Radiation exposure to family members of patients with thyrotoxicosis treated with iodine-131

  • Tone Cappelen
  • Jan Frede Unhjem
  • Anne Lise Amundsen
  • Gunnhild Kravdal
  • Ivar Følling
Original Article

Abstract

Purpose

The purpose of this study was twofold: (1) to measure the radiation exposure to family members of out-patients with thyrotoxicosis treated with radioiodine, 131I, using the recommendations from the European Commission (EC) guidance and age-specific periods for behaviour restrictions; (2) to use the results to identify necessary restrictions to ensure recommended dose constraints.

Methods

The study population comprised 76 family members (46 adults and 30 children below the age of 18) of 42 patients. The patients were treated with an average activity of 417 MBq (range 260–600 MBq). They received oral and written EC recommendations about behaviour restrictions (translated into Norwegian). On the day of treatment we repeated the oral instructions to the patient and an adult family member. The time periods for restrictions were 14 days for children aged 0–10 years, 7 days for persons aged 11–59 years and 3 days for persons aged 60 years and older. Family members wore a thermoluminescent dosimeter (TLD) on each wrist day and night for 2 weeks. The doses received were adjusted to give an estimate of the expected values if the TLDs had been worn indefinitely.

Results

Radiation doses well below the recommended dose constraints were measured for all adult family members and children, except one 2-year-old child; in the latter case the mother probably did not comply with the instructions given.

Conclusion

The radiation dose to family members of thyrotoxic patients treated with up to 600 MBq of radioiodine is well below recommended dose constraints if EC instructions are given and compliance is adequate. The duration of restrictions for various age groups used in this study may be considered when establishing guidelines in Norway.

Keywords

Iodine-131 therapy Thyrotoxicosis Radiation protection Guidelines 

References

  1. 1.
    Hoefnagel CA, Clarke SE, Fischer M, Chatal JF, Lewington VJ, Nilsson S, et al. EANM Radionuclide Therapy Committee. Eur J Nucl Med 1999;26:277–82CrossRefPubMedGoogle Scholar
  2. 2.
    Beckers C, Alexander WD, Burger A, Lazarus J, Krenning E, Schlumberger M, et al. A report of the European Thyroid Associations’s committee on radioiodine therapy in thyrotoxicosis. 131I therapy for thyrotoxicosis towards 2000. Eur J Nucl Med 1996;23:BP13–5CrossRefGoogle Scholar
  3. 3.
    Lassman M, Hänscheid H, Schelper LF. Measurement of incorporation in family members of patients with benign thyroid disease after radioiodine therapy. Nuklearmedizin 1998;37:120–3PubMedGoogle Scholar
  4. 4.
    Schomaecker K, Fisher T, Gaidouk, M, Schicha H. Exhalation of 131I after radioiodine therapy: time dependence and chemical form. Proceedings of the 47th annual meeting, Society of Nuclear Medicine (abstract). J Nucl Med 2000;41 Suppl:251PGoogle Scholar
  5. 5.
    Jacobson AP, Plato PA, Toeroek D. Contamination of the home environment by patients treated with iodine-131: initial results. Am J Public Health 1978;68:225–30PubMedGoogle Scholar
  6. 6.
    Council of the European Union. Guideline 96/29/EURATOM to determine basic directions for health protection of public and workers against ionizing radiation related dangers. Leafl Eur Commun 1996;L159/1Google Scholar
  7. 7.
    Council of the European Union. Directive on the health protection of individuals against the dangers of ionizing radiation in relation to medical exposures. 97/43/Euratom OJ 1997;L180:22–7Google Scholar
  8. 8.
    International Commission on Radiological Protection. Recommendations of the International Commission on Radiological Protection. Ann ICRP 1991;21(1–3)Google Scholar
  9. 9.
    European Commission. Radiation protection 97: radiation protection following iodine-131 therapy (exposures due to outpatients or discharged inpatients). Luxembourg, Belgium: Office for Official Publications of the European Communities; 1998Google Scholar
  10. 10.
    Monsieurs M, Thierens H, Dierckx RA, Casier K, De Baere E, De Ridder L, et al. Real-life radiation burden to relatives of patients treated with iodine-131: a study in eight centers in Flanders (Belgium). Eur J Nucl Med 1998;25:1368–76CrossRefPubMedGoogle Scholar
  11. 11.
    Barrington SF, O’Doherty MJ, Kettle AG, Thomson WH, Mountford PJ, Burell DN, et al. Radiation exposure of the families of outpatients treated with radioiodine (iodine-131) for hyperthyroidism. Eur J Nucl Med 1999;26:686–92CrossRefPubMedGoogle Scholar
  12. 12.
    Thomson WH, Mills AP, Smith NB, Mostafa AB, Notghi A, Harding LK. Radiation doses to patient’s relatives: day and night components and their significance in terms of ICRP 60. Eur J Nucl Med 1993;993 poster nr 697Google Scholar
  13. 13.
    Barrington SF, Kettle AG, Mountford PJ, Thomson WH, Batchelor S, Burrell DN, et al. Radiation exposure of patient’s children at home post I-131 administration. Eur J Nucl Med 1995;22:798Google Scholar
  14. 14.
    Mathieu I, Caussin J, Smeesters P, Wambersie A, Beckers C. Doses in family members after 131I treatment. Lancet 1997;350:1074–5CrossRefGoogle Scholar
  15. 15.
    O’Doherthy MJ, Kettle AG, Eustance CNP, Mountford PJ Coakley AJ. Radiation dose rates from adult patients receiving 131I therapy for thyrotoxicosis. Nucl Med Commun 1993;14:160–8PubMedGoogle Scholar
  16. 16.
    Wasserman HJ, Klopper JF. Analysis of radiation doses received by the public from 131I treatment of thyrotoxic outpatients. Nucl Med Commun 1993;14:756–60PubMedGoogle Scholar
  17. 17.
    Cappelen T, Unhjem JF. Patients with hyperthyroidism treated with radioactive iodine and exposures to family members. Eur J Nucl Med Mol Imaging 2004;31:P828, S457Google Scholar
  18. 18.
    Regulations No. 1362 of 21. November 2003 on Radiation Protection and Use of Radiation (Norwegian Radiation Protection Regulation)Google Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Tone Cappelen
    • 1
  • Jan Frede Unhjem
    • 2
  • Anne Lise Amundsen
    • 1
  • Gunnhild Kravdal
    • 1
  • Ivar Følling
    • 3
  1. 1.Department of Clinical Chemistry and Nuclear Medicine, Akershus University HospitalUniversity of OsloOsloNorway
  2. 2.Norwegian Radiation Protection AuthorityØsteråsNorway
  3. 3.Section of Endocrinology, Akershus University HospitalUniversity of OsloOsloNorway

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