X-ray rise hikes radiation exposure - The Press Association

X-ray rise hikes radiation exposure(UKPA)

A rise in the number of X-rays is fuelling an increase in the amount of radiation people are exposed to each year, experts have said.

There has been a 140% rise in the use of CT (computerised tomography) scans over the last decade, according to the Health Protection Agency (HPA).

This has pushed up the annual radiation dose to each member of the public in the UK from all X-rays from 0.33 millisieverts (mSv) in 1997 to 0.4mSv. However, this level is still within safe limits and is lower than in comparable countries, the HPA said.

CT scans involve taking an X-ray and using a computer to create detailed images of the inside of the body, and can be used to diagnose or monitor a range of health problems, including bone disease and cancer. CT scans make up about 68% of the radiation dose to the public from all X-rays.

Some 1.4 million CT scans were carried out in 1997, jumping to 3.4 million in 2008, and around 20,000 of these were carried out on people with no symptoms who had opted for a private scan.

HPA experts believe about 46 million medical and dental X-ray examinations were carried out across the UK in 2008, a 10% rise since 1997. Some 67% of these procedures were performed in NHS hospitals and the rest in dental surgeries.

The NHS Breast Screening Programme accounted for 2.03 million X-rays in 2008, up 45% on 1997. This is due to more older women, up to the age of 70, undergoing screening.

Medical X-rays make up about 15% of the total amount of radiation people are exposed to, with other sources including radon from the ground. The average radiation dose from all sources of ionising radiation remains about 2.7mSv per person per year.

Dr John Cooper, director of the HPA's centre for radiation, chemical and environmental hazards, said: "Despite the increased use of diagnostic X-rays in medicine in the UK, the average dose to the population is still considerably lower than in comparable countries.

"This is because in the UK we carry out fewer X-ray examinations per head of population and because radiology departments are well managed by healthcare professionals. Well-framed regulations and guidance exist to maximise the clinical benefit and protect the public and workers."

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Study reveals frequent pediatric rad exposure - Health Imaging & IT

The average child will be exposed to seven procedures using ionizing radiation before the age of 18, while nearly half of children receive a procedure with radiation in any given year, according to a study of more than 350,000 children published in the Archives of Pediatrics and Adolescent Medicine.

"To our knowledge, we report the first large, population-based study examining the use of diagnostic imaging procedures with low-dose ionizing radiation specifically in a pediatric population," wrote Adam L. Dorfman, MD, of the department of pediatrics at the University of Michigan Medical School in Ann Arbor, and co-authors.

Dorfman and colleagues investigated the occurrence of procedures using radiation in 355,088 children enrolled in UnitedHealthcare from 2005 through 2007. The sample included all such enrollees residing in Arizona; Dallas, Texas; Orlando, Florida; south Florida; and Wisconsin, and included plain radiography procedures, CT, fluoroscopy and/or angiography and nuclear medicine scans.

"Among 355,088 children across five large health care markets in the U.S., we found that use of these procedures during a three-year study period was frequent, with at least one of these procedures being performed in 42.5 percent of children. Importantly, many children underwent more than one procedure," the researchers reported.

A total of 436,711 procedures using ionizing radiation were reported over the three-year study. Plain x-rays comprised the most common procedures, with 40 percent of children receiving at least one procedure during the study. Twenty-two percent of children received two or more radiography procedures and 14 percent received three or more.

CT was the second most common procedure, with 8 percent of children receiving at least one over the study period. Two percent of children received one or more fluoroscopy and/or angiography procedures and 1 percent received a nuclear medicine scan. Radiography accounted for a total of 85 percent of all procedures.

"Based on these data, the average child in this study population will have received more than seven procedures by the time he or she reaches age 18 years," Dorfman and colleagues wrote. Overall, male enrollees had higher rates of imaging than females, with 44 percent of boys and 41 percent of girls receiving at least one procedure using radiation. Children over ten years of age also had significantly higher imaging rates.

The authors expressed concern given the National Research Council's findings that any exposure to radiation poses at least some risk, while also citing studies indicating that risk increases linearly with greater exposure to radiation. "Developing tissues in children are more sensitive to radiation and their longer expected life spans also allow additional time for the emergence of detrimental effects," said co-author, Reza Fazel, MD, of the department of cardiology at Emory University School of Medicine in Atlanta.

The authors made no attempts to judge the appropriateness of the procedures, however, while also abstaining from estimating radiation doses due to "a paucity of available data on radiation dosimetry in the pediatric population." They also cautioned that conducting the study in five states and considering only insured children might limit the generalizability of their findings.

"Of course, there is immense life-saving value in medical imaging, so our study doesn't suggest at all that these tests shouldn't be used in children," said co-author Kimberly E. Applegate, MD, vice chair for quality and safety in the department of radiology at Emory.

"It should encourage discussions about the value of each imaging test that is ordered, recognizing that radiation exposure, even in small amounts, may not be risk free," stated Andrew J. Einstein, MD, PhD, a cardiologist at Columbia University in New York City.

Last updated on January 5, 2011 at 9:24 am EST

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