Article Submitted by: Syeda Sarah Gilani (MS – IESE), Supervised by: Dr. Imran Hashmi
In many hospitals of Pakistan diagnostic radiography including X-rays, CT scan, MRI and radiotherapy is being excessively applied to patients depending on their need and condition. Radiology technicians, are at risk to be exposed to radiations while performing their duties, carry out these tests and diagnoses. Unfortunately, in Pakistan, there is no specific health and safety regulation to protect workers from the exposure to radiations. These radiations are harmful for human bodies and can cause serious (at times, fatal) consequences. Therefore, it is necessary to take protective measures to avoid any unwanted consequences on health of workers.
Against the backdrop of recent health and safety concerns particularly relating to diagnostic radiography, this article attempts to address the potential array of health risks to the people who are routinely exposed radiations. Generally, the workers in interventional radiology laboratories are at high risk of exposure to harmful radiations, and this presents a range of issues for concern. As evidenced in many past instances, many laboratory workers have encountered problems like skin cancer, contraction of eye lens etc. One of the emerging health problems is Cancer. According to WHO estimates that without intervention radiology, 84 million people will die of cancer between 2005 and 2015. Nowadays doctors excessively use radiotherapy to treat just about every type of cancer and noncancerous (benign) tumors. National Cancer Institute reports that one of the causes of skin cancer is chronic low to moderate levels of exposure to radiation. In a survey of 65,304 technologists, scientists identified that 1,355 confronts carcinoma. Risks of developing leukemia in a person who works in constant exposure, as the dangerous chemicals make their way into his bloodstream. The intestine lining is damaged due to direct exposure resulting in nausea, vomiting, rapid pulse and fever for acute dose of approximately 1Gy; showing consequences in few hours after the exposure. Depletion of white blood cells starts after a dose of 3-10Gy. Doses of 10-50Gy may be lethal, depending upon time of exposure. The cause of death is usually dehydration and massive bacterial invasion due to the damage sustained by the intestinal lining. Fibrosis, stricture, intestinal perforation and fistula formation are common in survivors of doses in this range. Central nervous system tissues are destroyed on doses in excess of 50Gy resulting into death within a few hours. Death in this manner is a somatic, acute and deterministic effect. The most common radiation induced cancers are skin tumors, leukemia and thyroid cancer, though tumors other organs also possible. Similarly sometimes, the cell instead of losing its ability to control reproduction starts contracting; retina and lens of eye, resulting in blindness.
For the safety and security of workers some basic rules and OHS guidelines are required. Unfortunately, in Pakistan, there is no such regulatory agency, which devise the rules and regulation for OHS of workers at radiologist centers. Whereas, in other countries substantial amount of research has been carried out on this subject. Depending on the precise conditions of individual work, the definite exposure on how much exposure any individual worker receives is not available. It is also unclear, what nature or type of x-ray is used and the amount of x-ray taken, it is advisable that each institute should provide minimum regulatory advice to the workers to avoid surpassing the safety limit. In order to make the work environment safe and effective, many national & international organizations have in print, there irradiative-information and recommendations on occupational safety, which are applicable and being followed by many standardized lab’s. Radiologic technologist’s key responsibility is to manage a medical x-ray & radiology machine, which emits radiation. The workers working in these laboratories, where radiation emits, which could be damaging for health of workers, it is vital to gain knowledge of using and maintain appropriate machine settings and the exposure limits for radiation. Caution lights, shielding, & other protection devices should be preserved in good working order. To operate the equipment properly, the required Training to the workers must be delivered. During working hours and when the x-ray machine is active, wearing a shielded apron should be compulsory. To monitor individual’s potential exposures to radiations, personal dosimeter must be used to identify that the limit for exposure is not increasing.
Excessive exposure to diagnostic radiation could have negative consequences and effect on workers, who routinely handle radiologic systems. So there must be special guideline for their occupational health and safety.