Joint Commission Warns About Diagnostic Radiation Dangers

A new Joint Commission Sentinel Event Alert warns that health care organizations must seek new ways to reduce exposure to repeated doses of harmful radiation from diagnostic procedures. The Alert urges greater attention to the risk of long-term damage and cumulative harm that can occur if a patient is given repeated doses of diagnostic radiation.


Over the past two decades, the U.S. population’s total exposure to ionizing radiation has nearly doubled with the increased use of diagnostic imaging in hospitals, imaging centers, physician and dental offices. Any physician can order radiologic tests at any frequency with no knowledge of when the patient was last irradiated or how much radiation the patient received. Several recent studies have raised concerns about the risk of cancer from diagnostic imaging, especially in vulnerable populations such as children, young adults and pregnant women.

“Diagnostic imaging is a necessary medical tool, but it must be used with great care,” says Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., president, The Joint Commission. “Although there is still debate about how much is too much radiation, and the timeframe within which radiation can be safely administered, the recommendations in this Alert give health care organizations practical strategies to make sure that patients get the right diagnostic imaging tests with the lowest dose of radiation needed to make a diagnosis. In addition, The Joint Commission’s standards support the use of safe and effective diagnostic radiation and promote a safety culture, which is necessary for the safe use of diagnostic radiation.”

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Radiation Patient Safety Addressed in New York Times Letter

“W. Virginia Hospital Overradiated Brain Scan Patients, Records Show” (news article, March 6) again highlights issues of concern regarding radiation safety for patients. The American College of Radiology has always been a leader in developing programs to ensure quality and patient safety.

As chairman of the A.C.R. board of chancellors, I am pleased to report that as an element of its broad registry program, the college has developed a CT dose index registry that facilitates direct reporting of CT radiation dose for each examination to a central database, while preserving legally required patient confidentiality.This registry permits facilities to compare dose levels to national benchmarks, helps standardize the dose reporting process, and may potentially alert a facility when a threshold dose has been exceeded.

The college agrees that a requirement for dose reporting should be an integral component of safe medical practice, and we are working with federal legislators and regulators to create a national policy that would mandate such reporting. 

John A. Patti
Boston, March 9, 2011
The writer is a radiologist at Massachusetts General Hospital.