Lawmaker calls on NRC to “stop gambling” with public health in cancer patient rules, outlines possible health risk from exposure
WASHINGTON, D.C. – Representative Edward J. Markey (D-Mass.), Chairman of the Energy and Environment Subcommittee of the Energy and Commerce Committee, today released a staff report entitled “Radioactive Roulette: How the Nuclear Regulatory Commission’s Cancer Patient Radiation Rules Gamble with Public Health and Safety.” The Markey staff report was prepared after reviewing NRC’s latest response to an inquiry by Chairman Markey into the NRC’s regulations surrounding the treatment of cancer patients with radionuclides as well as other materials.
“With the release of this report, I call upon the NRC to immediately reverse its actions and stop gambling with public health and safety - and if it won’t, I will introduce legislation that will direct it to do so,” said Rep. Markey. “In the past, the NRC adopted a ‘see no evil, hear no evil’ approach to protecting members of the public from exposure to the radioactive iodine used to treat many cancer patients.”
“The NRC has turned a blind eye to the relevant radiation exposure standards used in much of the rest of the world, a deaf ear to reports of problems with its own less stringent regulations, and has consistently opposed attempts to strengthen its own standards. This puts the public at risk and places an unfair burden on cancer patients already battling a disease, all because the medical community felt that keeping these patients in the hospital while they recovered would cost too much.”
Today, Chairman Markey also released a series of letters to thirty-four state regulators requesting data and inspection records related to their oversight of nuclear medical licensees. In these states, the NRC has ceded regulatory authority to the States to enforce federal radiation protection standards.
A FULL COPY OF THE REPORT CAN BE FOUND HERE: http://markey.house.gov/docs/STAFF_REPORT_031810_FINAL_with_crest.pdf
An example of today’s letters from Chairman Markey to State regulators can be found here:
http://markey.house.gov/docs/lettertostate.pdf
The March 5, 2010 response from the NRC to Chairman Markey can be found http://markey.house.gov/docs/NRC_Ltr_to_Markey_030510_attachments.pdf
The January 14, 2009 letter from Chairman Markey to NRC can be found here http://markey.house.gov/docs/11410nrc.pdf
The November 17, 2009 response from the NRC to Chairman Markey can be found here http://markey.house.gov/docs/nrcltomarkeyisotopes.pdf
Chairman Markey’s October 13, 2009 letter from Chairman Markey to the NRC can be found here http://markey.house.gov/docs/signed_isotope_nrc_letter.pdf
A list of all 34 State regulators can be found here: http://nrc-stp.ornl.gov/asdirectory.html
A summary and recommendations follows.
SUMMARY:
In 1997, the Nuclear Regulatory Commission (NRC), in response to a proposal initiated by its own staff, weakened its rules surrounding the release of patients treated with radioactive iodine. The new rules were weaker than regulations used across Europe and other countries, and were also weaker than NRC’s regulations for exposure limits from other sources of radiation.
NRC’s weaker, current regulations depend on the ability of medical professionals to assess the living conditions of patients and use the results of this assessment to calculate the likely radiation dose to those the patient might come into contact with. It is unclear whether such a calculation could be accurately performed for a patient choosing to recover from treatment with radioactive iodine in a hotel, since it would be impossible to characterize every hotel’s layout, or know whether the hotel staff or other hotel guests included vulnerable populations such as pregnant women or children.
Despite reports from individuals and State regulatory authorities that patients are choosing to recover from treatment with radioactive iodine in hotels, unwittingly exposing members of the public to radiation, the NRC has consistently refused to ban or limit this practice, and indeed, has never even issued guidance in this area to its licensees. Though NRC is aware that its regulations permit the release of patients to hotels, NRC’s Office of General Counsel actually denied this was the case in a brief submitted to a Federal Court in opposition to a citizen petition that was attempting to compel NRC to strengthen its regulations.
REPORT RECOMMENDATIONS:
1) The NRC should immediately commence a rulemaking to return to its pre-1997, dose based regulations surrounding the treatment of patients with radionuclides, and ensure that its regulations are made to be consistent with the International Commission on Radiological Protection (ICRP). Hospitalization should be mandatory for those patients who are treated with doses of I-131 above internationally accepted threshold limits.
2) Patients should be prohibited from recovering from such treatments in hotels, and specific written and verbal guidance in opposition to hotel release should be provided both to medical licensees and to patients.
3) The NRC should immediately commence a rulemaking to determine whether its current regulations for safe radiation exposure levels adequately, and in a manner consistent with international standards, protect the most vulnerable populations – pregnant women and children – and make revisions where necessary.
4) The NRC should aggressively enhance its oversight of medical licensees to better identify, track and respond to potential regulatory violations, including its oversight of such activities by Agreement States.
5) The NRC’s Inspector General should investigate, and NRC should then take all appropriate action, regarding conflicting statements made by its Office of General Counsel (OGC) as to whether NRC regulations permit the release of patients to hotels. These include OGC’s April 2008 concurrence with an NRC document that provided assistance to a regional office, which stated that “release to a hotel was not prohibited by the regulations,’ and the conflicting statement made by OGC in a legal brief submitted to the U.S. Court of Appeals for the Ninth Circuit on November 4, 2008, which inaccurately states that “NRC’s rule does not permit or encourage doctors to send treated patients to hotels.”
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