Radiation Concerns among Parents and Radiation Safety for Children

Paula A Paez

University of Wisconsin- La Crosse

Word count: 829

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Paula Paez
Fundamentals of Radiation Safety
Radiation Safety and Children
The adverse effects of radiation are prevalent among all; however, children are more
susceptible to negative long-term side effects from ionizing radiation.1 This is an immense
concern many parents have when their children need to undergo testing that requires ionizing
radiation and, in many cases, radiation therapy treatment. Diagnostic testing, such as computed
tomography (CT) and positron emission tomography (PET) scanners, delivers some radiation
doses to patients. CT scanners are used to diagnose non-cancer-related illnesses, but the patient
will still be exposed to ionizing radiation. However, these diagnostic tests are needed to provide
lifesaving therapy to children who are diagnosed with cancer. Due to the concern of many
parents, and as science and medicine have evolved, protocols regarding dose delivery during
diagnostic imaging and treatment have been implemented to provide as low as reasonably
achievable (ALARA) ionizing radiation to children and adults.
Ionizing radiation has been identified as a carcinogen; studies correlate the exposure of
children to ionizing radiation to cancers such as Leukemia and solid tumors.1,2 Understandably,
parent's concern regarding radiation exposure is high. One of the differences the effect of
exposure has between children and adults would be that children have a longer life expectancy
from the time of exposure; stochastic effects can take decades to arise.1 As part of the new
practices implemented, hospitals and physicians will only use CT scanners when necessary;
providers have been encouraged to use other imaging modalities such as Ultrasounds and
magnetic resonance imaging (MRI) and avoid CT scanners when appropriate.1 These additional
imaging modalities are recommended as they do not deliver ionizing radiation. Often, diagnostic
images are needed for additional information. These images obtained from CT scanners provide
significant details the physician needs when diagnosing a patient.2 Using other imaging
modalities provided parents with ease that if their child were recommended to have a CT scan, it
would be because it was necessary and other modalities would not be appropriate.
When CT scanners were first introduced, they were built and used, focusing on image
quality and how long it would take to obtain the image; dose was not of concern.1 During early
diagnostic imaging, children and adults were exposed to larger amounts of ionizing radiation.
Today, when using a CT scanner, one can obtain a good-quality image while identifying an
appropriate dose values that does not overexpose the patient to high doses of ionizing radiation.1,2
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Paula Paez
Fundamentals of Radiation Safety
Radiation Safety and Children
Radiation penetrates the body at different rates depending on the thickness of the patient as
opposed to the patient's age.2 Due to this difference in thickness, radiologic technologists are able
to change the milliampere-second (mAs) values considering the size and weight of the patient,
this is also done for small adults.1 By doing this, children and small adults do not get the same
exposure that a thicker adult or child might get, decreasing their chances of adverse late side
effects. Protocols in place also guide providers to only scan a patient once, focusing solely on the
area of interest and avoiding all surrounding areas.1 This reduces the amount of tissue that is
being irradiated. Implementing the protocols and techniques mentioned allows radiologist to
provide as low as reasonably achievable (ALARA) ionizing radiation.
Based on the new protocols implemented to reduce the exposure of radiation to children
during CT scans, parents can have the ease that their child is not being exposed to unnecessary
radiation or large amounts of it. With the protocols and modern technology in place, CT scans
have become safer for pediatric patients over the years, and the value the CT images provide can
outweigh the risks. Providers need to discuss and educate parents on the imaging modality used
and the implications and benefits of it. Many parents may not know the new protocols or
technology that are in place to protect children from ionizing radiation. Transparency and
education can potentially change parents’ minds about allowing their child to undergo necessary
CT scan after a discussion with a provider. Overall, parents can now feel that CT scanners are
safer and an essential medical tool. Implementing these additional safety measures has taken
many years, but it has proven to be effective in reducing overall exposure.
In conclusion, radiation therapy departments and imaging centers where CT scanners are
available should take additional precautions to ensure safety when treating and imaging a patient.
The NRC requires a double check on patient identity.3 This is extremely important as the wrong
dose or imaging can be delivered to a patient. Patients can often mishear and respond to the
wrong name. Therefore, a double identity check is crucial. Technologists and therapists should
follow specific guidelines based on child size and weight.1,4 The region to be scanned should be
selected and not go outside of the given parameters, as well as input the appropriate mAs and
dose values.1,4 It is essential for radiologists to remember to use image techniques that will
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Paula Paez
Fundamentals of Radiation Safety
Radiation Safety and Children
reduce exposure as low as reasonably achievable (ALARA) daily for children and adult patients
to protect them from overexposure.

References
1. Goodman, Thomas R., et al. “Pediatric CT Radiation Exposure: Where We Were, and
Where We Are Now.” Pediatric Radiology, vol. 49, no. 4, 29 Mar. 2019, pp.
469–478, https://doi.org/10.1007/s00247-018-4281-y.

2. Huda, Walter, and Kent M. Ogden. “Computing Effective Doses to Pediatric Patients
Undergoing Body CT Examinations.” Pediatric Radiology, vol. 38, no. 4, 15 Jan.
2008, pp. 415–423, https://doi.org/10.1007/s00247-007-0732-6.

3. Consolidated Guidance about Materials Licenses Program-Specific Guidance about

Medical Use Licenses Draft Report for Comment Office of Nuclear Material
Safety and Safeguards. https://www.nrc.gov/docs/ML1632/ML16328A214.pdf

4. “National Cancer Institute - Radiation Risks and Pediatric Computed Tomography.”

Webharvest.gov, 2 Aug. 2002,
webharvest.gov/peth04/20041016183438/www.cancer.gov/cancerinfo/causes/
radiation-risks-pediatric-CT.