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FDA Cracking Down On X-ray Exposure For Kids
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."
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.
Give me Classic Slashdot or give me death!
...insist on these rules also applying to the TSA?
Check out my sci-fi/humor trilogy at PatriotsBooks.
What about those machines the TSA is using?
TSA will be involved ?
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.
#fuckbeta #iamslashdot #dicemustdie
I realize this may not be possible because they'd be costing Chertoff ^W^W sympathizing with terrorists, but the FDA should work on TSA body scanners too while they're at it. In medicine, doctors are at least remotely concerned about how much radiation people are exposed to. The TSA is only concerned with keeping people in line, maintaining a security theater, and spending/receiving lots of public money. Limiting children's exposure to X-rays is a respectable, important cause, and not all children will travel by air, but it will all be wasted if the kids run through too many body scanners with traveling parents. Plus, parents will probably not know anything about body scanners, and will believe the TSA agents when they say the scanners are "perfectly safe".
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."
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.
It's a small world and it smells funny; I'd buy another if it wasn't for the money; Take back what I paid (SoM)
It's worth noting that the Society for Pediatric Radiology has had a campaign (http://www.pedrad.org/associations/5364/ig/) called Image Gently for a couple years now to raise awareness of this in the radiology community, and in general the trend us towards doing more with MRIs, especially with children.
see your monthly premiums go up in response. There are always trade offs and safety is a frequent one in pretty much every aspect of people's lives. If this is the type of thing where 1 in a million kids might get cancer because of x-rays over more expensive alternatives then it may not be worth switching. Money spent treating the 999,999 kids that are unaffected with the more expensive option could possibly be put to better uses. I am not saying whether or not it is worth it in this case because I have absolutely no idea. I don't know what the chances of problems arising are or the comparative costs of the safer alternatives. What I am saying is that it isn't just a matter of "always use the safer method."
Last time I checked neither x-ray machines nor CT scanners are considered food or drug so why is the FDA involved? I could see the FCC or OSHA but not FDA.
(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.
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.
What are the dose differences between older machines that need to develop film versus those that use a CCD or such instant imager?
Every time a doctor/hospital/clinic orders a scan of any type, they can bill you or your insurance company a huge fee. The more advanced the scanning equipment, the more they can bill. (hence the popularity of CT scans when a plain old X-ray would be fine)
It does not matter if they find out what they already knew from a physical exam with the scan. (aka if they find nothing broken or nothing they didn't already know)
It does not really even matter if it's a duplicate scan for a known injury, they can bill for it anyway.
It doesn't matter if the scan was even medically justified, since said justifications can easily be papered up by the people filling out the claim forms.
Since each scan is just money in the pockets of whoever is doing it, they're going to order them as often as they possibly can.
Apparently last time you checked was prior to 1983?
The FD&C Act was passed in 1883. It defines medical devices and gives FDA authority over their approval and use.
Read any good book covers lately?
The FDA regulating the TSA.
Those full body scanners've got to go.
Some days it's just not worth
chewing through my restraints.
Law of supply and demand dictates we need superheroes. Artificially reducing the number of X-Ray superheroes will upset the unnatural balance.
Gently reply
N/T
Vote monkeys into Congress. They are cheaper and more trustworthy.
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
Muchas Gracias, Señor Edward Snowden !
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-rays, the case may have turned out with a funeral this weekend.
You know what can cause lifelong problems in the development of a child? An undiagnosed femur or C-spine fracture with a delay in assessment of an abdominal bleed.
So some newb doctor (I can look back and say that now) decided my few month old kid needed some major CT scan because he had a flat spot on the back of his skull (from difficult childbirth) that was slow to round out. I think it was either that or his head was slightly larger than average, or both things. Never mind he's half white and half Asian... no that wouldn't possibly change the average shape and size of the head now would it?!?!?! (I can look at my nephew, 100% Japanese, and realize that my kids head was similar to his with some Caucasian influence).
So anyway, it was all a load of complete CRAP that my kid would need some huge doses of Xrays to prove that he's completely fine. Better than that, my kid (much older now) is smarter than all the kids in his fucking class, thank you very much, you God damned medical idiot.
I swear, the older I get the less impressed I am by the average medical doctor I run into. And looking back, all the people I knew in college who went into medicine were just memorizing junkies who couldn't think themselves out of a mouse maze. I had a Dr. in the not so distant past that used a handheld to look up symptoms and another who just plain admits when I know more about him because I just researched it for 2 days before I went in to see him. At least they aren't afraid to admit it... there is no harm in not knowing everything... I sure don't know it all, so how can I expect them to?
Anyway, what's a parent to do? You hope the Dr. halfway knows what they are talking about... you hope the risk for a scan isn't too large if it can find some curable problem. But really, the Dr.'s just love bullshit tests so they get more $$$. It's easy for them too, they just send you on your way and look at the results while sipping coffee and dreaming about memorizing facts that are more accurately found on a computer.
I hope my kid doesn't get cancer at age 25... because if he does I'm blaming the medical idiots for it....
..get hot TSA agents?
I'll bet complaints would drop off.
For in politics, as in religion, it is equally absurd to aim at making proselytes by fire and sword. - Publius
Anyone who visits their dentist every 6 months to a year for x-rays is a fucking idiot who must secretly lust for cancer to ravage their body and leave them as a statistic.
Take care of your teeth and gums and eat right, and you shouldn't need to allow someone to blast you with x-rays so frequently.
I'm now starting to notice cancer warning signs outside of dentist offices and inside/outside some fast food places, this is simply sick.
I don't understand this at all.
In my experience doctors don't just order tests or imagery because it's fun. They do it because they need it, or because you present with symptoms that could be something serious. If a kid is getting repeated X-Rays, in most cases it's time to call CPS, not accuse the doctor of excessive use of imagery.
A doctor doesn't want to tell you it's stomach flu and send you home only to find out that you have abdominal cancer (as happened to a member of my family) and then turn around and sue them (did not occur with a member of my family, she died). That's the main reason for unneeded tests; they're a CYA to protect against ambulance chasing attorneys.
From a doctors point of view, this is like an NEO. It's a very low probability event, but it's catastrophic when/if it occurs. Missing a diagnosis these days could cost you your practice and every penny you and your family have, all because you didn't order that CT scan and the patient/family got a good lawyer.
In short, if the feds want to regulate something to death, how about the trial attorneys?
What the fuck is ct?
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?
Laws affecting technology will always be bad until enough techies become lawyers.
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. Recent high profile incidents (such as what happened with CT patients getting CT angiograms at Cedars Sinai) prompted many institutions to review their imaging protocols. The Image Gently campaign has worked towards getting institutions to develop pediatric specific imaging protocols for several years now. For procedures involving potentially high radiation exposures, radiologists review and protocol the requests to make sure the requested exam fits the clinical indications. Outpatient imaging centers performing CT imaging need to get their scanners accredited in order to get Medicare reimbursement. Accreditation by the ACR (American College of Radiology) places dose limits on several types of scans. If a site's protocol results in a radiation dose that exceeds the limits, they fail accreditation and need to adjust their protocols.
The FDA can and should require manufacturers provide the tools to enable imaging facilities to monitor and record the amount of radiation given during a procedure, but it needs to be the responsibility of the users to make sure the imaging equipment is used properly on patients.
"For I am a Bear of Very Little Brain, and Long Words Bother Me"
"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."
Seriously...? "If you don't stop irradiating children, we'll put a label on the irradiating machine"??