FDA Cracking Down On X-ray Exposure For Kids 138
ericjones12398 writes "The Food and Drug Administration is proposing that manufacturers of X-ray machines and CT scanners do more to protect children from radiation exposure. If companies don't take steps to limit X-ray doses, the agency may require a label on their new equipment recommending it not be used on children. X-rays and CT scans can provide doctors with lots of useful information. But the radiation that creates the helpful images also increases a person's risk for cancer. There's been an explosion in the use of imaging tests. And rising radiation doses, particularly from CT scans, have drawn concern. The cancer risk increases with the dose of X-rays received during a person's lifetime, so kids' exposure is particularly important. It's also the case that children are more sensitive to X-ray damage. The FDA is also telling parents to speak up. If a doctor orders a test or procedure that uses X-rays, parents shouldn't be afraid to ask if it's really necessary. Also, it doesn't hurt to ask if there's an acceptable alternative, such as ultrasound or MRI, that doesn't rely on X-rays."
Growth (Score:5, Informative)
Radiation will be especially bad for children, since any mutation their cells acquire will be passed on to all daughter cells. For a growing child that will be a lot more cells than for adults who are only replacing their cells.
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Try telling the pro-nuclear lobby that.
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While your statement is correct the cancer risk is minimal.
A typical xray is about 1-10 mrem. You get about 5 mrem of radiation dose from just an airplane ride. If a child lives in a concrete apartment building he/she will receive 100 mrem just from the radiation the concrete gives off. Annual occupational exposure limits for radiation workers are 5000 mrem. A deadly dose of radiation is about 50,000 mrem.
They irradiate you then they grope you (Score:4, Insightful)
And that what TSA is all about
It's not about terrorism, it's not about security, it's about numbing the public through excessive harassment
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Can we please... (Score:5, Insightful)
...insist on these rules also applying to the TSA?
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Re:Can we please... (Score:5, Informative)
Perhaps the fact that the TSA scanners are NOT regulated by the FDA, not certified by them, nor do they license their operators, might change your mind.
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And they lied about them being certified for human use.
Re:Can we please... (Score:5, Interesting)
I'm not conflicted at all. Forcing kids to experience pat-downs just might anger the public enough to force our government to eliminate the bulls**t.
Re:Can we please... (Score:5, Insightful)
I'm not conflicted at all. Forcing kids to experience pat-downs just might anger the public enough to force our government to eliminate the bulls**t.
I couldn't agree more. The TSA costs way too much money, violates far too many freedoms, and produces nothing more than FUD. I would seriously like to see the TSA removed and each airport and airline worry about their own security.
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I would seriously like to see the TSA removed and each airport and airline worry about their own security.
If it wasn't trivial to move about after passing the security screening, I might agree. Since someone who flys airline X can freely mingle with someone who flies on Y, if X has lax security then so do, effectively, Y. Same for the issue of mixing people between airports. If airport X has no security and Y does, the first plane to land at Y that came from X means Y also has no security.
Much worse was the kind of issue created when England temporarily enacted really draconian security policy. If you weren't
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There needs to be national standards and a national implementation.
I fear we'd just end up with something like the TSA all over again...
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I would be fine with removing the lot of it. If enough people are scared enough and sufficiently lacking in personal boundaries, let individual airlines implement security areas at their gates complete with the 100 rad X-ray and mandatory cavity search up to the elbow. Let the market decide.
Re:Can we please... (Score:4, Insightful)
I know... Oh, those crazy Pauls... Always coming up with those crazy political ideas. I mean just crazy, like this one. Eliminate the TSA... That's just crazy! I mean what would we... I mean, what... Uh... OK, they may not be that crazy after all.
Re:Can we please... (Score:5, Insightful)
But but but.... that would mean you're supporting a REPUBLICAN? Do I see that correctly? You must be a Republican. Or how could any Democrat in their right mind support a Republican, even when their ideas make sense for a change?
OK I'm not an American but that's my view of America's super-partisan "as long as it's one of us" politics. Switch Republican and Democrat at will. And it's also why I don't think this TSA-abolishment will happen any time soon, because if one side wants it the other side is automatically against.
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Double bonus points if schools review 'bad touch' and yelling for help just before vacation time.
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The TSA is a cult to Dread Cthulhu. What makes you think there's a lesser evil?
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Groping.
Cancer can kill you. Your personal space being violated can not.
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Re:Can we please... (Score:4, Insightful)
I'm pretty sure that suicide or other maligned conditions affect people who have been exposed to molestation as a child more often than it does those who have not.
In the future it's probably going to be easier to cure cancer than it is to repair a totally screwed childhood.
Are you seriously comparing full-on, bare genital contact, sexual molestation with over the clothes pat-downs performed in public spaces within sight of a parent?
I'm no fan of the TSA or their security procedures, but this kind of hyperbole doesn't help your argument. I'd much rather my children get the pat down, though each time they've flown through LAX they get sent to the old style metal detectors, while I got sent through the backscatter* (or mm-wave or whatever it is).
*Next time, I'm asking for the pat-down.
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Are you seriously comparing full-on, bare genital contact, sexual molestation with over the clothes pat-downs performed in public spaces within sight of a parent?
I'm no fan of the TSA or their security procedures, but this kind of hyperbole doesn't help your argument. I'd much rather my children get the pat down, though each time they've flown through LAX they get sent to the old style metal detectors, while I got sent through the backscatter* (or mm-wave or whatever it is).
*Next time, I'm asking for the pat-down.
When you do not have the ability to say no, it is rape. Your argument is like saying some rape is not as bad because he used mouthwash... Irrelevant. Rape is about power, and being raped in full public view in front of your parents sounds very damaging to me.
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I'm sorry, a pat-down search is not rape.
Rape requires a sexual act.
Re:Can we please... (Score:5, Insightful)
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[TSA]You buying an air ticket means you may very well be a terrorist bound to blow up the plane, traveling with wife and children for decoy. So that's a "really good reason" to search you extra.[/TSA]
Re:Can we please... (Score:5, Interesting)
Wait for it...
18 out of over seven billion passengers who are (were) terrorists. In other words, stopping and searching every airline passenger gives you a one in 388 million chance of actually catching a terrorist. Pick any other crime and tell the public that you'll have a one in 388 million chance of catching a bad guy if they would just allow the cops to stop and search people at random, and there would be torches and pitchforks marching towards D.C. Yet we think that's "reasonable" when we want to get on an airplane?!?!
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Not quite. Stopping and searching every passenger failed to stop any of those terrorists. What you mean to say is that if the TSA were absolutely perfect at its job, then it would catch at most one terrorist per 388 million passengers screened. Given that 100% detection is impossible in practice, however, and given that they are not, in fact, catching an average of two te
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I think the number you're looking for is "0".
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You took me far more serious than intended.
That said, the underwear bomber and shoe bomber that got on a plane, were not screened by TSA as they did not board in USA. IIRC the father of the underwear bomber already warned US intelligence about the man having this kind of ideas - so that's an intelligence failure even.
The second underwear bomber you refer to the one just uncovered? That bomb didn't even reach an airport, much less a plane, and again wouldn't have been screened by TSA but by some Middle East
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Regarding the underwear bombers, you are correct -- that wasn't a TSA failure, and in hindsight, I worded my post...imprecisely. It did sound like I was implying TSA had a one in 388 million chance of catching a terrorist, when what I meant was that only one passenger in 388 million actually *had* any terrorist intent, and since TSA has a far less t
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Meanwhile, the TSA is 0 for 2 after a decade.
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Regarding knives and guns: Pre-9/11, I used to travel with a pocket knife because it used to be okay to do that. Guess how many airplanes I hijacked during that time? And there have been numerous documented cases where someone realized they had packed a weapon inadvertently and went public about it after the fact because they were concerned that TSA had missed the prohibited item (Adam Savage from "Mythbusters," for starters). Guess how many of those cases resulted in hijackings?
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Are you seriously comparing full-on, bare genital contact, sexual molestation with over the clothes pat-downs performed in public spaces within sight of a parent (who desperately wants to comfort the child but cowers ineffectually against the authority of the touchy feelie strangers)?
FTFY. It's probably not AS damaging, but it's probably not exactly good either.
Re:Can we please... (Score:5, Interesting)
Actually sir, I have two genetic disorders, Hemophilia and Osteochondroma.
The Hemophilia basically means my blood clotting proteins are ineffective and thus it takes me longer to stop bleeding and then to heal.
The Osteochrondoma causes a variety of non-cancerous bone tumors to grow near joints during the bone growth phase. They can be in many different shapes and sizes.
The groping/padding down can cause a bone tumor to break, which can cause me to bleed to death if it manages to puncture an artery. Chances are I'll be dead before they get me to a hospital.
The radiation from the scanners can cause my bone tumors to become cancerous. If this happens, I'm pretty much sentenced to a long and painful death.
Dose from CT scans is vastly larger... (Score:4, Informative)
(Doesn't change my opinion that all full-body airport scanners are a waste of money, and xray backscatter scanners in particular should be banned.)
But the FDA is right to focus on over-prescribed medical xray procedures.
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Yeah. I was going to say.... 0.6 grays is something like an eighth of the LD50.... :-D
Re:Dose from CT scans is vastly larger... (Score:5, Insightful)
The radiation dose from a properly functioning backscatter xray full-body scanner is about 0.6 Sv. The dose from a properly functioning chest CT scan is about 7mSv, 10000x larger.
Assuming that it is working properly. And the FDA mandates frequent testing for their machines. How about the TSA? And do they actually do it?
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If they found a machine had a dodgy resistor and was over-irradiating people, I suspect this discovery would be classified secret for 'national security' reasons. You'd never hear about it. Maybe it already happened.
They'd also be desperate to keep it secret from their own goons, since they'd be the ones getting most exposure. (Yes, they're further from the machine than when you're standing inside it, but they're near it for much longer than passengers are, day after day.)
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1. Political embarassment. The TSA isn't popular already, and a scandal like that could mean congressional enquiries, sackings and cut budgets.
2. Liability. If the irradiated passangers/workers don't know they have been exposed, they can't sue you when they later develop cancer.
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They'd have to look for one, in order to find it. Remind me... who is certifying/testing these backscatter machines?
Re:Dose from CT scans is vastly larger... (Score:5, Insightful)
And when the TSA starts preforming regular testing of their machines by an independent contractor, installing "x-ray on" indicators, training staff on the dangers of ionizing radiation, providing staff with personal safety equipment, and otherwise taking all the other basic precautions that every other industry using ionizing radiation already take, then we can talk about the relative danger, and compare it to the benefit.
Until then we can only assume that the TSA is operating death-rays, because the machines they're running are inherently dangerous and they can't be bothered to install basic safeguards.
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Now how many chest CT scans does an average person receive in their life?
Compared to xray backscatter?
And then indeed we have to assume they "work properly" which I will happily assume for the CT scanner (specialised medical grade device; highly trained operators; relatively high dose making radiation safety more of an issue) vs. the airport scanners (non-medical; used 24/7; low dose so low assumed risk; operators with limited training; too low dose will result in no image so such a malfunction is easily de
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Too bad the TSA machines have no certification at all. Then they are operated by people who haven't the slightest clue how they work and who have none of the training required to use any other sort of x-ray device on a human being.
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As a matter of fact, yes: http://www.tsa.gov/research/reading/xray_screening_technology_safety_reports_jan_2012.shtm [tsa.gov]
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Following are surveys of checked and carry-on baggage screening equipment:â..
Not backscatter machines.
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Read them. Or look at the page title.
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What can possibly go wrong? I hang my balls everyday in front of a CRT monitor connected to a megavolt power supply, in fact its a pretty good contraceptive :P
Re:Can we please... (Score:5, Funny)
What can possibly go wrong? I hang my balls everyday in front of a CRT monitor connected to a megavolt power supply, in fact its a pretty good contraceptive :P
And it works even better on the days you forget to retrieve them and take them home with you, right? I can hear it now, in the car on the way home, "Damn, I've got an itch and no place to scratch."
Or, can we please... (Score:2)
I'll bet complaints would drop off.
Parents? (Score:2)
Why the hell should the parents have to request a less invasive and safer alternative? If the doctor doesn't need to do an x-ray, then performing one is negligent. If this is a question of cost (ultrasounds may cost more money), then the problem is the insurance companies... and we should pass a law at once telling them to eat a bag of dicks and that patient safety comes first.
and then... (Score:3)
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see your monthly premiums go up in response.
They'd go up anyway. They've been rising at about 1,200% of the inflation rate since... well, the day they went into business. And it has nothing to do with the costs of medicine and more to do with shitty management and administration.
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Re:and then... (Score:4, Insightful)
Well...that is true...but forcing them to use more expensive treatments would make it go up even more.
Not true. Every law that has increased your safety came on the cries of "It'll ruin us!" by the businesses who were tasked with improving safety. Air bags, antilock brakes, refridgeration of food, OSHA... every last one of them had a business using that argument. I have yet to see a case of an industry winking out of existance because the government demanded a more stringent safety standard.
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Step 2, re-read my posts.
Step 3, read this post.
I never said more stringent safety standards has, or would, destroy any industry (this is where that wikipedia page I linked comes in).
My argument really boils down to these 4 points:
#1 Getting x-rays can be dangerous
#2 There are safer but more expensive alternatives
#3 Not all increased safety is worth the cost
#4 We should evaluate if this is a case where the increased safety is w
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Your premiums go up 25-40% a year? You really need to cut a better deal.
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Statistically X in 1 million kids will get cancer because of x-rays, not might get cancer. There's a well established link between ionizing radiation and cancer. The risk in any single exposure is statistically small, but if you're the unlucky one that gets cancer from the procedure the low population risk probably won't be much comfort.
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There is a risk/benefit calculation to be done, so let's do the math: Given, radiation exposure carries at least a tiny risk, so we'll just say risk=non-zero. Meanwhile, the TSA has NEVER caught a terrorist, so benefit=0. so non-zero/zero = infinite risk per unit of benefit. Translation: it's all down side.
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Re:Parents? (Score:5, Insightful)
If the doctor doesn't need to do an x-ray, then performing one is negligent.
It's nowhere near that simple. Like most medical procedures, imaging has costs (in a medical sense) and benefits. The medical "cost" of performing a few radiographs of a potentially broken limb are very low, but the diagnostic benefit is very high. The medical "cost" of doing a thoracic CT is significant enough that every radiologist thinks it over in some detail before ordering one - the radiation dose is several orders of magnitude higher than a single peripheral radiograph. However, the diagnostic benefit in many circumstances is so thoroughly outweighed by the tiny risk of cancer that the CT is often worthwhile. There are many borderline circumstances though, where it's simply a judgment call as to whether the radiation dose is worthwhile to obtain the image. What about a person who loses consciousness and falls, doesn't remember whether he hit is head, but shows no signs of brain injury? Is a head CT worthwhile? Most ER docs say yes, but some would wait and see if any neurological symptoms appear. The increased cancer risk from radio-imaging in children has to be balanced against the increased sensitivity of children to injury, the difficulty of using other (more subjective) non-imaging diagnostic approaches with children, and the increased impact on quality of life of a missed diagnosis in a child. Bottom line: There is no clear answer as to whether radiological imaging is worth the risk in some cases. I tend to believe that radiation exposure is less harmful than most people make it out to be, and that the established limits for exposure are already extremely cautious, and there's little reason to avoid most imaging procedures. At the same time, I am reluctant to get repeated abdominal CT's for my kidney stones because I know that if the procedure is repeated every time I have a problem my cumulative exposure will eventually be very substantial.
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Here is a classic problem: Right lower quadrant pain and fever in a child or adolescent. The diagnosis that comes to mind is appendicitis, but not every case of right lower quadrant pain and fever is appendicitis. You don't want to miss this diagnosis - if the appendix ruptures it spills bacteria all throughout the abdomen causing a significant amount of morbidity and possibly mortality.
The classic diagnostic method was history, physical examination and a couple of lab tests. In most cases, this worked
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Often, x-rays are unnecessary because the doctor is going to prescribe the same course of treatment regardless of what the X-ray tells him. So as a medical consumer, it's always in your interest to ask the doctor what he is looking for, how likely it is that he will find it, how much the diagnostic test will cost and how having the test results will affect the course of treatment.
You owe it to yourself (and if you're insured, to the insurance company) to know these things before you consent to the test.
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In these judgement calls, I expect there is another piece to the equation, at least in the USA.
If you don't order a scan, and there was something bad which the scan might have picked up, you get sued.
If you do order a scan, find nothing, but scan results in the patient getting cancer 15 years from now, you don't get sued, as there is no way to know that it was your scan which triggered the cancer.
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It IS a failure to exercise the care a reasonably prudent person in like circumstances would exercise. That is, carelessly exposing the patient to radiation for no benefit. It is a neglect of the duty to make sure the benefit outweighs the risk for any treatment.
Focus on TSA too (Score:4, Insightful)
Sorry... (Score:5, Funny)
Also, it doesn't hurt to ask if there's an acceptable alternative, such as ultrasound or MRI, that doesn't rely on X-rays.
"There is, but it is not covered by your health insurance."
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Why is this modded Funny and not Insightful?
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Because there is no "sad but true" mod option available.
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Keep in mind that insurance companies are aware that if you get cancer from the X rays, they'll be on the hook for chemo, surgery, and rad therapy which can easily run into the $250,000+ range [...]
But by the time you get cancer (remember, it's not one X-Ray, it's lots of X-Rays), you'll have a different company by then. Or they'll come up with some other excuse to drop you...
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No, it's one x-ray. The chance from any single x-ray is very small, but ultimately it's exactly one x-ray energy photon that flips your cell from "normal" to "cancer", and that one photon will come from any single exposure. There are often contributing factors to that change; generally speaking a single DNA transcription error/etc. by itself is not enough to cause cancer, but even so there's a discrete change from "non-canerous" to "cancerous" and that change can easily be caused by a single ionization even
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exactly true.
I have a doctor friend, in his surgical specialty, he does a type of flouroscopy imaging, to allow him to see, in great detail, the bone structure of his patient, as he moves his laproscopic instruments. He takes a great deal of precaution to limit exposure as much as possible, but he's exposed much more than say, your average radiologist. A few years ago, he developed a rare form of leukemia. (now in remission, after bone marrow transplant, and treatment). Nobody can conclude that it was his
Interesting problem (Score:4, Insightful)
The "ideal" would be to add a stipulation that no provider (be they medical or otherwise) is permitted to cause the person to exceed the stipulated yearly dose without informed consent, with total dosage accumulated to that point being recorded by the provider before and after a scan.
What I do not see is any way you could possibly achieve this, without being incredibly invasive and/or potentially causing worse side-effects.
Nonetheless, the goal should be to not merely ensure individual scans are given responsibly but that the cumulation of scans is also being done responsibly. That's much harder to do, since human memory isn't reliable and patients can't possibly know what they've been exposed to up to that point (especially in the case of TSA scans). It doesn't matter if individual scans are relatively harmless, it's the dosage per unit time that matters.
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Image Gently (Score:5, Informative)
Re:Image Gently (Score:4, Funny)
After my daughter swallowed some magnets, the stupid doctors refused to do an MRI instead of X-Rays.
Also: Vaccinations Bad!
FDA is going to cause more harm than good (Score:3)
The FDA can regulate medical equipment, but it can't regulate the practice of medicine. So if these rules are too onerous, medical equipment manufactures will just label the machines as not for use on children (and likely take out any canned child-specific protocols), and doctors will continue to use the machines on children. In the middle ground, if the rules aren't too hard for the manufacturers to follow, but they cause the images to be poor, doctors and technologists will modify the protocols or use adult protocols on children. And if they're no different than what is done now, what's the point?
If there's really a problem with the protocols being such that the dose to children is higher than necessary to make good images, both manufacturers AND radiologists have to be involved in the solution.
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Indeed, and it has been for years. Manufacturers have long been looking for ways to cut the dose. Nobody wants unnecessarily high doses; equipment-induced cancer makes for bad headlines if nothing else. Which is another reason to be puzzled: Why does the FDA think it has to step in? Are they just bored and need something to regulate?
I look forward to (Score:2)
The FDA regulating the TSA.
Those full body scanners've got to go.
Increases Dependence on Radioactive Spider Bites (Score:2)
Does this include the TSA? (Score:2)
N/T
On the other hand... (Score:2, Insightful)
As a trauma ER nurse who just last night treated a 3 year-old who fell 35 feet out of her apartment window, I agree with the sentiment of the effort without agreeing with the implementation.
Sometimes, the extended waiting and confusion caused by more red tape can destroy a child's life sooner and with more pain than the possibility of radiation exposure.
If we had to produce written statements, warnings, and consents instead of a verbal okay from the parents last night before that girl's CT and head to toe X
Surprise! Inconsistent Positions (Score:3)
Because we all know that all the agencies of the US Government work together seamlessly to develop and implement policy:
FDA: Protect the children from radiation
TSA: Protecting the public from terrorists requires us to irradiate the public
FDA: Radiation is bad
TSA: Radiation is good
FDA: Too much radiation for kids is bad
TSA: Radiation is harmless
FDA: Think of the children!
TSA: The children might be terrorists
Anyone else surprised?
the need for proper imaging protocols (Score:2)
It is ultimately the responsibility of the imaging professionals (radiologists, technologists and medical physicists) to develop proper imaging protocols to suit the age and sizes of the patients being imaged, not only from a radiation dosimetry point of view, but also an image quality point of view.
For a long time now the tendency, particularly with CT imaging, has been to use a one size fits all protocol for everybody.
The move to reducing medical radiation exposure has been going on for several years now.
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In addition to drugs, the FDA is also responsible for clearing medical products and devices [fda.gov].
Here's this year's list [fda.gov] of newly-approved devices so far. If you're going to stick it in your coronary artery [fda.gov], your cardiologist probably wants to know that people smarter than him have spent a lot of time asking a lot of hard questions about it.
Not every d
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If you're going to stick it in your coronary artery [fda.gov], your cardiologist probably wants to know that people smarter than him have spent a lot of time asking a lot of hard questions about it.
We are talking about a government agency here... Or were you going for the +5 funny?
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FDA regulates medical devices, too. Their name is just that: a name. It could be Wakalix Agency for all I care. Your name hanged-upness is silly.
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Maybe look up what the FDA does and you'll educate yourself a little?
The FDA also regulates medical devices, radiation-emitting devices, cosmetics, vaccines, biologics, tobacco products, veterinary products, interstate travel sanitation, and probably a bunch of other things. All of which is mind numbingly obvious within 10 seconds of looking up the FDA.
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Film vs digital detector doses are comparable, but when you factor in repeats due to improper exposures, film is a little higher. It's not enough to make it worth switching to digital detectors based on dose considerations alone though. There are plenty more compelling reasons to switch from film to digital.
The wider dynamic range of digital detectors gives a lot of flexibility when it comes to the amount of exposure used. If not enough radiation is used, a digital detector will produce a noisier, but often