Thyroid Radiation Protections Revised

The Nuclear Regulatory Commission has issued new guidelines designed to protect infants and children from radiation emitted by thyroid cancer patients.

The guidelines advise doctors to strengthen warnings to patients about radiation risks and to consider hospitalizing parents who might expose their children to secondhand radiation.

But the NRC didn't make the guidelines legally binding, denying a three-year-old petition filed by former NRC lawyer and thyroid cancer survivor Peter Crane. He said Wednesday that he has notified his former colleagues he would challenge the ruling in the 9th U.S. Circuit Court of Appeals.

Crane says the NRC ruling lets stand regulations allowing hospitals to discharge radioactive patients, sometimes against their will. "We've got to sue," he says. "I want binding regulations to make sure people aren't sent home to their 16-month-olds" while they're giving off radiation from their cancer treatment."

The medicine, iodine 131, is an effective cancer fighter with a five-year survival rate of 97 percent. But in higher doses, radioactive iodine can cause cancer. Children are especially sensitive to the radiation, which patients emit for days after treatment.

A USA TODAY survey in November, the first to examine thyroid cancer patients' concerns, found 85 percent worry they will expose others to radiation. Many patients check into hotels, potentially putting cleaning staff at risk or temporarily send children away.

The NRC says it issued guidance in response to "concerns" raised in 2007 by the International Commission on Radiation Protection and by Crane. But the agency denied his petition for binding rules on May 21.

Instead, the NRC instructed medical personnel to urge patients to avoid "direct or indirect" contact with infants and young children "by having the child stay outside the home or with family members" for a few days and by living in voluntary isolation within the home.

The guidelines also "suggest" doctors hospitalize parents who could not avoid "contamination of infants and young children."

"Under current regulations, a patient can be treated as an outpatient if a doctor finds that the potential for exposure for others is likely to be below a certain level," says NRC spokeswoman Elizabeth Hayden. "But the NRC is concerned that hospitals and insurance companies deny hospitalization for patients who do not want to go home immediately after treatment. This guidance makes it clear you can hospitalize them."

Hayden said the guidance is likely to work more quickly than a two-year rule-making procedure.

But Crane and other thyroid cancer survivors say it will take more than voluntary guidelines to persuade insurance companies to cover hospital care.

"The NRC's guidance is a useful interim step, but it doesn't go nearly far enough," Crane says. "This country is out of step with international standards for protecting children from radiation, and the NRC now recognizes it. The NRC is asking doctors and insurance companies to be more generous in hospitalizing patients, but the guidance has no legal force whatever."