Radiation safety in radiology

¶ … history of radiation and complications with it through the years, along with the safety precautions developed today. Today, it is difficult to imagine any branch of medicine that does not rely on some form of radiology for diagnosis and ultimate treatment. Early X-rays were dangerous, and doctors quickly discovered repeated exposure could cause radiation poisoning and even death in extreme cases. However, today's safety precautions make X-rays safer, more useful, and even more detailed, which aids in diagnosis and treatment for a wide variety of diseases and conditions. X-rays changed the face of medicine, and they continue to influence it in many vital areas.

Wilhelm Conrad Roentgen discovered X-rays quite by accident in 1895. In his laboratory shortly before Christmas, Roentgen noticed a barium platinocyanide screen fluorescing in his laboratory as he generated cathode rays in a Crookes tube some distance away" (Assmus 10). Leaving his other work, he concentrated on this new discovery, and after perfecting it, he announced it shortly after Christmas. By January 1896, the news had quickly spread around the world that Roentgen's machine could view the bones of the body through the skin and muscles (Assmus 11). At first, because the rays could penetrate wood and metal, and resulted in what looked like a photographic image, they were classified as a type of photography (Assmus 14). However, Roentgen discovered the rays did not refract, and maintained "longitudinal vibrations" caused them (Assmus 14). It was not long that doctors were using X-rays to photography humans for removing everything from bullets to setting broken bones (Assmus 14).

In 1897, the first dangerous side effects of X-rays began to emerge, which included hair loss and burns on the skin (Assmus 15). After much research, scientists discovered X-rays actually combine the actions of waves and particles to produce their images (Assmus 23). Physicians and others in the medical community comprehended the importance of X-rays almost immediately, and began using them to diagnose broken bones, internal organ diseases, and even treat some forms of cancer. Antoine Beclere, a French physician was the first to introduce lead gloves and aprons to help protect the radiologists producing images with early X-ray machines, soon after their discovery, in fact (Assmus 24). X-rays would become one of the most important tools for doctors around the world, and they have branched into many different forms of imaging of the human body today, including mammography, digital scanning, MRI's and ultrasounds. It was in the 1950s that doctors began to specialize in reading X-rays and using other forms of the technology, such as ultrasounds, and it was really then that the field of radiology began to take shape and become much more popular.

Today, there are two types of radiologists, the diagnostic, and the interventional. Diagnostic radiologists help diagnose a wide variety of diseases and conditions, and often consult with physicians in interpreting the meaning of digital images, while interventional radiologists use radiation to treat patients directly. Diagnostic radiologists seldom interact with patients, while interventional radiologists interact almost exclusively with patients and their families (Stack, Gartland, and Keane). In recent years, many healthcare companies have begun offshoring the reading and diagnostic areas of radiology, because it is much cheaper for foreign radiologists to read and diagnose the images (Stack, Gartland, and Keane).

While X-rays proved to be a major medical breakthrough, they did have complications, especially in the early years, when scientists were discovering the side affects of intense radiation, including radiation poisoning, genetic defects, and other dangerous side affects, such as some forms of cancer, and ultimately, death. In 1928, a committee called the International Commission on Radiological Protection was created to help create guidelines for X-ray safety and decide what the maximum safe doses of X-rays were. Early X-ray users came down with what they called "X-ray dermatitis." One early researcher writes, "It interferes with the growth and nutrition of the nails. The skin round the roots of these become red, irritable and cracked, and the nails themselves thin and brittle. Most constant workers suffer in this way" (Guy). This is one reason early committees were formed to study the affects of X-rays. There were already reports of deaths from over-exposure to x-rays, which many researchers pooh-poohed. However, one researcher, Dr. John Hall-Edwards of England, suffered such dramatic results that both of his hands had to be amputated, one all the way to the forearm (Guy). After this, many operators began to use lead shields, aprons, and/or gloves, such are still in use today.

As technology and understanding has improved, so has the safety of radiology. Another writer notes, "Today, a woman receives one-tenth the dose of radiation that was given just 20 years ago in a typical mammogram, with virtually no risk statistically" (Fishman). In fact, studies indicate that a patient receiving a typical X-ray at the dentist's office receives far less radiation than we are normally exposed to in nature over a year. Author Fishman continues, "According to Geise, the amount of man-made radiation to which the average American is exposed in one year, including medical care, is less than one-fifth the amount of natural radiation exposure" (Fishman). In addition, radiation treatments for cancers are now so precise that usually no other organs or tissues but the cancerous ones are affected by the treatment. Most patients who understand the risks of radiology also believe the benefits are worth the risks. Author Fishman notes, "Although risks increase with higher doses of radiation, the chance that radiation therapy will cure a certain type of cancer almost always outweighs the theoretical risk for the patient. Many cancer patients feel that, what ever risk there may be, the chance of being cured is worth it" (Fishman). There can still be many side affects of radiation, including hair loss, nausea, a general lack of energy, and many others, but the fact that so many people survive cancer after radiation therapy is a testament to the necessity of using radiology for diagnosis and treatment of many diseases. Thus, radiation treatment has become much more safe and effective for patients and practitioners, and new technologies that are continually being developed ensure even more safe radiological practices in the future of radiology.