RESUMO
This work evaluates the radiological risk that patients treated with I for differentiated thyroid cancer could present to relatives and occupationally exposed workers. Recently, the International Atomic Energy Agency issued document K9010241, which recommends that patient discharge from the hospital must be based on the particular status of each patient. This work measures effective dose received by caregivers of patients treated with I at the Instituto Nacional de Cancerología, Mexico City. Thermoluminescent dosimeters were carried during a 15-d period by 40 family caregivers after patient release from hospital. Relatives were classified into two groups, ambulatory and hospitalized, according to the release mode of the patient, and three categories according to the individual patient home and transport facilities. Categories A, B, and C were defined going from most to least adequate concerning public exposure risk. Measurements were performed for 20 family caregivers in each group. The effective dose received by all caregivers participating in this study was found to be less than 5 mSv, the recommended limit per event for caregivers suggested by ICRP 103. In addition, 70 and 90% of ambulatory and hospitalized groups, respectively, received doses lower than 1 mSv. Caregivers belonging to category C, with home situations that are not appropriate for immediate release, received the highest average doses; i.e., 2.2 ± 1.3 and 3.1 ± 1.0 mSv for hospitalized and ambulatory patients, respectively. Results of this work have shown that the proper implementation of radiation protection instructions for relatives and patients can reduce significantly the risk that differentiated thyroid cancer patients treated with I can represent for surrounding individuals. The results also stress the relevance of the patient's particular lifestyle and transport conditions as the prevailing factors related to the dose received by the caregiver. Therefore, the patient's status should be the criterion used to decide his/her release modality. This work provides support to recommend the implementation of the "patient specific release criteria" in accordance with ICRP 94, IAEA Safety Report No. 63, and IAE document K9010241 A for patients treated with radiopharmaceuticals.
Assuntos
Cuidadores , Radioisótopos do Iodo/uso terapêutico , Proteção Radiológica , Dosimetria Termoluminescente/métodos , Neoplasias da Glândula Tireoide/radioterapia , Adulto , Exposição Ambiental , Família , Feminino , Hospitalização , Humanos , Masculino , México , Pessoa de Meia-Idade , Alta do Paciente , Fatores de Tempo , Adulto JovemRESUMO
In order to better understand the most important experimental aspects for performing correct measurements of relative thermoluminescent (TL) efficiencies, an investigation has been carried out to quantify the effect of using different experimental procedures in the evaluation of 3 MeV proton-to-gamma relative efficiency (etap,gamma) of LiF:Mg,Ti. Variations in batch, presentation, annealing and reader have been studied. When the same protocol is used to measure proton and gamma TL response, efficiency values obtained range from 0.36 to 0.59 for peak 5 and from 0.44 to 0.79 for the total signal. The use of different annealings and different batches leads to 20% and 10% differences in etap,gamma respectively. Large differences (40%) are found between efficiency values measured with TLD-100 chips and those obtained using TLD-100 microcubes. When 'mixed' procedures are used to measure the proton and the gamma response, differences in etap,gamma may increase even more. The main conclusion of this work is to stress the importance of measuring an entire series of experiments in the same laboratory with a carefully defined protocol and using dosemeters from the same batch to obtain heavy charged particle TL response and gamma TL response with identical annealing and readout procedures.