Edward J. Markey, D-Mass. Image source: www.markey.house.gov

Due to the “potential dangers to public health from patients who have been released from the hospital after being treated with radioactive materials for cancers and other diseases,” there is a need for increased oversight and regulation by the Nuclear Regulatory Commission (NRC), according to a congressional analysis, led by Rep. Edward J. Markey, D-Mass.

The subcommittee’s investigation, which drew from a survey of more than 1,000 thyroid cancer survivors’ experiences, indicates that there is a “strong likelihood that members of the public have been unwittingly exposed to radiation from patients who are discharged after being treated with radioisotopes.”

In a press release, Markey said that the analysis found that these risks occurred because of “weak NRC regulations, ineffective oversight of those who administer these medical treatments and the absence of clear guidance and procedures to ensure that such exposures do not occur.”

Markey, chairman of the Energy and Environment Subcommittee of the Energy and Commerce Committee, also sent a letter transmitting the analysis to NRC Chairman Greg Jaczko in advance of two NRC meetings on Oct. 20 and 21, where these health risks are scheduled to be discussed. In the letter, Markey calls on the NRC to revise its regulations to ensure that the public is protected against unnecessary exposure to radioactive patients.

Markey’s letter calls on Jaczko to consider four recommendations at the meeting:

1.      The NRC should commence a rulemaking to revise its 1997 regulations surrounding the treatment of patients with radionuclides, and ensure that these regulations are consistent with and as protective of the most vulnerable populations as policies that are in place in other developed countries. Hospitalization should be mandatory for those patients who are treated with doses of I-131 above internationally accepted thresholds.

2.      The new regulations should ensure that patients who are released from the hospital after treatment are prohibited from recovering from such treatments in hotels or taking taxis or public transportation in the days following treatment and that written and verbal guidance prohibiting such activities is provided both to medical licensees and to patients. Enforcement actions should be taken against medical licensees who fail to provide such guidance to patients, or otherwise fail to advise a patient.

3.      The NRC should enhance its oversight of its medical licensees and the Agreement States to better identify, track and respond to regulatory violations. NRC should pay attention to whether New Hampshire, Arkansas and Alabama are capable of implementing NRC regulations, in light of their failure to respond to information requests.

4.      NRC should implement a reporting requirement for incidents that could have resulted in unintended radiation exposures from patients treated with radioactive isotopes, and ensure that data related to reports of such incidents are promptly made public in a centralized location such as the NRC website.

“It is time for the NRC to re-evaluate its current ‘treat and release’ policy regarding medical treatments using radioisotopes,” Markey said.