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Chest 141; Radiation

27 Mar
Chest 141J

Chest 141; Radiation 

I have worked with radiation most of my career and seen the best and the worst it can be associated with. Medical radiation is the greatest existing source to the general population, even greater than the fallout from previous nuclear accidents and bombs – though that radiation was high and localised.

There is an interesting correlation between rates of radiological investigations for medical conditions and medical litigation. As litigation has increased, doctors have ordered more and more X-rays in order to “protect” themselves against allegations that they have not taken enough care. Unfortunately discrimination between those cases that do not need investigation for medical reasons because the result will not change management, and those cases that lawyers think should “always” have an X-ray, is poor.

In two consultant positions in two very different countries I saw roughly 15% increase in investigation rates year by year, with a significant jump when one of the medical defence societies went bust. It would be interesting to see, in 50 years time, what the impact of this increase has been on the general population, meanwhile defensive medicine continues to be practiced.

This image reminded me of pictures I have seen of a mushroom cloud – Hiroshima – or the radioactive plume rising from Chernobyl. All clouds have silver linings they say, except for mushroom shaped ones that have a lining of Iridium, and Strontium 90. Where does it all go? Chernobyl will tell you – into the surrounding area, or blown across borders into neighbouring countries.

The X-ray I chose to include, although it could have been any one at all, was a post-treatment study from a lady who had received successful radiation treatment for lymphoma.

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