Radiation Exposure to Relatives of Patients Treated with Iodine-131 for Thyroid Cancer at Siriraj Hospital.

OBJECTIVE: Thyroid cancer patients treated with 1-131 are potential source of radiation exposure to relatives who are knowingly and willingly exposed to ionizing radiation as a result of providing comfort to patients undergoing I-131 therapy. This study aims to determine radiation dose received by relatives who care for non self-supporting 1-131 patients at Siriraj Hospital. MATERIAL AND METHOD: Twenty caregivers of 20 patients underwent I-131 therapy for thyroid cancer with a standard protocol were given specific instructions with regard to radiation safety and provided with electronic digital dosimeter to continuously measure radiation dose received on daily basis, three days in the hospital. On the day patient is released, thyroid uptake estimates were performed to assess internal radiation dose received by caregivers. RESULTS: The 3-day accumulative doses to caregivers to patients receiving 150 mCi (n = 11) and 200 mCi (n = 9) of I-131 ranged from 37 to 333 uSv and 176 to 1,920 pSv respectively depending on the level of supports required. Thyroid uptake estimates in all caregivers were undetectable. Dosimeter indicated a maximum whole-body dose of1.92 mSv was more than the public dose limit of] mSv but within the dose constraint of 5 mSv for caregivers. DISCUSSION: Radiation dose to caregivers of a non self-supporting hospitalized patient undergoing 1-131 therapy were well below the limits recommended by the ICRP. The patients can be comforted with confidence that dose to caregivers will be less than the limit. CONCLUSION: This study provides guidance for medical practitioners to obtain practical radiation safety concerns associated with hospitalized patients receiving I-131 therapy especially when patient needs assistance.

Total Effective Dose Equivalent to Caregivers from Hospitalized Patients Treated with High Dose Radioiodine for Thyroid Carcinoma.

Thyroid cancer patients treated with high-dose radioactive iodine (3.7-7.4 GBq) are different from other people because after the administration, the radionuclide I-131 is excreted via urine, feces, saliva and breathing, and also via exposure to other patients. Caregivers of the patient may receive higher radiation doses than normal. The purposes of this study were to estimate the total effective dose equivalent from internal and external exposure to caregivers of patients treated with high dose I-131 admitted at Siriraj Hospital, and to compare the estimated dose with the dose constraint of 5 mSv per annum for caregivers. Thirteen caregivers of 13 patients who underwent radioiodine therapy for thyroid cancers following a standard protocol were given specific instructions with regard to radiation safety and were attached to an electronic personal dosimeter and a personal air sampler pump continuously to measure received radiation dose on a daily basis over three days in the hospital. On discharge day, caregivers were asked to perform an in vivo bioassay by the thyroid uptake instrument. The results from the thirteen caregivers were divided into 3 groups. The total effective dose equivalent to caregivers of patients administered 3.7 GBq (n = 1), 5.55 GBq (n = 9), and 7.4 GBq (n = 3) were 0.159 mSv, 0.123 to 0.629 mSv, and 0.631 to 0.718 mSv, respectively. There values were well below 5 mSv per episode as proposed in the IAEA Safety Reports Series No. 63 and the ICRP Publication 103.