by Thomas Dworetzky
, Contributing Reporter | March 11, 2019
Radiation treatments prior to death may make a patient's body a little too hot to handle with regular crematorium procedures – and more attention needs to be paid to the issue of the proper management of such remains.
The matter came to light in a recent JAMA research letter, which reviewed the 2017 case of a cancer patient who had received radioactive treatment at the Mayo Clinic in Arizona prior to his death, and whose cremation led to contamination of the crematorium.
"It's not the second coming of Chernobyl or Fukushima, but it's unwanted, unnecessary radiation," Kevin Nelson, the radiation safety officer at Mayo Clinic in Arizona and one of the research letter's authors told The Arizona Republic
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The JAMA letter and subsequent publicity – even alarm – surrounding it requires perspective, advised a statement from The American Association of Physicists in Medicine (AAPM) and the American College of Radiology (ACR).
It is important to remember several key points regarding the potential dangers, they advised, including:
- Radioactive materials are used routinely in medical practice to improve human health.
- The risk of harm to the crematorium operator is so small that it cannot be measured.
- Consensus guidelines from national (CDC and DOE) and international radiation protection and public health organizations provide clear guidance on how to identify radioactivity in patient remains and appropriately deal with the body of the decedent.
- Healthcare providers who administer radioactive material must have a designated Radiation Safety Officer whose credentials meet criteria established by the U.S. Nuclear Regulatory Commission. These individuals are often certified medical physicists or health physicists.
- The low-cost best practice of installing a simple radiation detector in hospital morgues, funeral homes and crematoriums would quickly alert staff to the presence of radioactivity. A certified medical physicist or health physicist has the expertise to determine when the measured radiation levels will have decreased to a level where it is safe to release the body to coroners, medical examiners, or mortuary services.
The research letter called the after-death challenge from radiopharmaceuticals “unique and often overlooked,” noting that "cremating an exposed patient volatilizes the radiopharmaceutical, which can then be inhaled by workers (or released into the adjacent community) and result in greater exposure than from a living patient."