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Not wearing X-ray protective clothing and exposure to X-rays may induce cancer. How many people are currently experiencing this

2017-10-13 08:05:55
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The speech of Chen Shaohua, a member of the Guangzhou Municipal Political Consultative Conference, has drawn widespread attention to the term 'naked inspection' in society. He said that the vast majority of hospitals do not have any protective measures when conducting X-ray examinations on patients, and according to research by the International Commission on Radiological Protection, in a city of millions, about 350 people may develop cancer, leukemia, or other genetic diseases each year due to exposure to X-rays. Moreover, the Ministry of Health has clear regulations that doctors should shield and protect sensitive organs near X-ray exposure when diagnosing and treating patients, but many hospitals have not implemented them.


More than two months have passed, and a reporter from Life Times visited several tertiary hospitals in Beijing again and found that the issue of "naked testing" has not been taken seriously or resolved, and many patients are indifferent to it. On the contrary, many foreigners living in China told reporters that foreign countries have very strict requirements on CT, chest X-ray and other protection work. They even dare not do X-ray examination in China because of fear of radiation.


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First class hospitals encounter 'naked testing'


On July 21st, the reporter investigated several top hospitals in China, including Beijing Tongren Hospital and Beijing Hospital. There is a long queue in front of their CT examination room and CT registration office, and a large number of waiting people fill the corridor. However, when the reporter asked multiple patients who came out of the examination room one by one, only one patient from Tongren Hospital said that the doctor had put on protective clothing for him during the examination. In front of the X-ray examination room on the first floor of the inpatient department of a Beijing hospital, a young woman was pushing an elderly person in a wheelchair and had just received the examination report. She told reporters that not only did the doctor not let the patient wear protective clothing during the examination, but she also did not wear it as an accompanying person. But before entering the examination room, she clearly saw the promotional poster on the outside wall that said accompanying personnel should wear protective clothing.


In the investigation, the reporter found that the phenomenon of "naked testing" is quite common, and medical staff rarely actively provide protective clothing. Ms. Zhang, who had undergone a physical examination at the Peking Union Medical College Medical College Hospital's examination center, has a deep understanding of this. She said, "When I arrived at the chest X-ray room, the doctor directly asked me to stand in front of the instrument. I was worried that radiation was not good for my body, so I voluntarily requested to wear protective clothing. The doctor reluctantly took out a set from under the shelf and gave it to me. Patients like Ms. Zhang who have protective awareness are only a minority, and in most cases, doctors do not tell patients about the dangers of radiation, and patients themselves are not aware. At Tongren Hospital, a patient casually told reporters that the X-ray was only taken once in a while and would end quickly without any problems.


Abuse can lead to potential dangers


In sharp contrast to the "naked examination" in China, even if a tooth X-ray is taken abroad, the patient will be fully armed. Our reporter stationed in Germany has a profound experience with this. Before filming, the doctor gave him a detailed introduction to the X-ray radiation process and personally helped the journalist put on heavy lead protective clothing, covering his neck, chest, lower body, and other parts, as well as wearing a protective headgear. Only when everything is ready will the doctor press the shutter button.


Li Kuncheng, director of the Beijing Medical Imaging Quality Control and Improvement Center and director of the Radiology Department at Beijing Xuanwu Hospital, believes that inadequate protection is indeed common in China, and the reason why foreign countries are doing well in this area is because there are fewer patients in hospitals. For example, in CT scans, they only treat about 20 patients per day, while a hospital in China has to treat at least one or two hundred patients per day. Although there are relevant regulations in the country and the vast majority of hospitals have protective clothing, if every patient wears it, it is too troublesome and time-consuming, and the examination will definitely not be completed

Regarding the hazards of X-rays, research by Oxford University and Cancer Research UK has shown that 0.6% of new cancer cases in the UK, 1.5% in Germany, and 3.2% in Japan are caused by X-ray and CT examinations. It poses greater harm to pregnant women and children, seriously impairing their intellectual development and leading to fetal malformations. However, Zhou Cheng, Executive Vice President of the Chinese Medical Imaging Technology Research Association, Vice Chairman of the Radiology Branch of the Chinese Medical Association, and Director of the Radiology Department of Beijing Hospital, pointed out that this is only a hypothesis and there is no convincing evidence in clinical practice. But he also acknowledges that the potential risks of X-ray examination certainly exist, especially when it is misused. The Radiology Society of the Chinese Medical Association once released a set of data: about 250 million people in China undergo X-ray examinations every year, but 20% of them have no clinical significance. CT abuse is more common, and some hospitals even lower prices to attract patients.

Don't proactively request an X-ray

According to the relevant regulations of the Ministry of Health, a continuous working radiology medical staff should receive less than 20 millisieverts (msv) of radiation per year, with one X-ray taking 0.02-0.03 msv and one CT taking 6-8 msv. Feng Xiaoyuan, Dean of Shanghai Medical College of Fudan University, Chairman elect of the Radiology Branch of the Chinese Medical Association, and Director of the Radiology Department of Huashan Hospital, pointed out that the radiation dose in routine examinations is within the safe range of the human body, but we should still try to minimize it. Adult physical examination, with a maximum of one CT or X-ray examination per year, repeated physical examinations are not necessary. If seeking medical treatment, one should decide whether to undergo an X-ray examination based on the condition and should not proactively request it. You can inquire whether other methods such as magnetic resonance imaging and ultrasound can achieve the same effect, and try to choose a method with low radiation dose that can ensure the examination effect. He also reminded:

Proactively request radiation protection before inspection. If the patient actively asks if there is protective equipment, the hospital must provide it. The gonads, thyroid gland, and other areas highly sensitive to X-rays should be given special protection.

Do not enter the examination room unless necessary. Do not enter the examination room when the red light is on, try not to accompany the patient for X-ray examination, and if necessary, be sure to wear protective clothing.

Pregnant women and children need to be most vigilant. Pregnant women aged 8-15 weeks should refuse abdominal X-ray examination unless there is a special need. Many mothers eagerly request CT scans for their children after they are injured, without considering the issue of radiation. The American Journal of Radiological Medicine has found that CT scans in children are not as effective as commonly believed, with only 7% detecting intracranial injuries.


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