Hospitals keep close tabs on radioactive items

December 29, 2008
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Radioactive waste is becoming a smaller problem for hospitals.

While some cancer research hospitals in Michigan found themselves stuck with radioactive items when a disposal site closed in South Carolina earlier this year, West Michigan hospitals have not been affected.

“It never has been a problem for us. The stuff we have is fully decayed by the time we get done with it,” said Spectrum Health spokesman Bruce Rossman. Any waste is collected by the company that provides the isotopes, GE Healthcare.

Medical use of radioactive materials falls under the purview of the federal Nuclear Regulatory Commission, which inspects hospitals without warning and levies fines against hospitals when they don’t follow the rules.

For example, the NRC earlier this year levied a $3,250 fine against Dickinson County Memorial Hospital in Iron Mountain for failing to properly secure storage of a medical device that contained radioactive material. The agency first discovered the violation in August 2007 and levied the fine when the problem recurred in a January inspection. The hospital has since made changes in the security of radioactive materials, the NRC said.

Today’s nuclear medicine and radiation therapy utilizes low-dose radioactive isotopes —

or variations of atoms — sealed in tiny metal devices, from pellets of one-eighth inch to one-inch rods, explained Tewfik Bichay, medical physicist and radiation safety officer at Saint Mary’s Health Care’s Lacks Cancer Center.

The isotopes are used in nuclear medicine and implanted in cancer patients, he said.

Some isotopes are short-lived, decay quickly and can then be disposed of in the trash.

“It’s typical for a hospital to hold onto them till they decay and, like any other substance, are thrown away in the trash,” Bichay said.

Others are implanted permanently in patients. Some have long half-lives and are used over and over again. Still others have half-lives so long that they must be safely stored for decades once no longer useful for medicine — too active for disposal.

“There is yet another class of isotope we use which are little bit longer-lived and much more energetic. Those are typically returned every three months to the vendor, so that circle runs very nicely,” Bichay explained.

Some older radioactive material has a half-life — the duration that the isotope remains radioactive — of decades, Bichay said.

“Then there are other isotopes, they are an interesting category. They are very long-lived. Cesium is one,” he said.

With a long half-life, radioactive cesium must be stored properly for many years. Some of those radioactive items are still useful clinically after 20 years, he said, and Saint Mary’s is not currently interested in disposing of them. But some hospitals are seeking ways to remove those isotopes from their property and dispose of them properly, he said.

“Hospitals that can’t find a way to dispose of them will have to hold them for hundreds of years,” Bichay said.

“The isotopes we do have in-house, we intend to use periodically,” he added. “The ones that have a long half-life are placed in a safe that is locked in a room that is locked. There are only three keys available,” he said.

The safe and room are lined in steel and lead. The measures not only keep radiation from escaping, but are security measures as well.

“It’s very hard to get to those isotopes,” he said. “The structure of the safe is to keep radiation from escaping. The purpose of the special room and locks are to secure the isotopes. They do have enough activity to pose a risk to the general public if they were ever lost somehow.”

He said the NRC has tightened up security regulations in the wake of the 9/11 attacks.

At Mercy Health Partners in Muskegon, the last of the radioactive waste destined for special disposal sites was removed from Hackley Hospital shortly before the cancer treatment program moved into the Johnson Family Center for Cancer Care last spring, reported medical physicist Jennifer Fisher, also the radiation safety officer. MHP is currently establishing a radiation safety committee, after the merger of Hackley with Mercy General Health Partners, which did not provide cancer treatment.

“We did in fact send the last bit of some radioactive sources we have for therapy applications at the Hackley Campus, we did in fact send those to Barnwell,” said Fisher, referring to the low-level radioactive waste site that closed in July in South Carolina. “Fortunately, it was still open.”

Today’s climate of heightened security means MHP must be careful with radioactive materials, even though the hospital no longer uses isotopes with long half-lives, she said.

“There are security concerns. That’s why the NRC…no longer actually publishes reports of where these sources are located,” Fisher said. “We keep that deliberately confidential. While I think the risk is minimal, you wouldn’t necessarily know where to go to find it.”

Fisher said the need to deal with radioactive waste is diminishing.

“By and large, the quantities of materials that a hospital utilizes in this day and age are decreasing significantly,” she said. “Activity (of isotopes) is much lower, quantities are much lower. The need for a place to store radioactive materials is going to be present for quite some time. Most places have done due diligence and gotten rid of quantities there just in storage.”

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