Radiation Dangers of Being in the Medical Field

This article is the fifth part of a multi-part series of hazards within the medical field. Catch up on parts one, two, three, and four.

A healthcare worker (HCW) is anyone who works in a healthcare or social care setting, including healthcare students on clinical placement, frontline healthcare workers, and other healthcare workers not in direct patient contact.

HCWs deliver care and services to the sick directly as doctors and nurses or indirectly as assistants, technicians, aides, or medical waste handlers. Many studies focus on patients' well-being and quality of care, but little attention has focused on the well-being of HCWs. 

Hospital staff is exposed to ionizing radiation from radiation-generating devices used during surgical procedures, including X-ray machines and fluoroscopy units. The following article breaks down the radiation dangers of being in the medical field. 

Ionizing Radiation

Ionizing radiation is atomic particles or electromagnetic waves that possess enough energy to produce ions when interacting with matter. The hazard level of radiation depends on the activity, energy, and type of radiation. 

In hospitals, ionizing radiation is used in diagnostics and therapeutic procedures and can cause various types of cancer. These cancers include the stomach, liver, colon, lung, breast, uterine, thyroid, and leukemia. 

High radiation levels can also damage blood and tissues, including the heart, eyes, intestine, skin, and reproductive organs. 

Nuclear Medicine

Nuclear medicine is a specialized area of radiology that uses minimal amounts of radioactive materials and radiopharmaceuticals to examine organ function and structure. The majority of procedures in this area are diagnostic. 

Technologists' job tasks in this area include receipt and processing of radioactive materials, elution  Mo-99 generators, preparing radiopharmaceuticals, injecting patients, positioning and imaging patients, post-imaging processing, radioactive waste collection, thyroid and liver cancer treatment, and surveying for contamination.

At the end of each day, the technologists collect the radioactive waste and transfer it to a secure radioactive waste storage room. Generally, workers will store radioactive wastes with half-lives of less than 90 days of “decay in storage.”

Aside from cancers, nuclear medicine procedures can cause allergic reactions, skin reddening, and hair loss because they’re longer and use more radiation than other types of radiology. 

Radiation Therapy

Procedures used in radiation therapy are either teletherapy, brachytherapy, or open sources. More significant amounts of radioactivity are used in therapy than used in diagnosis. The radioactive material-sealed sources with the highest risk are used in the Radiation Oncology department. 

Teletherapy machines use external radiation beams from sealed, high-activity sources to deliver the prescribed dose to a patient’s tumor. 

Brachytherapy treats cancers by inserting radioactive implants directly into the tissue. Worker exposure is the highest during the time the seeds are manually implanted. Once inside the patient, the tissues attenuate the radiation, and the patient presents a minimal external radiation hazard to others. 

I-131- sodium iodide is an “open source” treatment for hyperthyroidism and thyroid cancer. Because the source isn’t sealed, the main hazard is radioactive contamination. Workers do not receive significant exposure from the patient because they generally require little bedside care or are sent home. 

But once the patient receives the dose, all bodily secretion will contain some radioactive iodine. Workers have a slightly increased risk of developing leukemia, stomach cancer, and salivary gland cancer in the future. 

X-Rays

X-rays are ionizing radiation used in stationary and portable X-ray machines, fluoroscopes, and computed tomography (CT). Fluoroscopes are used in many departments for image-guided procedures. 

The worker is in a shielded booth for X-rays and most CTs, receiving minimal exposure. But fluoroscopy workers are generally near the radiation source during the procedure, resulting in a higher dose. 

Sources of radiation for all these procedures include the primary X-ray beam (the physician is trained to avoid exposure to), scatter from the patient (a major source of exposure) to surroundings, and leakage from X-ray generation equipment.

Hospitals should specially construct X-ray rooms to reduce the radiation levels outside the room to permissible radiation exposure levels for members of the general public. The potential health effects of X-ray radiation exposure include erythema, dermatitis, skin cancer, and bone marrow suppression.