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By John W. Gofman, M.D., Ph.D. Fall 2000.
XaHP: The X-rays and Health Project.
An educational project of the
Committee for Nuclear Responsibility.
Post Office Box 421993
San Francisco CA 94142-1993.
Gifts are tax-deductible.
Fact: Accumulated exposure to x-rays, for medical imaging, is a proven cause of Cancer. This is not in dispute. Therefore, reducing current doses during x-ray imaging is a program which is guaranteed to reduce future cancer rates.
Effective, Safe, Low-Cost, Easy: We know of no other idea for preventing Cancer which is all of the following:
- Is guaranteed to deliver benefits;
- Is guaranteed to be safe and risk-free;
- Is low-cost;
- Is so easy to do;
- Is also going to prevent cases of x-ray-induced Coronary Heart Disease, according to the newest evidence.
All The Benefits, With Much Less Risk: A dose-reduction program requires no one to give up any of the benefits of x-ray images. The fact is that the benefits of x-ray images can be obtained from lower doses. Only 25% of x-ray practitioners are using the lowest doses technically possible. The other 75% are giving patients higher doses than the doses needed for high-quality images --- in some cases, 5-times, 10-times, 15-times more dose than needed.
Goal: We suggest that the goal in the Bay Area, and in every county of the nation, should be that all x-ray practitioners give patients the lowest x-ray doses technically possible, consistent with obtaining good images. No patient deserves to receive an unnecessary x-ray-induced death later on, due to uselessly high x-ray exposure.
Two Do-Able Suggestions: We have two do-able suggestions for making the Bay Area a model for California and the nation. You will have many additional ideas. Our suggestions do not include government regulation. The goal can be achieved with much greater speed and much lower cost by keeping the government out of it, provided that the physicians join the effort.
Suggestion #1: Citizens need to collect signatures on the Patients' Right-to-Know Policy Statement and to send the signed Statements to a central location, where the total signatures are counted by zip codes and where the names stay private. A growing number of signatures is what will demonstrate that people are serious about obtaining the guaranteed health benefits from receiving only the lowest possible doses of x-rays. Never miss an opportunity to collect more signatures.
Suggestion #2: Start exploring, and never stop exploring, how you can work co-operatively with the x-ray practitioners in the Bay Area. The initial list can be short and do-able: The radiologists, the Chief Operating Officer and Radiation Safety Officer at each hospital, and a policy-maker at each HMO which operates widely in the Bay Area. We suggest sending a letter to each which:
- States the goal;
- Encloses the Patients' Right-to-Know Policy Statement;
- Asks for a meeting to discuss the Policy Statement;
- Assures them in advance that you understand the time pressure and financial pressure under which physicians and hospitals operate today, that the goal of the Policy Statement requires no government regulation, and that you request the meeting to listen to their own ideas on how to do the job with the least cost and maximum speed.
Aim High, Think Positively: What you'd really like is leadership on this goal from the x-ray practitioners. Indeed, the radiologists are in a position to inspire every type of x-ray practitioner to join the effort: The dentists, internists, cardiologists, neurologists, urologists, gastro-enterologists, orthopedists, and chiropractors.
Aim For The Most Possible Signatures: Sustained effort toward the goal, by x-ray practitioners and by the referring physicians who order the x-rays in the first place, will be immensely fortified if you sustain a vigorous drive for more and more signatures on the Patients' Right-to-Know Policy Statement.
Better Late Than Never: If the two goals of the Policy Statement had been adopted 30 years ago, when it was first clear that x-rays are a cause of Cancer in adults, countless cases of misery would have been prevented. It is a moral imperative to do now what could have been done ago. The Bay Area can lead the way, as a model for the rest of California and the nation.
" ... Therefore, medical and dental patients have the right (a) to know their radiation exposures from x-ray imaging procedures and to possess a reliable dose-record, and (b) to know that the medical and dental communities are actively seeking the most effective ways to reduce dosage during x-ray imaging procedures."