New Study Shows Dangers of Cremating the Radioactive Dead
Each year, millions of people are treated with radioactive compounds called radiopharmaceuticals for a variety of conditions and illnesses. In 2017, a new study reports, one such person – a 69-year-old Arizona man – was treated with lutetium Lu 177 dotatate for a pancreatic tumor. Three days later, he died of his disease at another hospital – unbeknownst to the physicians at the initial treatment facility – and was cremated two days later: five days after receiving the radiopharmaceutical.
Upon becoming aware of the patient's death, doctors and a radiation safety officer at the original hospital notified the crematorium of the possibility of radioactive contamination. The crematorium ordered a radiation survey of its equipment – which was executed a month after the deceased patient's last treatment – and a urinalysis for the attendant. Low levels of radiation were detected in equipment. "This wasn't like the second-coming of Chernobyl or Fukushima," said Kevin Nelson, a Mayo Clinic radiation safety officer, in an interview with The Verge, "but it was higher than you would anticipate." This was the first documented case of radiation contamination in a crematorium facility.
Most interesting, however, was the urinalysis result from the attendant. Although no lutetium was detected in the sample, a different radiopharmaceutical – technetium Tc 99m – was found. "Given the contamination from this unexpected radioisotope," the researchers wrote, "it is plausible that the crematory operator was exposed to volatilized technetium Tc 99m while cremating other human remains." This points to a greater problem: radiation exposure through cadavers in crematoriums – and conceivably mortuaries and funeral facilities – that goes either unreported or undetected. The problem is additionally complicated by the fact that pharmaceutical companies don't have any safety literature relating to deceased patients who've been exposed to radioactive drugs. To further muddy the waters, there is currently no federal legislation regarding guidelines for handling the bodies of deceased patients who've received radioactive isotopes in a clinical setting. It's just one of those things that no one has noticed... until now.
Although the Smithsonian Institute reports that over half of Americans now opt for funerary cremation, it's important to note that the amount of radioactive material that would leave a facility during a radiopharmaceutical-treated cremation is nearly negligible. The amount that workers are exposed to is also quite small, though the cumulative effects of exposure to radioactive isotopes should be considered. The disconnects due to a lack of regulation and illustrated by the Arizona case make communication a necessity to at least allow facilities to make informed decisions regarding employee safety when it comes to handling such cases. "I don't think this is an issue that may entail any risk of cancer or other radiation-induced illnesses," Dr. Paolo Boffetta of New York's Icahn School of Medicine at Mount Sinai told UPI. "Having said that, it's clear it's a possible source of exposure, and if someone is exposed regularly, every week or every few days, then it may become a source of concern. There is a need for a notification process to be put into place." It's unclear, however, where the onus of responsibility lies. Should grieving families bear the additional burden of having to track down the specifics of the medical technology used to treat their loved ones? Can hospital bureaucracies be expected to manage a new layer of information flow when patients die? If regulation is the answer, how will it be enforced? These are all questions to consider.
Those with their loved one's ashes needn't necessarily worry, however. "It's a small amount of radiation," Nelson assured UPI, "and I would wager the urn the ashes are in is probably going to block most of the emissions."