Last year state lawmakers combined two environmental agencies -- one that handled radiation control and one that oversaw solid and hazardous waste disposal. Now some medical professionals in Utah fear the move puts patients at risk.
Their concerns came into focus last month, after a new state board praised a special advisory panel for its suggestions on regulating underground fuel tanks.
The year-old Radiation Control and Waste Management Board itself gives advice on state regulations. Most members of the 12-person panel are experts on waste -- everything from household garbage to nuclear-plant rubbish.
Next on their September agenda they considered medical technology, a company’s request for an exception to state radiation rules.
“The unit is for superficial treatment of skin cancers and keloids,” a staff aide explained, inviting a company representative to the mic to explain the request.
The variance would allow a Provo dermatologist to use a radiation-therapy device without the required state certification. Kal Fishman, who works for the device maker, Sensus Healthcare, Inc., said his company has rigorous training programs and approval from 40 states and the FDA.
“We have about eight interlocked safety mechanisms that would not allow the user to operate and treat patients if there’s the slightest deviation from the safety protocol,” he reassured the board.
But a critic stepped forward from the audience. Karen Langley, who supervises radiation safety at the University of Utah, urged the panel to take more time and expert input before deciding.
“Bottom line,” she said slowly, “this is radiation therapy.”
Langley used to lead Utah’s Radiation Control Board, which was eliminated when the agencies merged. She told Waste Board members the National Association of Radiation Control Officers has a task force on the very question they were considering.
The board also heard the concerns of Jeremy Hawk, a hospital radiation safety officer and the only Waste Board member who uses radiation in medical settings. “Given the potential output of these machines,” he said during the board discussion, “it warrants a closer look here locally by people who are locally affected.”
Hawk voted “no,” but the rest of the Waste Board voted “yes” to a temporary exemption. It was a move the Ohio Department of Health rejected two years ago as a risk to public health and safety.
It was also the kind of question that could have been handled by an expert advisory committee, the one the medical community pushed for when lawmakers combined the agencies last year. But the committee’s never been appointed, and it might never be.
Utah has thousands of machines that use radiation for x-rays, MRI’s and radiation therapy for cancer. Just two staffers – a veterinarian and an X-ray technician -- oversee them all and the people use them. Budget cuts axed two other radiation staffers last year. But Director Scott Anderson remains confident in his Division of Radiation Control and Waste Management.
“We have a very capable staff,” he says. “They’re very experienced, but we’re smart enough to know that there are other people out there that have expertise that we don’t -- and we know who to talk to.”
Anderson sees no need for the outside advisory committee. In fact, he says agency attorneys dispute the legal authority for it.
“Whether or not people disagree with the way we gather input,” he adds, “the rule is illegal. Story over. End of debate.”
The Waste Board is now reviewing Anderson’s recommendation to scrap the medical advisory committee.
In a University of Utah classroom, Peter Jenkins is telling the next generation of nuclear medicine technologists how radiation particles damage living cells. A diagnostic medical physicist at University Hospital, Jenkins led the Radiation Control Board that created the advisory committee to help the new Waste Board with medical questions.
“The point of the advisory committee,” he says, “was to supplement the review of the division staff and then make that recommendation from subject-matter experts to the board.”
Jenkins says waste division staffers just don’t have the expertise to give advice on how radiation is used in medical settings. The Waste Board doesn’t either. And he says that puts Utahns at risk.
“These rules are meant to protect the patient,” he says.
Jenkins and others in Utah’s health care community are fighting to keep the advisory committee. They’re sharing their concerns during the public comment period that ends October 3rd. And they’re hoping this is advice the Waste Board doesn’t toss out.