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X-Rays

07/29/2008

Question:

I have rheumatoid arthritis and osteoarthritis. So I get alot of x-rays, CT Scans, Bone Scans, etc. I also have to get a yearly ECHO for a lung problem. Evey time I visit my doctors, one of them wants x-rays or something like that done. I know that the radiation used is a low dose, but I`m getting one done about every three months. Would this cause any harm, either short-term or long-term?

Answer:

This is really the million-dollar question when it comes to radiation. Short answer is maybe. The long answer:

Background radiation is usually about 3 mSv (a measure of radiation dose) a year, perhaps double if you live at high altitude. Most studies suggest that up to about 20 mSv a year is acceptable, particularly if a person needs that additional exposure for medical issues. X-rays run about 0.2 or 0.3 mSv, or about a tenth of your annual background exposure. Therefore, 10 X-rays per year adds about as much as moving from sea level to, say, Denver.

I don’t think short-term effects from frequent x-rays, etc. would be a big issue. The long-term question is harder to answer. However, if the individual is older, then long-term effects may be less important than the short-term treatment of his/her other medical conditions.

CT scans are a different story – a partial-body scan will run about 6 mSv, and a full scan will go up to 10 or 12. So, 2 partial CTs and 10 X-rays a year would still be in the “safe” zone. Beyond that, it’s really a cost-benefit issue. Every exposure is potentially threatening, just like cigarettes and lung cancer; you’re never guaranteed that anything bad will happen, but your chances increase as your exposures do.

The person submitting the question says that they get a quarterly procedure, but doesn’t specify which one. If they’re quarterly x-rays, with a yearly ECHO and an occasional CT scan, they would be well under the generally-accepted yearly dose for medical procedures. This doesn’t guarantee safety, but it probably wouldn’t be considered excessively risky.

I’d advise this person to keep all of their doctors apprised of their radiation exposure history, and discuss with the doctor whether the next procedure is worthwhile. It may be that the slightly increased risk due to radiation pales in comparison to the effects of not monitoring their health condition.

This answer was provided by Ryan Mayes, a PhD candidate in the College of Public Health’s Division of Epidemiology, Ohio State University. Ryan worked for a time for a company that specializes in ionizing radiation measurement and in abatement of radiation contamination.

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Response by:

J Mac Crawford, PhD, RN J Mac Crawford, PhD, RN
Clinical Associate Professor of Environmental Health Sciences
College of Public Health
The Ohio State University