Importance of Environmental Health Studies

Patient Exposure to Multiple Diagnostic Treatment Procedures

The objective of this study is to examine patient exposures to multiple diagnostic and/or treatment procedures.

Environmental health research is reported as the "study of the effects of the environment -- both natural and built -- on our health." (Environmental Health for Nations and Intuit, 2012, p.1) It is reported by the EU that links existing between "environmental factors and disease trends are now being discovered through numerous scientific project" and that those include the following links: (1) rates of cancer and specifically cancer in children is on the increase approximately 1% each year and linked to environmental pollutants; (2) decline in fertility rates; (3) neurodevelopment disorders increasing in children including autism and environmental exposures are believed to play a role; (4) allergies and asthma increasing by 5% a year across the continent and air pollutants are believed to be the reason for the increase; (5) Finally, it is reported that "new and emerging technologies and social challenges such as widespread and use of mobile phones and the consequences of climate change could bring new long-term health consequences that must be assumed and managed. ( p.5)

I. Diagnostic Procedures

It is reported in the work of Kleinerman (2006) that the expanded use of "interventional and fluoroscopic imaging in children represents a tremendous benefit for the diagnosis and treatment of benign conditions. Along with the increasing use and complexity of these procedures comes concern about the cancer risk associated with ionizing radiation exposure to children. Children are considerably more sensitive to the carcinogenic effects of ionizing radiation than adults, and children have a longer life expectancy in which to express risk. Numerous epidemiologic cohort studies of childhood exposure to radiation for treatment of benign diseases have demonstrated radiation-related risks of cancer of the thyroid, breast, brain and skin, as well as leukemia." (p.1)

Stanford School of Medicine reports that nuclear medicine "involves the use of small amounts of radioactive materials (or tracers) to help diagnosis and treat a variety of diseases. Nuclear medicine determines the cause of the medical problem based on the function of the organ, tissue, or bone." (2012, p .1) PET is one of the diagnostic testing procedures that is stated to be "powerful" and to have a "major impact on the diagnosis and treatment of disease." (Stanford School of Medicine, 2012, p.1) PET is able to detect and stage the majority of cancers "often before they are evident through other tests. PET can also give physicians important early information about heart disease and many neurological disorders, like Alzheimer's." (Stanford School of Medicine, 2012, p.1) The PET scan is such that examines the individual's body chemistry and enables physicians to collect "images of function throughout the entire body, uncovering abnormalities that might otherwise go undetected." (Stanford School of Medicine, 2012, .1)

II. Increases in Use of Radiation in Imaging

The June 2012 Physicians Guide to Imaging Radiation Exposure reports that imaging procedures that utilize "ionizing radiation may pose a small increase in a patient's lifetime cancer risk." (p.1) Stated is that imaging procedures using radiation "are essential tools for medical diagnosis and treatment, and no published studies have conclusively linked cancer with radiation at the levels used in imaging. However, consensus statements from the American College of Radiology and other clinical organizations suggest that it is reasonable to act on the assumption that low-level radiation may have a small risk of causing cancer." (Physicians Guide to Imaging Radiation Exposure, 2012, p.1) The individual is exposed to "70 times more radiation" in a CT scan and 160 times more radiation in a CT angiogram when compared to a chest radiograph. (Physicians Guide to Imaging Radiation Exposure, 2012, paraphrased) The use of imaging tests using radiation is reported to have "grown dramatically" as the use of radiation in imaging has "increased twenty-fold between 1980 and 2005 up to 72 million CT scans" being performed each year in the United States. (Physicians Guide to Imaging Radiation Exposure, 2012, paraphrased) It is reported that there are no epidemiological studies that "directly link cancer to radiation at the levels used in imaging procedures." (Physicians Guide to Imaging Radiation Exposure, 2012, p.2) The cancer risk from imaging radiation is reported to be dependent upon the age of the patient at the time of exposure in that the "younger the patient, the higher the risk." (Physicians Guide to Imaging Radiation Exposure. 2012, p.2) There should be extra caution taken when pediatric patients are being imaged and unborn fetuses are reported to be "at even greater risk -- imaging radiation should be avoided if at all possible in pregnancy." (Physicians Guide to Imaging Radiation Exposure, 2012, p.2)