The Pan American Health Organization supports actions to ensure radiation safety of patients
Many actions for the radiation protection of patients undergoing diagnostic radiology examinations or radiotherapy procedures are promoted by the Pan American Health Organization (PAHO) within the ministries of health of countries within the Americas region, with the collaboration of the radiation regulatory authorities.
Guidelines for patient radiation protection were presented at the International Conference on the Radiological Protection of Patients in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiotherapy, held in Malaga, Spain, in 2001, co-sponsored by the International Atomic Energy Agency ( IAEA), the European Commission , PAHO and WHO. The Proceedings were published by the IAEA in 2001. In 2002 the IAEA Board of Governors approved an “International Action Plan on the Radiological Protection of Patients” to be carried out in co-sponsorship with PAHO and WHO/HQ. The objective of the International Action Plan is to make progress in patient safety as a whole. The involvement of international organizations and professional bodies is crucial to performing the actions and achieving the goals outlined in it. A Steering Panel Committee was established and a first meeting was held in Madrid, in January 2004. The Panel analyzed the actions of the Plan implemented, in progress and pending. In addition, the Panel prepared the actions for 2004/5 and drafted the actions for 2006/7.
The implementation of standards at the institutional level is best monitored by quality assurance programs. At the regional level, the oldest program PAHO coordinates in Latin America and the Caribbean is on Postal Dosimetry Service, in collaboration with the IAEA, dating from the 1960’s. The program verifies the accuracy of the calibration of high-energy radiotherapy units used for cancer treatment by checking the radiation dose delivered to thermoluminescent dosimeters (TLDs) that are placed by the user in the radiation beam simulating a tumor under treatment. More than 150 units are currently evaluated yearly in public and private radiotherapy facilities.
A particular case of PAHO's consultations involve responding to radiation incidents/accidents, including patient radiation overexposure. The most important overexposure regarding patients occurred in Costa Rica and Panama. In San Jose from August to October 1996, an erroneously calibrated Cobalt-60 unit used for cancer radiotherapy treatment overexposed 115 patients, many of them children. By July 1997, 42 had already died. Of the surviving patients, 46 showed radiation-related symptoms that ranged from severe to mild. In Panama from August 2000 to March 2001, also involving a Cobalt-60 teletherapy unit used for cancer therapy treatment, 28 patients were overexposed due to an improperly used software to calculate the treatment times. By October 2002, 19 patients have died; at least half of them from the overexposure.