More radiation victims at cardiology unit

By Kumudini Hettiarachchi and Dhananjani de Silva

Another doctor of the Institute of Cardiology has undergone surgery for brain cancer. This was just last week.

In November 2004, The Sunday Times highlighted the cases of four ‘unrelated’ patients – a retired nurse who had died of thyroid cancer, a minor staffer whose bladder had been removed due to cancer and was wearing a urinary bag, a senior radiographer who had undergone surgery for thyroid cancer and a consultant cardiologist who was suffering from a malignant brain tumour. The consultant cardiologist is now no more.

Electronic personal dosimeter

In all these patients there is one common link – all have worked or are working at the Institute of Cardiology of the Colombo National Hospital. What has gone wrong at the premier heart centre in Sri Lanka, where the staff work tirelessly to save patients with heart problems, but themselves succumb to cancer?

“The staff thinks this is due to radiation,” says Christie Fernando, Superintendent Radiographer of the National Hospital, explaining that all the protection precautions such as using aprons lined with lead, thyroid shields, head caps, ceiling shields and side aprons, according to the Atomic Energy Authority (AEA) requirements have been fulfilled. “We have asked for portable mobile shields to be supplied from the Medical Supplies Division, as an added precaution,” he said.

The Sunday Times understands that those workers dabbling in radiation are covered by a Radiation Protection Monitoring System under which they use a monitoring device called the trans-luminous dosimeter (TLD) which records the amount of radiation they are exposed to and their bodies absorb. The TLD, which looks like a diskette to the layman, is then inserted into a reader and the amount of radiation checked to verify whether it is below acceptable/standard levels.

With the serious issue of life and death facing those who work with radiation, Mr. Fernando said a top level meeting was held with Health Ministry officials where several crucial decisions were taken.
“It was decided to set up our own radiation protection monitoring service under the Health Department employees headed by a qualified medical physicist. We will also identify numbers for the issue of Personal Dosimeters”, said Mr. Fernando explaining that with a TLD one had to await the radiation reading in about two months while with a Personal Dosimeter, an immediate reading could be taken. “A Personal Dosimeter could also be shared by two people,” he said.

While such discussions have been ongoing, several radiographers have expressed serious doubts about the quality of a recent stock of over 200 TLDs, imported recently.

“When questions were asked, we were told that they were imported from the mother company, but when we checked it out we got a letter from the company that no such TLDs had been issued by it. As such we are concerned about the accuracy of the readings, as these TLDs are not compatible with the main machine,” said another radiographer who declined to be named, adding that the matter has been taken to the District Court of Colombo, with the Government Radiological Technologists’ Association filing action against the Department of Health and the AEA.Meanwhile, when contacted by The Sunday Times an AEA official said the problem at the National Hospital had not been officially intimated to the AEA.

We have seen only what has been reported in the media, said H.L. Anil Ranjith, Head of the Radiation Protection Department of the AEA, explaining that necessary measures had been taken to ensure the safety of employees working in the sensitive areas of the National Hospital.

“We have carried out inspections and given licences to several units of the National Hospital including the Cardiology Institute, ensuring maximum protection. But we have not yet finished inspections at the Department of Radiology. No date for inspections have been give to us as the hospital is full of patients all the time,” he said, stressing that although the AEA has the authority no action could be taken regarding the delay as it was due to a practical reason.

“All jobs are associated with some sort of a risk. Likewise radiographers too are subjected to a certain percentage of rays while carrying out their work, but if that percentage is below the standard dose limit, then that is considered an acceptable risk”, he said. According to him despite radiographers being given the necessary training to adopt self-protection measures while at work, which is a vital aspect in the prevention of such harmful conditions, most of them did not use such measures.

“Taking preventive measures on the part of the radiographer is necessary. But most of the radiographers ignore this practice and ultimately get affected by various diseases,” said Mr. Anil Ranjith adding that cancer can be due to other reasons as well.

Meanwhile, the AEA official dismissed the move by most radiographers not to wear the TLDs and their excuse that they were of poor quality.