A person who died of cancer was cremated with a radioactive substance in his body, spreading potentially dangerous material around the facility, according to a case study published in JAMA.
Two years ago, the 69-year-old patient was taken to a hospital in Arizona where he received a therapeutic radioactive compound known as Lutetium Lu 177 dotatate to treat a cancerous pancreatic tumor.
The next day he was admitted to another hospital for hypotension or low blood pressure, but died of cancer two days later.
The medical staff who had initially treated him with radiotherapy was unaware of his unexpected death and the patient was cremated just days after his first hospitalization.
"When the treating physicians and the radiation protection officer learned of the death, the crematorium was informed and an empty cremation chamber survey and equipment was performed one month after the treatment. [with a Geiger counter], Wrote the authors of the study.
Tests on the cremation equipment (furnace, vacuum filter and bone grinder) allowed the detection of radiation, still relatively low, mainly from the lutenum Lu 177, substance used to treat the patient. This is the first time that such a case is documented.
"Although other case reports have described potential safety issues after cremation of patients treated with radiopharmaceuticals, contamination of facilities has not, to our knowledge, been observed," wrote the authors. authors.
Fortunately, the urine samples taken from the crematorium operator showed no evidence of luetium Lu 177. However, scientists found traces of another radioactive compound used as a therapy, the technetium Tc 99m, which the crematorium operator declared never having received before. a medical procedure.
This discovery led researchers to believe that the operator may have been exposed to the unexpected substance during the cremation of another set of human remains.
The Lu 177 lutetium levels detected in the crematorium and 99m Tc in the urine sample are sufficiently low that it is unlikely that they posed any problem to any of the workers in the urine sample. the installation, the researchers said. However, the case study highlights what could be a prevalent – and apparently under-investigated – health and safety problem, with 18.6 million nuclear medicine procedures performed in the United States each year.
"Further studies are needed to assess the frequency and extent of radioactive contamination and the health effects of repeated or long-term exposure of crematorium employees in the United States, from the United States. as much as the cremation rate was over 50% in 2017, "write the authors. .
According to the researchers, monitoring the movement of radioactive compounds among deceased people is made more difficult by the fact that laws and standards differ from state to state.
"Arizona has no regulations regarding the information of the crematoriums of deceased patients who have received a radiopharmaceutical," they said. "In contrast, Florida requires that no other material, including radionuclides other than human remains, be incinerated."
To try to reduce the risks of situations such as that described in the last study, the researchers make a number of recommendations.
"Future safety protocols for radiopharmaceuticals should include post-mortem management, such as assessing the radioactivity of patients who died before cremation and standardizing crematoria notification," the study authors said.
In the comments provided to NewsweekKevin Nelson, author of the Mayo Clinic Arizona study, said: "Although we believe the risk is low, the risk of radiation is additive and measures must be put in place to minimize unnecessary exposure to radiation. public. "
This article has been updated to include Kevin Nelson's comments.