Problems of management of patient biological waste in radionuclide diagnostics
L. A. Chipiga,
S. A. Ryzhov,
A. V. Vodovatov,
I. A. Zvonova,
A. V. Petryakova,
A. A. Stanzhevsky,
K. D. Kiselev,
I. V. Glotova https://doi.org/10.21514/1998-426X-2024-17-3-29-38
Abstract
Biological excretion from patients (urine) generated during radionuclide diagnostics enters directly into the hospital sewage system. The establishment of new clearance level according to Resolution of the Government of the Russian Federation No. 1069 of October 19, 2012 may entail amendments to regulatory documents for radionuclide diagnostics departments. One of these requirements is a mandatory dedicated sewage system. Establishment of the requirement may lead to an increase the cost of the radionuclide diagnostic examinations, and to a decrease the accessibility of radionuclide diagnostic. The aim of this study was to estimate the activity of radionuclides in patient urine after radionuclide diagnostic and activity concentration in sewage water in the hospital and in the transport tank of toilet for evaluation of paths of waste manage. Based on published literature data, models of biological excretion were constructed for the following radiopharmaceuticals: 99mTc-pyrophosphate, 64Cu-Labeled Monoclonal Antibody, 18F-FDG, 68Ga-PSMA-617. The activity of radionuclides in the patient waste in the hospital and in public transport during the patient transportation to home was calculated. Various scenarios of patient transportation were considered. The values of the excreted activity, activity concentration and dose rate at 1 m from the tank with sewage water for each type of transport were calculated. The calculated values of the radionuclide activity concentration in sewage water in transport tank of toilet for the majority scenarios exceed the clearance level (up to 180 times for 68Ga-PSMA-617 when traveling by bus). According the regulatory requirements, it is necessary to collect patient excretions after radionuclide diagnostic examinations and hold it for decay. However, estimated effective doses of individuals from the public from contact with biological patient waste do not exceed the acceptable value. This is due to the short half-life of diagnostic radionuclides. The paths of management system of biological patient waste were proposed.
Keywords
radionuclide diagnostic,
patient,
biological waste,
public exposure,
clearance level,
radiation safety
Supporting agencies: The work was performed as a part of the program of Federal Service for Surveillance on Consumer Rights Protection and Human Well-Being «Development and scientific justification of a set of measures to ensure radiation protection in nuclear medicine» and within the framework of the research works «Scientific development of medical technological and organizational aspects of radiation safety in the provision of medical care» (No. EGISU: №123031500006-9) and «Development of personalized methods of radionuclide diagnostics and therapy of children and radiological control including using artificial intelligence technologies» (No. EGISU: 124021200036-9).
About the Authors
L. A. Chipiga
Saint Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing; A. Granov Russian Scientific Center of Radiology and Surgical Technologies of the Ministry of Health of the Russian Federation; Almazov National Medical Research Centre of the Ministry of Health of the Russian Federation; Association of Medical Physicists of Russia
Russian Federation
Russian Federation
Larisa A. Chipiga - Candidate of Engineering Sciences, research fellow, Saint Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Federal Service for Surveillance on Consumer Rights Protection and Human Well-Being; research fellow, A.M. Granov Russian Scientific Center of Radiology and Surgical Technologies of the Ministry of Health of the Russian Federation; docent, Almazov National Medical Research Centre of the Ministry of Health of the Russian Federation.
Mira Str., 8, Saint Petersburg, 197101
S. A. Ryzhov
Association of Medical Physicists of Russia; Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of the Ministry of Health of the Russian Federation; Research and Practical Clinical Centre of Diagnostics and Telemedicine Technologies of Moscow Healthcare Department
Russian Federation
Russian Federation
Sergey A. Ryzhov – vice-president, Association of Medical Physicists in Russia; research fellow, Research and Practice Center of Diagnostics and Telemedicine Technologies; head of the radiation safety and medical physics department, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of the Ministry of Health of the Russian Federation.
Moscow
A. V. Vodovatov
Saint Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing; Saint Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
Aleksandr V. Vodovatov - Candidate of Biological Sciences, Head of Laboratory, Saint Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Federal Service for Surveillance on Consumer Rights Protection and Human WellBeing; docent, Saint Petersburg State Pediatric Medical University.
Saint Petersburg
I. A. Zvonova
Saint Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing
Russian Federation
Russian Federation
Irina A. Zvonova - Doctor of Technical Sciences, Chief Researcher of Protection Laboratory, Saint Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Federal Service for Surveillance on Consumer Rights Protection and Human Well-Being.
Saint Petersburg
A. V. Petryakova
Saint Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing; The City Hospital No 40 of the Kurortny District
Russian Federation
Russian Federation
Anastasia V. Petryakova - acting junior researcher, Saint Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing; radiation safety engineer, Saint Petersburg City Hospital No. 40.
Saint Petersburg
A. A. Stanzhevsky
A. Granov Russian Scientific Center of Radiology and Surgical Technologies of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Andrey A. Stanzhevsky - M.D., Deputy Director for Research, A.M. Granov Russian Scientific Center of Radiology and Surgical Technologies of the Ministry of Health of the Russian Federation.
Saint Petersburg
K. D. Kiselev
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of the Ministry of Health of the Russian Federation; National Research Nuclear University «MEPhI», Ministry of Science and Higher Education of the Russian Federation
Russian Federation
Russian Federation
Kirill K. Kiselev - employee of the radiation safety and medical physics department, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of the Ministry of Health of the Russian Federation; student of the Institute for physics and engineering in biomedicine of National research nuclear university МЕРҺІ, Ministry of Science and Higher Education of the Russian Federation.
Moscow
I. V. Glotova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of the Ministry of Health of the Russian Federation; National Research Nuclear University «MEPhI», Ministry of Science and Higher Education of the Russian Federation
Russian Federation
Russian Federation
Irina V. Glotova - employee of the radiation safety and medical physics department, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of the Ministry of Health of the Russian Federation; student of the Institute for physics and engineering in biomedicine of National research nuclear university МЕРҺІ, Ministry of Science and Higher Education of the Russian Federation.
Moscow
References
1. IAEA-TECDOC-1183. Management of radioactive waste from the use of radionuclides in medicine. IAEA: Vienna; 2000. 83 p.
2. Chipiga LA, Vodovatov AV, Zvonova IA, Stanzhevsky AA, Petryakova AV, Anokina EE, et al. Management of biological waste of patients after radionuclide therapy. Radiatsionnaya Gygiena = Radiation Hygiene. 2022; 15(2): 19-30. (In Russian). DOI: 10.21514/1998-426X-2022-15-2-19-30.
3. Chipiga LA, Vodovatov AV, Petryakova AV, Zvonova IA, Stanzhevsky AA, Maistrenko DN, et al. Justification of differential approach to management of patient biological waste in nuclear medicine departments. Radiatsionnaya Gygiena = Radiation Hygiene. 2022; 15(4): 34-44. (In Russian). DOI: 10.21514/1998-426X-2022-15-4-34-44.
4. Official website of the International Medical Center «URO-PRO» Sochi. Available from: https://sochi.upclinic.ru/information/urologiya-seksologi-ya/rasstroystva-mocheispuskaniya-/ (Accessed: 11.06.2024).
5. International Commission on Radiological Protection. Radiation Dose to Patients from Radiopharmaceuticals: A Compendium of Current Information Related to Frequently Used Substances. ICRP Publication 128. Annals of the ICRP; 2015;44(2S).
6. International Commission on Radiological Protection. Nuclear Decay Data for Dosimetric Calculations. ICRP Publication 107. Annals of the ICRP; 2008;38 (3).
7. Dowd MT, Chen CT, Wendel MJ, et al. Radiation dose to the bladder wall from 2-[18F] fluoro-2-deoxy-D-glucose in adult humans. Journal of Nuclear Medicine. 1991;32(4): 707-712. Chen CT, Harper PV, Lathrop KA. A simple dynamic model for calculating radiation absorbed dose to the bladder wall. 4th International Radiopharmaceutical Dosimetry Symposium; 1985:587-612.
8. Kurth J, Krause BJ, Schwarzenbo"ck SM, Stegger L, Schafers M, Rahbar K. External radiation exposure, excretion, and effective half-life in 177Lu-PSMA-targeted therapies. European Journal of Nuclear Medicine and Molecular Imaging research. 2018;8(1): 1-11. DOI: 10.1186/s13550018-0386-4.
9. Petryakova AV, Chipiga LA, Zvonova IA, Vodovatov AV, Gorsky GA, Stanzhevsky AA. Radiation safety problems during the patient traveling by public transport after radiopharmaceutical therapy with 1311. Radiatsionnaya Gygiena = Radiation Hygiene. 2024; 17(2): 97-108. (In Russian). DOI: 10.21514/1998-426X-2023-17-2-97-108.
Review
For citations:
Chipiga L.A., Ryzhov S.A., Vodovatov A.V., Zvonova I.A., Petryakova A.V., Stanzhevsky A.A., Kiselev K.D., Glotova I.V. Problems of management of patient biological waste in radionuclide diagnostics. Radiatsionnaya Gygiena = Radiation Hygiene. 2024;17(3):29-38. (In Russ.) https://doi.org/10.21514/1998-426X-2024-17-3-29-38
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