented in the papers. Professional organizations, including the American Association of Physicists in Medicine and the Health Physics Society, have developed policy positions in an effort to illuminate the controversy over the risks of low-level radiation exposures (see URLs in the supporting documents and additional readings). Scientific advisory groups such as the International Commission on Radiological Protection, the National Council on Radiation Protection and Measurements, and the United Nations Scientific Committee on the Effects of Atomic Radiation have also addressed the controversy (see URLs in the supporting documents and additional readings). Now the International Organization for Medical Physics, representing 80 national and six regional medical physics organizations and 18,000 medical physicists worldwide, has developed its own policy statement which is reproduced below. One can only hope that the policy statements issued by these knowledgeable organizations will have some deterrent influence on the continued propagation of unsupportable cancer risk estimates related to medical imaging procedures conducted with minimum doses of radiation consistent with high quality studies.

Over the past few years papers have appeared in the scientific literature that predict thousands of cancers and cancer deaths each year in populations of patients receiving medical imaging procedures (primarily computed tomography) employing ionizing radiation. The predictions in these papers are computed by estimating very small and hypothetical risks at low radiation doses and multiplying these speculative estimates by large numbers of patients experiencing medical imaging. The public media use these papers to develop print and electronic news releases that raise anxiety in parents, families and patients, at times causing them to delay or defer needed imaging procedures. Decisions to delay or defer examinations constitute real risks to patients, as contrasted with the hypothetical risks presented in the papers. Professional organizations, including the American Association of Physicists in Medicine and the Health Physics Society, have developed policy positions in an effort to illuminate the controversy over the risks of low-level radiation exposures (see URLs in the supporting documents and additional readings). Scientific advisory groups such as the International Commission on Radiological Protection, the National Council on Radiation Protection and Measurements, and the United Nations Scientific Committee on the Effects of Atomic Radiation have also addressed the controversy (see URLs in the supporting documents and additional readings). Now the International Organization for Medical Physics, representing 80 national and six regional medical physics organizations and 18,000 medical physicists worldwide, has developed its own policy statement which is reproduced below. One can only hope that the policy statements issued by these knowledgeable organizations will have some deterrent influence on the continued propagation of unsupportable cancer risk estimates related to medical imaging procedures conducted with minimum doses of radiation consistent with high quality studies.

The Image Gently in Dentistry campaign: promotion of responsible use of maxillofacial radiology in dentistry for children.

The process to arrive at the radiation protection practices of today to protect workers, patients, and the public, including sensitive populations, has been a long and deliberative one. This paper presents an overview of the US Environmental Protection Agency's (US EPA) responsibility in protecting human health and the environment from unnecessary exposure to radiation. The origins of this responsibility can be traced back to early efforts, a century ago, to protect workers from x rays and radium. The system of radiation protection we employ today is robust and informed by the latest scientific consensus. It has helped reduce or eliminate unnecessary exposures to workers, patients, and the public while enabling the safe and beneficial uses of radiation and radioactive material in diverse areas such as energy, medicine, research, and space exploration. Periodic reviews and analyses of research on health effects of radiation by scientific bodies such as the National Academy of Sciences, National Council on Radiation Protection and Measurements, United Nations Scientific Committee on the Effects of Atomic Radiation, and the International Commission on Radiological Protection continue to inform radiation protection practices while new scientific information is gathered. As a public health agency, US EPA is keenly interested in research findings that can better elucidate the effects of exposure to low doses and low dose rates of radiation as applicable to protection of diverse populations from various sources of exposure. Professional organizations such as the Health Physics Society can provide radiation protection practitioners with continuing education programs on the state of the science and describe the key underpinnings of the system of radiological protection. Such efforts will help equip and prepare radiation protection professionals to more effectively communicate radiation health information with their stakeholders.

A letter was received in August 2001 from the President of the Health Physics Society (HPS) referring to the critical reviews of expenditures over the past few years that are being carried out by the Society. The dues paid to the International Radiation Protection Association (IRPA) were included in this review and had been specifically singled out for examination by the HPS Executive Committee. In particular, information on funding, sources of funding and activities over recent years was requested.

The Health Physics Society (HPS) provided comment to the U.S. Environmental Protection Agency (EPA) on options to consider when developing an action plan for President Trump's Executive Order to evaluate regulations for repeal, replacement, or modification. The HPS recommended that the EPA reconsider their adherence to the linear no-threshold (LNT) model for radiation risk calculations and improve several documents by better addressing uncertainties in low-dose, low dose-rate (LDDR) radiation exposure environments. The authors point out that use of the LNT model near background levels cannot provide reliable risk projections, use of the LNT model and collective-dose calculations in some EPA documents is inconsistent with the recommendations of international organizations, and some EPA documents have not been exposed to the public comment rule-making process. To assist in establishing a better scientific basis for the risks of low dose rate and low dose radiation exposure, the EPA should continue to support the "Million Worker Study," led by the National Council on Radiation Protection and Measurement.

Better definition of the cancer risk on the basis of patient age and clinical condition at exposure are just two small parts of the overall radiation risk equation.

Contemporary radiation protection in dentistry: Recommendations of National Council on Radiation Protection and Measurements Report No. 177

The role of the SRP—a forward look

HomeRadiologyVol. 240, No. 1 PreviousNext Reviews and CommentaryEditorialsMammography: Better, Safer, and More Effective?Otha W. Linton, David A. SchauerOtha W. Linton, David A. SchauerAuthor Affiliations1From the International Society of Radiology (O.W.L.) and National Council on Radiation Protection and Measurements (D.A.S.), 7910 Woodmont Ave, Suite 400, Bethesda, MD 20814. Received August 17, 2005; final version accepted September 2.Address correspondence to O.W.L.Otha W. LintonDavid A. SchauerPublished Online:Jul 1 2006https://doi.org/10.1148/radiol.2401051399MoreSectionsFull textPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In References1 National Council on Radiation Protection and Measurements. A guide to mammography and other breast imaging procedures. NCRP report no. 149. Bethesda, Md: National Council on Radiation Protection and Measurements, 2004. Google Scholar2 National Council on Radiation Protection and Measurements. Mammography: a user's guide. NCRP report no. 85. Bethesda, Md: National Council on Radiation Protection and Measurements, 1986. Google Scholar3 Egan RL. Experience with mammography in a tumor institution: evaluation of 1,000 studies. Radiology 1960; 75: 894–900. Link, Google Scholar4 Strax P, Venet L, Shapiro S. Value of mammography in reduction of mortality from breast cancer in mass screening. Am J Roentgenol Radium Ther Nucl Med 1973; 117: 686–689. Crossref, Medline, Google Scholar5 Breast cancer screening. NIH Consensus Statement 1977; 1(1): 5–8. Google Scholar6 Hendrick RE, Smith RA, Rutledge JH, Smart CR. Benefit of screening mammography in women ages 40–49: a new meta-analysis of randomized controlled trials. J Natl Cancer Inst Monogr 1997; 22: 87–92. Medline, Google Scholar7 Jemal A, Clegg LX, Ward E, et al. Annual report to the nation on the status of cancer, 1975–2001, with a special feature regarding survival. Cancer 2004; 101: 3–26. Crossref, Medline, Google Scholar8 Houn F, Elliott ML, McCrohan JL. The Mammography Quality Standards Act of 1992: history and philosophy. Radiol Clin North Am 1995; 33: 1059–1065. Medline, Google Scholar9 National Institutes of Health Consensus Developmental Panel. National Institutes of Health Consensus Development Conference Statement: breast cancer screening for women ages 40–49, January 21–23, 1997. J Natl Cancer Inst Monogr 1997; 22: vii–xviii. Google Scholar10 Kolata G. Stand on mammograms greeted by outrage. New York Times. January 28, 1997: C1. Google Scholar11 National Council on Radiation Protection and Measurements. Evaluation of the linear-nonthreshold dose-response model for ionizing radiation. NCRP report no. 136. Bethesda, Md: National Council on Radiation Protection and Measurements, 2001. Google ScholarArticle HistoryPublished in print: July 2006 FiguresReferencesRelatedDetailsCited ByAnnals of Surgical Oncology, Vol. 17, No. S3Recommended Articles Digital Mammography and Breast Tomosynthesis Performance in Women with a Personal History of Breast Cancer, 2007–2016Radiology2021Volume: 300Issue: 2pp. 290-300Digital Breast Tomosynthesis Screening for Breast Cancer: It Is Cost-effective!Radiology2020Volume: 297Issue: 1pp. 49-50An Evidence-based and Inclusive Breast Cancer Screening Strategy: Summary of Current Guidelines from the American College of Radiology and Society of Breast ImagingRadiology: Imaging Cancer2022Volume: 4Issue: 2Benefit to Radiation Risk of Breast-specific Gamma Imaging Compared with Mammography in Screening Asymptomatic Women with Dense BreastsRadiology2016Volume: 281Issue: 2pp. 583-588City Patterns of Screening Mammography Uptake and Disparity across the United StatesRadiology2019Volume: 293Issue: 1pp. 151-157See More RSNA Education Exhibits Breast Health in the Elderly: Implications for ImagingDigital Posters2020High Risk Breast Cancer Screening  Digital Posters2020Let’s Talk about Next-Generation Breast Cancer Screening Programs: How Should We Do? What Should We Use?Digital Posters2020 RSNA Case Collection Fibroadenoma of the breastRSNA Case Collection2020Invasive ductal carcinoma as developing asymmetryRSNA Case Collection2021Hyperplastic Residual Breast TissueRSNA Case Collection2022 Vol. 240, No. 1 Metrics Altmetric Score PDF download

Radiation protection is foundational to harnessing the societal benefits of radiation in nuclear energy, security, and medicine applications. Significant challenges in radiation protection remain unaddressed for the nuclear fuel cycle, nuclear medicine, emergency response, national defense, and space exploration, as the United States is lacking a coherent research strategy prioritizing radiation protection mission needs and gaps in scientific knowledge to meet these needs. Research and development in the field of radiation protection calls for cooperation among governmental agencies, emergency responders, research organizations, and the academic community. Amidst atrophying national expertise in radiation protection, the Radiation Protection Research Needs Workshop was spearheaded by the Oak Ridge Associated Universities, Oak Ridge National Laboratory, and the Health Physics Society. This workshop facilitated critical dialogue among radiation stakeholders in the governmental and scientific communities, including national laboratories, academic institutions, and industry partners. The workshop featured presentations representing 12 federal agencies and breakout sessions involving the identification of scientific drivers by subject matter experts in each of the following areas: new fuel cycles/reactors, dosimetry, medical physics, instrumentation and operations, decontamination and decommissioning, space radiation, national defense, emergency response, environmental modeling, and low-dose effects. The goal of this workshop was to seek stakeholder input toward the development of a national strategic research agenda in the field of radiation protection. Consequently, the Health Physics Society has established a Special Task Force on Health Physics Research Needs, tasked with the prioritization of scientific drivers in radiation protection for the development of a national strategic research agenda.