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Radiation risks of diagnostic imaging.

Published for Joint Commission accredited organizations and interested health care professionals, Sentinel Event Alert identifies specific types of sentinel events, describes their common underlying causes, and suggests steps to prevent occurrences in the future. Accredited organizations should consider information in an Alert when designing or redesigning relevant processes and consider implementing relevant suggestions contained in the Alert or reasonable alternatives. Please route this issue to appropriate staff within your organization. Sentinel Event Alert may only be reproduced in its entirety and credited to The Joint Commission. To receive by e-mail, or to view past issues, visit www.jointcommission.org. Diagnostic radiation is an effective tool that can save lives. The higher the dose of radiation delivered at any one time, however, the greater the risk for long-term damage. If a patient receives repeated doses, harm can also occur as the cumulative effect of those multiple doses over time. 1,2,3 Conversely, using insufficient radiation may increase the risk of misdiagnosis, delayed treatment, or, if the initial test is inadequate, repeat testing with the attendant exposure to even more radiation. 4 The risks associated with the use of ionizing radiation in diagnostic imaging include cancer, burns and other injuries. 1 Over the past two decades, the U.S. population's total exposure to ionizing radiation has nearly doubled. 8 Diagnostic imaging can occur in hospitals, imaging centers, physician and dental offices, and any physician can order tests involving exposure to radiation at any frequency, with no knowledge of when the patient was last irradiated or how much radiation the patient received. From the 72 million CT (computerized tomography) scans performed in the U.S. during 2007, one study estimated that 29,000 future cancers and 14,500 future deaths could develop due to radiation (cancer incidence = 0.04 percent). 9 Another study estimates the incidence of cancer related to CT radiation at 0.02 to 0.04 percent. 10 While these studies' conclusions rely upon some currently unverified scientific assumptions – namely, a linear relationship between radiation dose and risk even at very low exposures – they do highlight the need to maintain radiation doses as low as reasonably achievable when obtaining needed diagnostic information. While experts disagree on the extent of the risks of cancer from diagnostic imaging, there is agreement that care should be taken to weigh the medical necessity of a given level of radiation exposure against the risks, and that steps should be taken to eliminate avoidable …