Doctors do a lot of x-rays on children. Is there a risk to that, or are x-rays completely safe? The answer, for chest, bone, and abdominal x-rays, is that they are very, very, very safe, but not totally risk-free. All of us are constantly exposed to radiation similar to x-rays. It comes primarily from naturally-occurring radioactive things around us, such as radon gas seeping up through the ground, or from outer space in the form of cosmic rays. People living at higher altitudes receive higher doses of such background radiation, amounting to about half again as much for someone living on the Colorado plateau compared with someone at sea level. To put things in perspective, the radiation dose in a single chest x-ray, on average, is similar to the background radiation most of us receive during a ten day time span living our normal lives.
There are several important things to remember about radiation risks. High radiation doses definitely cause death and disease (primarily cancer); the atomic bomb and the disaster at Chernobyl clearly showed this. A second key point is that radiation risk is cumulative over a lifetime. This is an important consideration for children, since they have most of their life ahead of them. Children are also more sensitive to the effects of x-rays than are adults. Still, it is logical to think of routine chest, arm and leg, and abdominal x-rays as being virtually without risk unless the child has already gotten for some reason a large radiation dose in the past.
Computed tomographic scans, CT scans, are another form of x-rays. We most commonly use CT scans to look at a child’s head, chest, or abdomen. The technology produces good images of the organs inside those body regions, and CT scanning has revolutionized how medicine and surgery are practiced. But CT must be used judiciously, particularly in children, because it subjects the child to much more radiation than does a simple chest or abdomen x-ray–200 to 300 times more, depending upon the particular technique used. So if a chest x-ray is the equivalent of ten days of background radiation exposure, a child getting a CT scan receives the same radiation dose as anywhere from five to ten years of normal living. I’ve written more about CT scan risk here.
The future cancer risk to a child from a single CT scan is still vanishingly small, and the benefits of getting the information the CT provides nearly always outweigh this tiny risk. However, this may not be the case for children who get many CT scans or have been exposed to other radiation in the past. Fortunately, this represents a relatively small number of children. There are ways of using reduced radiation doses in children, compared to the doses adults receive for CT. If you are concerned about this issue, ask your child’s doctor about it, or you can read more about it here.
I’ve also posted here about what medical risk means.
10/02/2010 • I've been doing this blog for three years, and by far the post that has provoked the most interest is this one, about the safety of x-rays. The comments, now at 102, keep steadily coming. ...more
07/03/2008 • Critically ill or injured children often develop their problems far from where they need to be in order to get the care they need. A common scenario is for a child to be brought initially ...more
05/12/2011 • Critically ill or injured children often develop their problems far from where they need to be in order to get the care they need. A common scenario is for a child to be brought initially ...more
- CT scans and cancer: thinking about the meaning of risk | Christopher Johnson M.D. PICU Author
- Reducing radiation exposure in x-rays for children: the Image Gently program | Christopher Johnson M.D. PICU Author
08/19/2013 • Many, myself included, have written about the overuse of head computed tomography (CT) scanning in children. This concern has become more focused now that we have some data on the radiation risk of those scans. ...more
06/08/2013 • I've written before about the increased risk for future cancer, if any, of diagnostic radiation (here , here, and here). These posts have generated a large number of comments and questions from parents. Most take ...more
10/05/2012 • The sinuses are air-filled cavities in our skulls. They are important for a couple of reasons. For one thing, they help warm and humidify the air we breathe in through our nose. For another thing, ...more
08/22/2011 • Nearly everyone has heard about the medical malpractice controversy. Most doctors call it a crisis, saying, among other things, that physicians are retiring early because of it or altering their practice -- not taking on ...more