"The dose makes the poison," Paracelsus said some 500 years ago. Paracelcus was a 16th century Renaissance physician who is often credited as the father of toxicology.
A doctor´s duty is to diagnose and treat. But, if mishandled, the treatment can oftentimes do as much damage as the disease. Nowhere is this more true than in the field of ionizing radiation, particularly in medical procedures that use of x-rays, as in computed tomography (CT) scans, or in interventional procedures such as cardiac catheterization for angioplasty.
Several studies published in peer-reviewed literature confirm global incidents of patients receiving more radiation than is necessary. The IAEA, with its decades of expertise in radiotherapy and nuclear medicine, is now working to remedy this problem and ensure patient safety in radiological settings. The Agency"s focus is on improving patient safety standards around the world, especially in developing countries.
"Radiation protection of patients was not on the agenda in developing countries until as recently as 2001," says Madan Rehani, a radiation safety specialist in the Radiation Protection of Patients (RPOP) unit at the IAEA. Surveys undertaken by Rehani and collaborating medical facilities revealed an urgent need to check and optimize radiation dose administered by health facilities in many developing countries.
So how does IAEA go about ensuring patient protection?
By carrying out surveys and research, RPOP in collaboration with IAEA"s Technical Co-operation department, has collected data on radiation doses being administered in hospitals in Asia, Africa, Eastern Europe, as well as in Latin America.
After analyzing the data, an RPOP team headed by Rehani works with the medical staff in developing countries.
"We train health professionals on how much radiation is appropriate for different examinations and how to achieve that," Rehani said.
The surveys that were carried out provided the country-specific data that Rehani and his team needed to design a training curricula for health practitioners. The aim is to raise awareness of the risks, thus minimizing radiation dosages while maintaining the quality of the x-ray image.
In addition, protecting the youngest patients is a priority for the RPOP unit. "It is particularly important to ensure safety of children receiving radiation because children are more sensitive to radiation, have longer to live, and hence, have an increased risk of developing cancers," Rehani said.
The quality control measures and training conducted so far are having positive effects and are measurably improving patient safety. An IAEA-led study showed that implementing quality control measures in 12 countries in Africa, Asia and Eastern Europe helped lower radiation doses and reduce poor quality films in radiographic examinations.
In daily patient care, both health-care professionals and their patients need authoritative information. The IAEA´s Radiation Protection of Patients (RPOP) website was launched to meet that demand and to provide patients and doctors with current information on proper radiation protection measures. RPOP is now one of the most frequently visited web destinations at the IAEA. The website gives users access to cost-free safety guides, safety standards and training material.
"Every care is taken to ensure that the information on the website is accurate, up-to-date, and the website remains a trustworthy source," says Rehani. People who are undergoing any type of diagnosis or treatment involving ionizing radiation are encouraged to explore the RPOP site to learn about the benefits and risks related to radiation in medicine.
"In the end, it is important to weigh the risks and benefits of radiation," says Rehani. "Unnecessary exposure must be avoided, but that being said, one must understand that the diagnostic and therapeutic benefits of radiation have been significant in not only in the area of cancer, but in all parts of the body, in various disease conditions, be it for infants or old people."