However, experts pointed out that X-ray examination of the human body has damage, the more rays of light, the greater the risk of cancer, therefore, the State Ministry of Health as early as 2002 issued the "radiation work health protection management approach" clearly stipulates that medical personnel should be examined by the necessary protection. But it is shocking that most hospitals are now operating in violation of the law, "patients without any protection for X-ray examination" seems to have become a practice, and few people realize the harm, in fact, most patients are afraid that the Ministry of Health did not know that this provision exists.
The weekend newspaper reported that X-ray examination as a common medical diagnostic means in the domestic clinic has been widely used, although most patients know that radiation has certain health hazards, but are considered to be minimal, in order to cure the disease is also accustomed to being exposed to X-ray radiation.
However, this is not the case in reality, said Du Guosheng, chief technician of the Beijing Municipal Center for Disease Control and Prevention's Radiological Health Protection Institute, in an interview with a reporter on Jan. 17. According to the latest study by the International Commission on Radiological Protection (ICRP), it is estimated that, for example, in a city of 10 million people, there are about 350 people who may be exposed to X-rays each year, which may lead to cancers, leukemias, or other hereditary diseases. Diseases. In Japan, where X-rays and CT scans are common, 3.2 percent of new cancer cases each year are caused by these two types of tests.
An expert pointed out that the X-ray examination of the human body has damage, the more rays of light, the greater the risk of cancer, so the Ministry of Health as early as 2002 issued the "radiation work of health care management approach" clearly stipulates that medical personnel should be examined by the necessary protection. But it is shocking that most hospitals are now operating in violation of the law, "patients without any protection for X-ray examination" seems to have become a practice, and few people realize the harm, in fact, most patients are afraid that the Ministry of Health did not know that this provision exists.
Hospital attitude: patients wearing protective clothing and how to check?
The reporter checked the "radiation work health protection management approach", which stipulates that Article 25: "engaged in radiological diagnosis, treatment units, should be developed and the unit engaged in the diagnosis, treatment projects compatible with the implementation of quality control programs to comply with quality control and monitoring specifications. The protection performance of radiation diagnosis and treatment devices and the technical indicators related to the quality of exposure shall meet the requirements of the relevant standards. Diagnosis and treatment of patients and examinees, should be in accordance with operating procedures, strict control of the irradiated dose, adjacent to the irradiated parts of the sensitive organs and tissues should be shielded protection; medical irradiation of pregnant women and young children should be informed in advance of the impact on health."
However, the real situation encountered by the reporter in the hospital is: the radiology doctor will lead the patient to the front of the instrument, requiring the patient's chest close to the instrument to stand, and then the doctor walked out of the room, closed the thick protective door, into the lead glass separated from the safety of the room to operate the instrument, leaving the patient without wearing any protective equipment to receive X-ray irradiation.
The reporter called the radiology departments of several large hospitals as a patient to ask about protective measures. The medical staff of the radiology department of a Chinese hospital froze for a moment after receiving the call, seemingly surprised by the questions posed by the reporter. Afterward, she advised the reporter to rest assured: "In the absence of protective measures in the case of exposure to X-rays, there is not much harm, which is common in hospitals. Ordinary patients to X-ray generally do not wear protective clothing. Moreover, nowadays the instrument is more advanced than before, the control of the ray beam is very precise, and will not irradiate the non-examination parts. Only pregnant women have their abdomens covered." Another large hospital radiology department of the medical staff of the reporter's question is laughable, they said "never heard of such a provision", that "X-ray must be close to the body of the instrument, if you wear a protective suit, how to check?"
Domestic chest X-ray utilization rate of more than 300 times that of developed countries
Reporters through the investigation confirmed that the hospital's irregularities are indeed widespread, it seems that the majority of people for the hazards of X-ray is indeed quite indifferent.
So the International Commission on Radiological Protection (ICRP) puts forward a city of ten million people a year 350 people due to exposure to X-ray-induced cancer, leukemia or other hereditary diseases, exactly how to come up with the data? The reporter asked Dr. Yu Ningle, chief of the Environmental and Radiation Protection Section of the Jiangsu Provincial Center for Disease Control and Prevention, about this.
"In fact, radiological examination of cancer is a 'probability' of the problem, with a random effect, not necessarily spread to the head of anyone." Yu Ningle explained to reporters, "The result of 350 people causing cancer is derived by multiplying the population by a certain rate. For an individual, the chance of cancer due to radiation is random, it could be 0 or 100%. But for a population, the increased prevalence is certain."
The most common sources of radiation that the average person is exposed to are X-ray exams and CT exams. This radiation is capable of penetrating cells, damaging DNA, and even inducing certain cancers.X-rays disrupt the internal structure of cells, causing irreparable, lifelong damage to genetic molecules. It has also been shown that X-rays destroy red blood cells and may induce blood disorders such as leukemia.
Despite the harmful radiation contained in X-rays, they are still widely used in China as a necessary medical treatment. X-rays and CT scans are used to help doctors make a definitive diagnosis, especially when a patient's superficial symptoms are not enough to confirm a disease. X-rays are most commonly used to detect fractures, but they can also detect abnormalities in internal organs such as the lungs, liver, kidneys, and spleen; bone tumors such as ribs, clavicles, and thoracic vertebrae; and mucosal swelling and tumors caused by gastric ulcers and gastroenteritis, etc. The principle of CT scanning is basically the same as that of X-rays.
Yu Ningle told reporters that China used to have no restrictions on X-ray examination, in recent years, under the appeal of relevant experts, the state began to pay attention to the issue of medical radiation, issued a series of regulations, but in practice, these provisions have not been well implemented. In comparison, foreign countries are ahead of China in this regard. Cells in various parts of the human body react to X-rays to varying degrees, with the gonads being the most sensitive. In many countries, when radiological examinations are conducted, it is required that non-examined parts, especially the gonads and thyroid, must be shielded and protected in order to minimize radiation damage. Doctors who are negligent are likely to have their radiology licenses revoked. The United States, Japan and most developed countries have eliminated the chest X-ray examination, in the few countries that use it, the United Kingdom's frequency of use is only 0.2 percent, while China is as high as 61.8 percent!
Du Guosheng, chief technician of the Beijing Municipal Center for Disease Control and Prevention's Radiological Health Protection Institute, mentioned two representative examples of X-ray hazards: In 2004, a Beijing hospital was warned by Australian quarantine authorities for sending unprotected X-rays to Australia. And when a foreign child visited a domestic hospital for an X-ray examination, he jumped out of bed and refused to be photographed, believing that patients were given lead aprons when they were photographed in their countries. The gap between Chinese and foreign perceptions of patient protection can be seen.
So how harmful are X-rays? Some experts have taken the orthopedic surgery that requires the most X-rays as an example, and projected the dose of radiation that a patient would receive during treatment. The number of times a patient needs to receive X-ray examination is: once at the time of diagnosis (if you need to further confirm the diagnosis, you need to add a CT), once after the operation to check the status of bone repositioning (joint repositioning patients need to add a time during the operation), once a month after the operation, once after the operation, three months after the operation. This is the basic number of checkups, as many as six times, as few as four times, and later according to the recovery of patients with fractures, as well as whether the film is clear and need to be redone, up and down the hospital referral redo and other factors, some patients at least to do more than 10 times.
Taking an X-ray chest film, when the ray is exposed in the examination area its exposure rate is about 160 mSv (unit of measurement of radiation) / hour, about 0.045 mSv / sec. For a rib fracture in the chest, for example, it takes about 0.5 seconds to take a chest radiograph, so a patient undergoing a chest X-ray is exposed to a radiation dose of about 0.023 mSv. At six X-rays, a patient with a rib fracture would receive a total **** radiation dose of 0.138 mSv before and after.
According to the standards set by the International Commission on Radiological Protection (ICRP), the total risk of radiation is 0.0165 / sievert, that is to say, the body receives a dose of radiation of one sievert (1 sievert = 1,000 millisieverts), which will increase the chances of cancer by 0.0165. By this reckoning, a patient with a broken rib would have an increased risk of about 3.8 parts per million.
And for other medical examinations, the general limbs to do an X-ray examination to receive the radiation dose of 0.01 millisievert, the abdomen for 0.54 millisievert, the pelvis for 0.66 millisievert, the lumbar spine for 1.4 millisievert, the upper gastrointestinal tract for 2.55 millisievert. To put this in perspective, the risk of cancer in a healthy population because of a medical exam is between one in 10 million and one in 100,000
Pregnant women and children among those at high risk of radiation exposure
While most hospitals don't take any precautions when X-rays are given to ordinary patients, there are some concerns about pregnant women, who have their abdomens covered. Dr. Yu suggests that pregnant women, especially those in their first trimester, should avoid such tests. Because this is a critical period for the formation of vital fetal organs, X-rays may cause mutations in these undeveloped cells and tissues, and the incidence of congenital malformations in the fetus may increase. Studies have also shown that CT scanning of newborns with head injuries can have an impact on later learning and logical reasoning, while having little effect on spatial recognition.
In addition to pregnant women, children are also one of the high-risk groups for radiation damage. From the radiobiological theory analysis, a tissue radiosensitivity and cell division activity is proportional to the children are in the peak of growth and development, active cell division, more sensitive than adults, and the younger the more sensitive. If a short period of time to accept a greater number of X-ray irradiation, the harm will slowly accumulate, resulting in irreparable damage to the body's cells, the future of cancer and other diseases will greatly increase the chances of inducing. Therefore, the state regulations, people under the age of 18 are strictly prohibited from engaging in occupations related to radiation work.
If the affected party is only occasionally exposed to X-rays, then the medical staff of the radiology department, who are the medical side, are more likely to be damaged by radiation, even though they have taken some protective measures. The Ministry of Health Legal Supervision Department of Public **** Health Division responsible person said, the Ministry of Health has 15 provinces and cities in the country's hospitals to monitor, records show that the medical profession personnel to receive the degree of radiation in the top of the various industries, medical radiation is the main source of radiation contamination at present, the medical staff due to contact with rays of long time, high frequency, short distance, they are subjected to the intensity of radiation than the staff of the traditional nuclear industry is also high.
Medical personnel short-term exposure to large doses of radiation, acute skin burns, necrosis, radiation dermatitis, eye crystal turbidity secondary to cataracts; long-term low-dose radiation, the onset of the general in a few years or even a dozen years, may occur after leukemia, other tumors, fetal malformations and so on. However, for the hazards of medical radiation, many doctors themselves do not have enough protection awareness, although the hospital also provides the appropriate protective measures, but in practice, some medical workers will be reluctant to use because of the trouble. Many doctors who perform orthopedic surgeries and manipulative repositioning under the X-ray machine have lost all the sweaty hair on their arms, indicating that the radiation has already harmed their bodies.
Standards in vain, chest X-rays are abused
What exactly is the cause of the rising rate of X-ray radiation hazards? "In fact, the problem is not in the lack of standards!" Yu Ningle believes that China's current introduction of a series of radiation health protection standards have been aligned with international standards, there is no difference. But in practice, these standards are often virtually useless, taking chest radiographs to enjoy the shielding protection of very few patients. What's more, sometimes when the physical examination, the doctor in order to save time, and even require a few medical examiners at the same time into the filming room, a person filming other people without any protection on the sidelines waiting. "Hospitals may think that patients come for an X-ray test once in a while, and even if they are unprotected, the harm is not great. But in reality, medical staff should not neglect to protect the subjects just because they come to the hospital just once."
"There is also a need to strictly control the indications for X-ray examinations!" Yu Ningle pointed out that the size of the radiation dose received depends on the radiologist, while the need to undergo radiological examinations is entirely up to the clinician. In order to obtain higher economic benefits, some hospital medical staff abused X-ray examination, there was absolutely no need for the patient to receive X-ray irradiation, but as a result, the doctor in order to collect more medical fees, let the patient receive irradiation for no reason. As a medical practitioner, you should always stand in the position of the patient for the patient's sake, can use ultrasound as much as possible do not use X-ray examination; must be used, but also should choose a relatively small radiation dose of X-ray film, and avoid the use of X-ray fluoroscopy.
Life is obviously abuse of X-ray examination examples abound: every year the child's school entrance examination, students to higher education check, practice check, unit physical examination, no one can leave the X-ray chest X-ray. And in 2003 the Chinese people *** and the country's latest promulgation of "ionizing radiation and radiation source safety basic standards" (GB18871-2002) provides: "X-ray diagnosis of screening census should avoid the use of fluoroscopic methods". China's and international radiation health protection standards for children also clearly state, "Routine examination of the lungs should not be used as a routine screening program for young children and adolescents, such as the annual physical examination." But in our country, especially living in the better economic situation of the urban population, "chest X-ray" has become a medical examination of the "reserved program", while this practice has long been abandoned abroad.
"Patients should also be aware of self-protection and reject unreasonable medical irradiation." Yu Ningle is concerned that the lack of awareness of protection among patients abounds, and some patients even act as their own doctors, blindly taking the initiative to choose X-ray examinations for themselves in the absence of relevant knowledge. There is also the patient's family, there is no special need to accompany the patient, family members do not have to go along with the examination, so the radiation is completely unnecessary.
However, people do not have to refuse the necessary X-ray and CT examinations because of the fear of radiation, not to mention the need for this even in the area of the hospital's radiology department are afraid to enter. When taking chest radiographs, X-rays in the examination area exposure rate of about 160 mSv / hour, two meters from this 80 microsieverts (1 mSv = 1000 microsieverts) / hour, about 1/2000 of the center point, the chance of cancer at this time is about one in a million; and in the distance from the center of the point of the 6 meters away from the radiation is 1.5 microsieverts / hour, about one in five million of the center, the chance of cancer is even more negligible. The chance of cancer is even more minimal.