CT scan surge for kids' emergencies raises concern

Greetings,
Please let your friends with children know of this new study.  
There are going to be times when a child will absolutely need a CT scan. 
Parents need to know about the need to prevent children from getting an adult size dosage of radiation.
I don't even like to let them take x-rays of my head when I go to the dentist.
Let us know what you think about this.
All the best,
Lou & Debbie

Associated Press

CT scan surge for kids' emergencies raises concern

By Lindsey Tanner

AP Medical Writer / April 5, 201

CHICAGO—Soaring numbers of kids are getting CT scans in emergency rooms, a study found, raising concerns some may be exposed to adult-sized radiation doses and potential risks for cancer down the road.  The number of ER visits nationwide in which children were given CT scans surged from about 330,000 in 1995 to 1.65 million in 2008 -- a five-fold increase. The number of kids' ER visits didn't increase measurably during the study, but the percentage of visits involving CT scans climbed from about 1 percent to almost 6 percent.

Increases occurred at children's hospitals but also at general hospitals, where most kids are treated, and which raises concerns some may have gotten adult-sized doses of radiation. The study didn't include dose information, but general hospitals may be less likely than pediatric facilities to use special CT protocols with kids to limit their radiation exposure, the study authors said.

Increases in CT scan use have also been found in adults, generating increasing awareness about overuse and potential harm because radiation exposure can cause later cancers.

A single CT scan of the abdomen and pelvis emits about the same amount of radiation as a person would get from five years of exposure to naturally occurring radiation in the environment, according to the American College of Radiology.

Radiation can damage rapidly dividing cells, and children have more of those than adults.

More scans may be done partly because imaging has improved over the years, the researchers said.

CT scans in kids require special oversight, including adjusting doses to their smaller size, because they are more sensitive to radiation than adults, with longer life spans and more time for radiation-related cancers to develop, they said.

The study "underscores the need for special attention to this vulnerable population to ensure that imaging is appropriately ordered, performed and interpreted," the researchers said, led by Dr. David Larson at Cincinnati Children's Hospital Medical Center.

The study authors analyzed annual government surveys on ER visits at non-federal hospitals nationwide, focusing on visits in patients younger than age 18. The data include information on CT scan use, but not on the radiation dose used.

The results were published Tuesday in the journal Radiology.

The increases may be due to improvements in CT technology; more modern scanners create clearer images and are much quicker than older models, producing results in just seconds -- a bonus for busy emergency rooms, Larson said.

But other factors likely contributed to the increases, and in some cases, overuse, including fear of lawsuits, which drives some doctors to order tests to avoid getting sued for a missed diagnosis.

"If you send a kid home (without a CT scan) and it turns out you missed an abnormality, not many juries are going to be sympathetic," Larson said.

CT scans were most commonly used for children with head injuries, headaches or abdominal pain.

Larson said it's impossible to tell from the data whether X-rays, which use less radiation, or other tests could have been done instead of CT scans.

Dr. Marta Hernanz-Schulman, a pediatric radiologist at Vanderbilt University Medical Center, said the study trends "are very believable" and illustrate the need to make sure imaging scans aren't used inappropriately in children.

She is a founder of the Image Gently campaign, started in 2008 by an alliance of doctors seeking to raise awareness about ways to reduce children's exposure to medical radiation.

Larson said there are signs CT scan use in kids may have started decreasing since the study ended.

Dr. Steven Krug, emergency department chief at Chicago's Children's Memorial Hospital, said many institutions including his own have started using ultrasound to diagnose appendicitis in some kids with abdominal pain. Ultrasound images aren't as detailed as CT images, and children with uncertain results will still need CT scans, but he said the trend may help limit radiation exposure.

At Carle Foundation Hospital in Urbana, Ill., about 20 percent of the ER patients are children, said Dr. Mike Swindle, emergency department chief. Procedures call for adjusting CT scan radiation doses to children's size and weight, he said.

"We've all become a bit more conservative with ordering" CT scans, Swindle said.

Parents, too, are becoming more aware and increasingly asking about the risks, instead of demanding a CT scan for every bump on the head, he said.

Scientists challenge TSA on scanner radiation

 Happy Thanksgiving everyone.  So let me ask you a question,  "Are you going to be flying home this week?"

I have been listening and watching what people have been saying about the TSA and the naked scans they are employing to "make us safe".

Somehow I don't feel safe with what I have been hearing.

Read this and let us know what you think.

Lou & Debbie

RAGE AGAINST THE MACHINES

Scientists challenge TSA on scanner radiation

Warn of 'potential health consequences' to elderly, pregnant women, children

Posted: November 22, 2010       11:09 pm Eastern
By Drew Zahn                     © 2010 WorldNetDaily


Federal officials claim radiation risks from the U.S. Transportation Security Administration's new full-body scanners are low, but several scientists are calling on the administration to rethink whether the numbers really add up.

The TSA says the radiation from its security scans amounts to about a thousandth of the amount a patient receives from a standard chest X-ray, or an amount "equivalent to two minutes of flying on an airplane."

But a physics professor at Arizona State University in Tempe not only conducted his own study, finding the radiation exposure 10 times what the TSA estimates, but also argues that the health risks aren't mathematically worth taking.

Prof. Peter Rez explained to MSNBC that while the risk of getting a fatal cancer from the screening is minuscule, it's about equal to the  probability an airplane will get blown up by a terrorist. Either way, the professor argues, dead is dead.

"There is not a case to be made for deploying [the scanners] to prevent such a low probability event," Rez says.

Furthermore, a team of scientists from the University of California San Francisco have written a letter to the White House warning that the scanners present – above and beyond the risks to the general population – "potential serious health risks" to certain segments of society, such as the elderly and the pregnant.

"There is good reason to believe that these scanners will increase the risk of cancer to children and other vulnerable populations," say the cosigners of the letter, which include experts in biochemistry, imaging, X-rays and cancer research. "We are unanimous in believing that the potential health consequences need to be rigorously studied before these scanners are adopted."

The backscatter X-ray technology used in airport security scanners penetrates the skin only about 1/4 inch before the rays are scattered,  whereas medical X-rays transmit completely through the body. The TSA has determined, therefore, that the amount of radiation emitted from the airport scanners is significantly less than at the doctor's office.

The University of California scientists, however, disagree.

"The X-ray dose from these devices has often been compared in the media to the cosmic ray exposure inherent to airplane travel or that of a chest X-ray," the professors' letter states. "However, this comparison is very misleading: Both the air travel cosmic ray exposure and chest X-rays have much higher X-ray energies, and the health consequences are appropriately understood in terms of the whole body volume dose. In contrast, these new airport scanners are largely depositing their energy into the skin and immediately adjacent tissue, and since this is such a small fraction of body weight/volume, possibly by one to two orders of magnitude, the real dose to the skin is now high."

The professors are calling on the administration to specifically reexamine potential risks to the following groups:

Older travelers, those greater than 65 years of age, who may be at particular risk from the mutagenic effects of the X-rays;
A fraction of the female population especially sensitive to mutagenesis-provoking radiation leading to breast cancer, women typically exempted from X-ray mammograms, for example;
The population of immuno-compromised individuals, such as HIV and cancer Patients;
Children and adolescents;
Pregnant women and their unborn children;
And men in general, because of the proximity of the testicles to skin, which is most highly effected by the backscatter rays.
The TSA claims that the machines' safety has been evaluated by the Food and Drug Administration's Center for Devices and Radiological Health, the Commerce Department's National Institute for Standards and Technology and the Johns Hopkins University Applied Physics Laboratory.

"In summary, the potential health risks from a full-body screening with a general-use X-ray security system are minuscule. Several groups of recognized experts have been assembled and have analyzed the radiation safety issues associated with this technology," the FDA states. "As a result of these evidence-based, responsible actions, we are confident that full-body X-ray security products and practices do not pose a significant risk to the public health."

When New York Times reporter Susan Stellini called these research organizations to ask about their evaluations, however, she discovered the machines were primarily tested for whether the amount of radiation emitted meets guidelines established by the American National Standards Institute, an organization she suspects may be operating with a conflict of interest.

"Guess who was on the committee that developed the guidelines for the X-ray scanners? Representatives from the companies that make the machines and the Department of Homeland Security, among others," Stellini writes. "In other words, the machines passed a test developed, in part, by the companies that manufacture them and the government agency that wants to use them."

Both Rez and the team from University of California have also brought up yet another "red flag" with the airport scanners.

"The scary thing to me is not what happens in normal operations, but what happens if the machine fails," Rez told the Times. "Mechanical things break down, frequently."

"Because this device can scan a human in a few seconds, the X-ray beam is very intense," the California professors' letter states. "Any glitch in power at any point in the hardware (or more importantly in software) that stops the device could cause an intense radiation dose to a single spot on the skin. Who will oversee problems with overall dose after repair or software problems?

"The TSA is already complaining about resolution limitations; who will keep the manufacturers and/or TSA from just raising the dose, an easy way to improve signal-to-noise and get higher resolution?" the professors continue. "Lastly, given the recent [underwear bomber incident], how do we know whether the manufacturer or TSA, seeking higher resolution, will scan the groin area more slowly leading to a much higher total dose?"

The scientists' letter, addressed to Dr. John P. Holdren, assistant to the president for science and technology, concludes, "We urge you to empower an impartial panel of experts to reevaluate the potential health issues we have raised before there are irrevocable long-term consequences to the health of our country. These negative effects may on balance far outweigh the potential benefit of increased detection of terrorists."