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Radiation exposure to family members of patients treated with radioactive iodine (131I): a systematic review and meta-analysis

  • Meta-Analysis
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A Correction to this article was published on 13 June 2023

This article has been updated

Abstract

Purpose

Radiation safety is one of the main concerns for thyroid cancer patients and their caregivers in radioiodine therapy. Even though there is a plethora of research describing radiation exposure to family members of patients, no meta-analysis study has been carried out on this subject. In this study, the doses received by the family members of the patients treated with 131I were investigated.

Methods

A systematic literature search was carried out using databases of Web of Science, PubMed, Embase, Scopus, and Google Scholar without the beginning date restriction until December 2022. The meta-analysis was performed using the random-effects model, and the doses received by caregivers were calculated as the effect sizes.

Results

This meta-analysis retrieved a total number of 2080 family members of thyroid cancer patients. The pooled estimates for radiation exposure to family members of inpatients and outpatients treated with 131I were calculated as 0.4 mSv (95% CI 0.26–0.55 mSv) and 0.54 mSv (95% CI 0.48–0.60 mSv), respectively. The shapes of Begg’s funnel plots seemed asymmetrical for both groups of studies evaluating the doses received by the family members of inpatients and outpatients (Begg’s test p = 0.011 and < 0.001, respectively) which demonstrate the existence of publication bias in the results of included studies. The level of significance calculated in meta-regression analysis to evaluate the effects of administered activity, male sex ratio, and study quality score on the doses received by the family members of the inpatients treated with 131I were p = 0.526, 0.759, and 0.129 respectively. The p-values obtained to evaluate the effects of administered activity, age average of the caregivers, male sex ratio, and study quality score on the doses received by the family members of the outpatients treated with 131I were p = 0.496, 0.974, 0.010, and 0.636 respectively. The study location significantly modifies doses received by family members of patients (both p < 0.001).

Conclusion

 There are considerable radiation protection considerations for the family members of patients after radioiodine administration. The results of this study showed that caregivers received doses of less than 1 mSv. There are no radiation hazards for family members of patients treated with 131I and the conventional advice provided by the radiation protection advisor is enough. The socioeconomic factors, lifestyle, and literacy levels of the patients’ family members determined the compliance of the caregivers with safety recommendations and therefore modifies the doses received by family members.

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All data generated or analyzed during this study are included in the article.

Change history

Abbreviations

131I:

Radioactive iodine

mSv:

Millisievert

GBq:

Gigabecquerel

CI:

Confidence interval

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Acknowledgements

The authors would like to thank the research affair of the Non-Communicable Diseases Research Center and Ilam University of Medical Sciences.

Funding

This study was funded by Ilam University of Medical Sciences.

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Authors and Affiliations

  1. Department of Radiology, Erbil Medical Technical Institute, Erbil Polytechnic University, Erbil, Iraq

    Aza Ismail Abdi

  2. College of Health Technology, Cihan University, Erbil, Iraq

    Aza Ismail Abdi

  3. Department of Surgery-Radiology, College of Medicine, Hawler Medical University, Hawler, Iraq

    Kataion Nadhim Khorshed

  4. Department of Pharmacology & Medical Physics, College of Medicine, Hawler Medical University, Kurdistan Region Government, Erbil, Iraq

    Ronak Taher Ali

  5. Department of Physiotherapy, Faculty of Applied Science, Tishk International University, Kurdistan Region Government, Erbil, Iraq

    Ronak Taher Ali

  6. Non-Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran

    Seyed Salman Zakariaee

  7. Department of Medical Physics, Faculty of Paramedical Sciences, Ilam University of Medical Sciences, Ilam, Iran

    Seyed Salman Zakariaee

  8. Department of Midwifery, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran

    Negar Naderi

Authors
  1. Aza Ismail Abdi
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  2. Kataion Nadhim Khorshed
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  3. Ronak Taher Ali
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  4. Seyed Salman Zakariaee
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  5. Negar Naderi
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Contributions

AIA: content planning, literature search and review, data collection, and manuscript editing. KNK: literature search and review, data collection, and manuscript editing. RTA: literature search and review, data collection, and manuscript editing. SSZ: project development, content planning, literature search and review, data collection, manuscript writing and editing, and meta-analysis. NN: literature search and review, data collection, and manuscript editing.

Corresponding author

Correspondence to Seyed Salman Zakariaee.

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The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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The study was approved by the local Medical Ethical Committee.

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Abdi, A.I., Khorshed, K.N., Ali, R.T. et al. Radiation exposure to family members of patients treated with radioactive iodine (131I): a systematic review and meta-analysis. Clin Transl Imaging 11, 465–477 (2023). https://doi.org/10.1007/s40336-023-00561-9

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  • DOI: https://doi.org/10.1007/s40336-023-00561-9

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