This Medical Mistake Could Give Your Child Cancer

This isn't the first time negligent radiological practices have enraged conscientious medical practitioners and others who are proactive about patient safety.

In 2009, physicians at Cedars-Sinai Medical Center in Los Angeles discovered some patients had received up to eight times the normal dose of radiation from improperly performed CT scans.The overdose was discovered when one patient lost patches of his hair after a brain scan, and upon investigation, it was revealed that more than 200 people had been overdosed on radiation during an 18-month period. It's well known that increased radiation exposure increases your risk for cancer. But that risk is FAR higher for your little ones.

Infants and Children are Far More Prone to Radiation Damage than Adults

Infants and children are more prone to the damaging effects of radiation for the following reasons:

• Children are smaller with thinner bones, making it easier for the radiation to reach sensitive areas, like their midbrain.
• Children’s cells reproduce more quickly, so they're more susceptible to aggressive cell growth, tumors, and DNA damage. The lens of the eye, thyroid gland, bone marrow and gonads are your child’s most radiosensitive organs. Exposing your child’s gonads to radiation can produce genetic defects in his offspring due to radiation-induced chromosomal damage.
• Your child’s immune system is not as developed as yours, so it’s more vulnerable to disregulation.
• Children face a far greater lifetime exposure to electromagnetic radiation, which is significant because the effects are cumulative.
• According to Dr. Klinghardt, radiation can flip certain genes in your child’s mitochondria. Your child can then develop a mitochondrial disorder, which can cause muscular atrophy or severe developmental problems.

Unfortunately, many parents are virtually unaware of these risks when they take their child in for a radiologic exam. Add to the "normal radiation risk" the additional risk of negligent overexposure, and you have a real recipe for disaster. It's disturbing that radiation errors seem to be happening with increasing frequency, and it is truly tragic because they are SO preventable! Aside from the lack of regulation of radiological technicians, part of the underlying problem is the sheer number of medical imaging tests being performed today.

Radiation Exposure is Seven Times Higher Now than in 1980

Due to rapidly advancing technology and more radiation-intense scans, diagnostic imaging tests have increased Americans' average radiation exposure seven times since  I was in medical school in1980,, according to the National Council on Radiation Protection and Measurements.

CT scans (and mammograms, for women) are responsible for a large part of our increased exposure. A CT of the chest delivers 100 times more radiation than a conventional x-ray. And a mammogram can deliver 1,000 times more radiation than a standard x-ray!

According to a study published in the New England Journal of Medicine (NEJM), more than 62 million CT scans are now performed in the U.S. each year, compared to just three million in 1980. And about one-third of them are unnecessary, according to David Brenner, the lead researcher of the study. Brenner predicts that CT scans may cause three million cancers over the next 20 to 30 years.

Of those 62 million scans done annually, at least four million are performed on children. According to one large study, the average American child undergoes seven radiation scans by the age of 18. Even more disturbing, CT scans of children are typically calibrated for adults, so children absorb two to six times the radiation needed to produce clear images. These are diagnostic exams—not senior portraits—so upping the dose of radiation (along with the risk) just to get a "pretty picture" makes no sense at all.

Some Dental X-Rays Have Nine Times More Radiation than Necessary

For children and teens, routine dental and orthodontic visits are a major source of excessive radiation. Most dentists use outmoded x-ray film, called D-speed film, which requires about 60 percent more radiation than faster films. It's unclear to me why some dentists don't upgrade to lower radiation film for the benefit of their patients—or better yet, digital x-rays that reduce radiation exposure by 80 to 90 percent.

Part of the problem is, there has been no push from state dental boards toward practitioners to convert to safer imaging technology.

Contributing to the radiological load on children, orthodontists are now using a new CT-like scanning device that generates 3-D images, called a cone-beam scanner, which emits far more radiation than older devices. It's not uncommon for a teen to receive one to four cone-beam scans during the course of his orthodontic treatment.

The problem with these scans is they subject your child to hundreds of times more radiation exposure than conventional x-rays, and there is absolutely no grounds to justify the risk. In fact, orthodontists could simply use a digital camera image, which requires no radiation, to get many of the same images—it just takes a little bit longer. The point is, with so many x-rays and other radiological diagnostics being done, there is a huge opportunity for errors—errors that can have dire consequences for you and your child.

40,000 Medical Errors are Made Every Day in the U.S.

It is a sad reality about our medical system that more than 40,000 medical mistakes are made every day in the U.S., according to HealthGrades, which has been studying the quality of care in the nation's hospitals since 1988. A 2008 study reported that one in seven Medicare beneficiaries are harmed by the medical care they receive while hospitalized. Forty-four percent of these medical errors were deemed "clearly or likely preventable."

Here are a few more statistics that may shock you:

• The U.S. ranks 49th in the world for both male and female life expectancy, down from 24th in 1999.
• The U.S. is 41 places behind other countries in infant mortality.
• If you are 45 or younger, your number one risk of dying is from being treated by a physician!
• There are about 450,000 preventable medication-related adverse events in the U.S. each year.
• Between 1976 and 2006, 62 million death certificates attributed cause of death to inpatient medication mistakes.

Federal Oversight of Medical Radiation May Be on the Horizon

It is much harder to nail down the number of radiation errors occurring each year because most states don't require radiation errors to be reported. And even when errors must be reported, there is no penalty (or penalty enforcement) for those who made the error. The medical imaging industry has been largely self-regulated—until now.

On February 26, 2011, a hearing in the House Committee on Energy and Commerce opened the door to federal oversight of the medical radiation industry. This was largely sparked by increasing reports of radiation nightmares, like the one in the New York Times articles above. At the hearing, multiple witnesses testified to the lack of training and licensure among people who operate these machines—technicians, physicists, and others. In 17 states, licensing is not required for radiation technicians, and only four states require medical physicists to be licensed.

In many states, hairdressers are more tightly regulated than radiation personnel!

Machines are becoming more complex, while training remains lax. There is no such thing as "point and shoot" in the x-ray department—although obviously, there are lazy, ignorant, or incompetent technicians who are operating x-ray equipment as if it were a pocket camera.

Hopefully, the growing awareness in Congress and increased media attention will lead to positive changes that will increase your safety, such as passage of the CARE bill (HR 3652: Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2009). In 2010, the Seattle Times reported the FDA might have suppressed evidence of the dangers of CT scans. Only public awareness and pressure will shine the light on corruption like this, and eventually bring about the needed regulatory changes.  But in the meantime, you need to be your own radiation safety advocate.

Suggestions for Minimizing Your Medical Radiation Risk

Do not simply consent to x-rays that seem unnecessary or excessive. Remember, there is no safe dose of x-rays, so the less you have, the better. The UC Berkeley Wellness Letter offers some good suggestions about questions you should ask before undergoing any diagnostic scan, and this includes dental X-rays or cone-beam scans:

Is the test really necessary?	Is the facility accredited by the American College of Radiology?
What difference will it make in my care?	Will the test use the lowest level of radiation for adequate imaging? (Will it be adjusted for my size, or my child's size?)
Is there a non-radiation alternative, such as ultrasound or MRI (or digital photographs)?	Will the scan be limited to the indicated area, and will nearby areas be shielded

Ask your dentist to use digital x-rays to radically reduce your child's radiation exposure. And avoid the new radiation-intense CT x-rays at all cost. Ultimately it is your body, or your child's body, that will be receiving the radiation from a diagnostic test, so you need to be fully informed and certain that the benefit will truly outweigh the risk, before you consent.