Is nuclear medicine staffs’ perception of risk following a 500 mSv skin dose incident from a Tc-99m source or a Ra-223 source correct?

OBJECTIVES: To gauge the views of UK nuclear medicine staff on a skin contamination incident of 500 mSv from Tc-99m and Ra-223 (an alpha source). METHODS: An anonymous questionnaire asked staff their concerns on anxiety, erythema, and skin cancer. Also, aspects of removal from open-source work. The same question set was used for Tc-99m and Ra-223. RESULTS: Replies were grouped as 37 RPAs, 121 other physicists, 78 technologists/radiographers, and 31 radiopharmacy staff. Scores encompassed 1-10 for all staff groups for questions on 'anxiety', 'erythema', and 'skin cancer'. However all staff groups scored significantly higher for Ra-223 than for Tc-99m. The majority of staff in all groups expected to be removed from open-source work, with timescales up to a year. Many staff indicated they would prefer not to be taken out of work (56% for a Tc-99m incident and 47% for a Ra-223 incident). But, a high proportion of staff wanted to have significant time off (≥3 months). CONCLUSION: In practice, there is no risk of erythema and the skin cancer risk is extremely low. This applies to Tc-99m and to Ra-223. Also, the IRR2017 allow for someone who receives an overexposure to continue to work, with modified dose limits and agreement from the appointed doctor. All staff groups need to have a clearer understanding of the risks and implications of receiving this level of skin dose. The high anxiety levels indicate that return to work needs careful communication that it is because of low risks and within the legal framework.