Capturing Radioactive Waste Before It Leaves The Hospital

Objectives To identify that radioactivity is continually being released from hospitals from patients that have undergone diagnostic and therapeutic nuclear medicine procedures.

Methods Scintillation radiation portal monitors were installed at the egress points where general waste and biohazardous waste exits the nine Cleveland Clinic hospitals in the greater Cleveland area. The environmental services staff at each hospital underwent training on natural background sources of radiation, sources of radiation in the hospital, potential effects of radiation and available methods to reduce exposure. Specific training on the portal monitors, developing a weekly QA program, developing forms for logging the triggered waste and the development of policies unique for each site were part of the program.

Results The nuclear medicine departments and the hospital sizes vary greatly within the health system from a single camera department to a broad scope licensee with multiple nuclear medicine and PET cameras. Radioactive waste has routinely been found in varying forms at all of the hospitals. A non-inclusive list of items triggering the detectors included: disposable gloves, syringes, IV tubing, urinary catheters, diapers, absorbent paper, adhesive bandages, bedpans and urinals. The recordkeeping of the weekly QA program and the logs of each in-house triggering were maintained and data was collected.

Conclusions Neither the Ohio EPA nor the Department of Health requires licensees to monitor general and biohazardous waste leaving their facilities. The waste triggering the portal monitors were found to originate from areas within the hospital, primarily nursing floors. The same State Departments also don’t require the waste haulers to install radiation monitors at the landfills, transfer stations and incinerators. Although that is the case, many do have these installed because of corporate policy and tack on a surcharge to the licensee if their detectors should trigger. Within less than a year the investment in the portal monitors has reduced the triggering of alarms outside the hospitals by over 80%. It is expected that because of the staggered installations, trainings and development of good practices that this value will only improve.