Do not underestimate the health risk of X-rays



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Imminent health risks from X-ray examinations

In light of a recent study by US researchers that found an increased risk of benign brain tumors through frequent X-ray examinations at the dentist, the discussion about the negative health effects of X-rays has flared up again.

X-ray offers a reliable method of diagnosis for many possible diseases, but the associated radiation exposure always brings with it a health risk. Therefore, X-ray examinations should only be used sparingly and carefully. But apparently some doctors tend to have more x-rays because of their own interests. The necessary machines are expensive and ultimately have to pay for themselves, so that an X-ray is often taken too much rather than too little.

The US researchers led by Elizabeth Claus from Brigham and Women’s Hospital in Boston and the University of Yale recently reported in the specialist magazine “Cancer” that there is a significantly increased risk of benign brain tumors through X-ray examinations at the dentist. The presented study not only shows that patients who have had their dentists x-rayed at least once or more annually were at three times the risk of a meningioma (a special benign brain tumor), but also that despite the known health risks, the x-ray examinations are apparently handled quite generously . However, according to the US researchers, the risks should not be underestimated. Children under the age of ten are particularly sensitive, which has led to a five times higher risk of meningioma due to the dental X-ray examination, Claus and colleagues report. Dental X-ray examinations play an essential role here as the most common sources of radiation exposure for people in modern industrial countries. The current results of the study make it clear that X-rays in dentist patients should in future be kept to an absolutely necessary minimum, write the US researchers, indirectly expressing that X-ray examinations have so far been handled far too generously.

The US scientists investigated the relationship between the development of benign brain tumors and dental X-rays using 1,433 meningioma patients and 1,350 healthy subjects in the control group. All participants stated how many dental X-ray examinations were carried out on them, whereby three different X-ray methods were taken into account: the so-called oral film recordings (patients bite on a piece of film), the lateral jaw recordings and the so-called Panorex recordings (X-ray cannon rotates once around the head). The US scientists then evaluated the data to determine possible connections with the formation of brain tumors. All three X-ray methods caused a significantly increased risk of benign brain tumors, according to the US researchers. The effect was strongest with the Panorex images, which led to a three to five times higher meningioma risk, write Claus and colleagues. Although X-rays “can be an important diagnostic tool, most patients benefit from more reluctance,” the US scientists concluded.

Under certain circumstances, German doctors should take this note to heart and in the future exercise more caution when it comes to X-rays. Statistically speaking, every German is x-rayed at least once a year. Doctors in Germany pay about 100 million X-ray examinations every year, although critical experts believe that not every one of these examinations would be necessary. The German Roentgen Society in Berlin comes to the conclusion that the number of X-ray examinations and computed tomography is correspondingly high due to the so-called self-referrals. With this, the radiologists of the medical society founded in 1905 refer to the possibility of different specialists to carry out their own X-ray examinations. Professor Norbert Hosten of the German X-ray Society explained that "for example specialists who deal with bone diseases can acquire the authorization to x-ray certain parts of the body." The specialists are "then sub-area radiologists", continued Hosten.

As part of the self-referral, the doctors can then send patients to their own X-ray department and have them examined there. This is a problem inasmuch as no second opinion is obtained, according to the expert from the German X-ray Society. Prof. Hosten explained: "If an X-ray examination is usually used, there is the four-eyes principle", but in the case of self-referrals, there is no control by coordination between the doctor and the radiologist. The coordination is necessary to ensure that the x-ray also enables a targeted diagnosis, emphasized Prof. Hosten. If this is not guaranteed, a radiologist would point this out in consultation with the doctor and recommend a gentler procedure, such as ultrasound, according to the expert. Consumer advocates also urge caution when making self-referrals, since the need for X-rays is not always clarified here. For example, Kai Vogel from the consumer advice center told “Welt Online” that especially privately insured people should be on guard here, as the reason for the X-ray examination may be a purely financial interest of the doctor. "The device has been purchased, then it should also be used," the consumer advocate describes the problem.

The risks of X-rays and computed tomography (CT) are often underestimated on the part of the patients, since the examination does not have any immediate health consequences. Because health complaints “actually only occur at very high doses of radiation”, which “are not to be expected in normal examinations of the skeleton or teeth,” explained Prof. Radiation exposure, which can cause reddening of the skin or even the destruction of skin tissue and hair loss normally only achieved when radiation is used for therapy. However, even the lower radiation levels can already lead to tissue changes, as the study by the US researchers currently points out. The X-rays "can cause cancer, and that is independent of the dose," emphasized the expert from the German X-ray Society. A single hit of an X-ray beam may be enough to permanently damage the genetic material of a body cell. Tissue with rapidly dividing cells, such as the "intestinal mucosa, gums or bone marrow, where the white blood cells renew themselves regularly in a short time," is particularly at risk, explains Prof. However, the risk of developing a tumor after a simple X-ray examination , relatively low, since the radiation dose of modern devices is extremely low, according to the X-ray expert.

However, the number of X-ray examinations increases the risk of tissue changes. Therefore, the X-rays must be carried out carefully and it is "important that examinations are not repeated unnecessarily," emphasized Professor Gunnar Brix from the Federal Office for Radiation Protection (BfS). Here, those affected are encouraged to take the initiative, because avoiding double examinations "patients can also pay attention themselves", the BfS expert continues. The growing number of CT screening examinations is particularly a thorn in Professor Brix's side, since here the organism is exposed to considerable radiation levels, in some cases without any proven benefit. This applies in particular to examinations of the heart, in which very high radiation exposure can occur, explained Prof. Brix and added that, moreover, "in many examinations, which are often called Manager check are offered, the benefits have not been demonstrated ”. "You shouldn't let something like this be done," warned the expert from the Federal Office for Radiation Protection. Overall, in view of the current study results of the US researchers, patients and medical professionals are encouraged to take a much more critical look at the X-ray examinations in the future and to do without the X-ray in case of doubt. (fp)

Also read:
X-ray German doctors too often?

Image: Rainer Sturm / pixelio.de

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