As an ear, nose and throat doctor I frequently use X-rays and CTs for patient evaluation and guiding me with decisions made for treatment and surgery. These techniques especially help me treat sinus disease and tumors in the head and neck area.
It is well known that radiation can be harmful, but it is also known that whether you get X-rays or not, each day we are exposed to radiation from the sun, foods and even from the earth.
The latter is radiation called “radon,” which comes from the dirt that we walk and live upon. This kind of radiation we cannot escape.
But when someone is sick and X-ray or CT scan technology is recommended, is it dangerous or is it going to cause us problems in the future? That is a question that can be answered by the amount of X-ray exposure you have. Over the years, X-rays and CT scans have improved, gotten more sophisticated, and there is a reduction in the amount of radiation one is exposed to during imaging.
Let’s look at a couple of levels of exposure and doses, so you can see the significance of radiation.
The unit that is used to measure radiation is called “millisieverts.” If you get a dental X-ray, you get .5/1000 of a millisievert. If you get a chest X-ray, you get 2/100 of a millisievert. When I am examining or evaluating a patient for problems in the head and neck area (depending on the problem), patients can be exposed to anywhere from 1/10 of a millisievert to 2 millisieverts.
OSHA, which is the federal agency that monitors radiation levels for workers who are exposed to radiation in the nuclear industry and health care industry, have set some standards. The dose limit for one year is 50 millisieverts, so you can see an image is a very small slice of a total safe dose that one can be exposed to.
Other risks of exposure that you may not have thought about includes where you live in the United States.
For example, if you live out West in a mountainous area as compared to Florida, at sea level, you are more likely to be exposed to radiation.
If you work in the airline industry and spend time at high altitudes, this also poses a greater risk for radiation and its associated side effects. This is because the earth’s atmosphere; the earth’s atmosphere provides some shielding for radiation, and the closer you are to the sun the less protection that you have.
The benefits and abilities of X-ray and CT scan to be minimally invasive and provide information that allows doctors to accurately diagnose and treat greatly outweighs the risk factors.
Think about the example of the patient who, years ago, may have had to endure an exploratory abdominal surgery, and now can be evaluated without being taken to surgery. We also use X-ray to kill cancer cells without having to do surgery, which means patients heal quicker, and return to normal activity.
So, as you can see, there are some risks and benefits, and the simple thing to do is weigh those risks and benefits.
The World Health Organization has guidelines as mentioned earlier for radiation exposure, and it is not a bad idea to calculate the amount of radiation you have during the period of a year so you can make a decision whether another X-ray or CT is worthwhile.
The previous numbers I gave you will help give you some idea, but when you go for an X-ray, they can give you the exact amount of millisieverts for the procedure so you can keep track.
However, generally speaking, most people do not reach the dose limit for one year simply by being evaluated for medical problems.
It helps to understand there are other things — including an MRI, magnetic resonance imaging scan, and ultrasound scans — that can be used in conjunction with X-ray and CT to diagnose, thus reducing the radiation risk and still allowing the doctor to accurately diagnose the problem so he or she can best implement treatment.
Manufacturers of X-ray and CT equipment constantly work to improve the technology, thus reducing the risk of radiation exposure.
Many of us are old enough to remember the first-generation of CT scanners that took sometimes a half-hour to complete a study. Nowadays, they are so fast they are done in minutes. This greatly reduces radiation exposure.
Overall studies suggest that less than 20 percent of radiation is received from medical imaging.
Denis Grillo, D.O., FOCOO, is an ear, nose and throat specialist in Crystal River. Call him at 352-795-0011 or visit CrystalCommunityENT.com.
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