WHO April 2016

When Dr Michael Kawooya, a radiologist at Mengo Hospital in Kampala, Uganda, performs an ultrasonography on pregnant patients he’s often asked, “Doctor, is this dangerous?”

His answer is always “No”.

“Ultrasonographies do not use ionizing radiation, so they aren’t dangerous,” says Dr Kawooya, who is also Director of Ernest Cook Ultrasound Research and Education Institute in Kampala.

Yet many of the procedures his patients do have or ask for, including X-rays, CT-scans and fluoroscopy-guided interventions, do use ionizing radiation. These have the potential to cause cancer and skin injuries, particularly in children. Many referrers, patients and caregivers are unaware of these risks.

“Often patients think that an X-ray is part of a cure without any knowledge of the risks involved,” explains Dr Kawooya. “This is our opportunity to educate them.”

Improving radiation safety

Worldwide, an estimated 3.6 billion diagnostic medical examinations, such as X-rays, are performed every year. This number continues to grow as more people access medical care. About 350 million of these are performed on children under 15 years of age. Using radiation in medical imaging can save lives and prevent the need for more invasive procedures, but inappropriate use may lead to unnecessary and unintended radiation doses for patients. Because children are smaller and have a longer lifespan than adults their risk of developing radiation-induced effects is greater.

“If patients and families are not properly informed about the risks and benefits of an imaging procedure, they may make choices that are more harmful rather than beneficial to their health, such as refusing a CT that is needed or demanding a CT that is not justified,” says Dr Maria del Rosario Perez, a scientist with WHO’s Department of Public Health.

To improve safety WHO launched a Global Initiative on Radiation Safety in Health Care Settings in 2008 with the aim to mobilize the health sector towards safe and effective use of radiation in medicine.

One key priority is to improve the communication of radiation risk in paediatric imaging to ensure an effective and balanced benefit-risk dialogue between health care providers, families and patients.

A new WHO publication, “Communicating radiation risks in paediatric imaging”, helps health-care providers communicate known or potential radiation risks associated with paediatric imaging procedures. The document provides several approaches to help medical professionals answer questions, like “How much radiation will my child receive?” and “How much medical radiation is too much?”

See: http://www.who.int/features/2016/to-xray-or-not-to-xray/en/

Figure: Miss Elizabeth Nabunya Kawooya