Are x-rays completely safe?
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.
September 10th, 2008 at 6:26 pm
My son is tree years old.Two weeks ago he had 7 pictures x_ray to both arm.I am worried that what kind of risk he has now.The radyolojist said there is no harmful effect to my child.is it right?
September 10th, 2008 at 7:32 pm
Thanks for your question.
I think what the radiologist told you is correct. Seven simple x-rays would carry essentially no risk to your child. That amount of radiation is in the ballpark of the amount of background radiation that your child would get in a month of two of normal living. (This background radiation comes from both naturally occurring materials in the earth and from the cosmic rays that strike everywhere on the earth from outer space.)
October 25th, 2008 at 2:04 am
My son, 5 years old, has had 2 abdominal x-rays in the past 3 months - the first about 3 months ago and the second one about a month ago. Is it safe to have another one in the near future? He is diagnosed with psychogenic constipation and we want another abdominal x-ray soon to see how much his colon has cleared since the last abdominal x-ray. Thank you.
October 25th, 2008 at 7:39 am
Alice:
Yes, I think that would be safe. As with any test, we weigh the risk of the test, which in your son’s case is very, very tiny, against the usefulness of the information the test will give us, which for your son is quite useful.
My own son was in a similar situation–we needed a series of abdominal x-rays to see what was happening when a steel ball he ate got stuck for a while in his intestines.
November 3rd, 2008 at 7:21 pm
This winter my 17 month old son has had pnemonia, a chest infection, hospitalised for viral wheeze and more recently another chest infection. During this period he had three sets of x ray’s (total of six pictures) in May and June 2008. And has had two more sets (four pictures) in the last 8 days. The doctor has requested another set be taken at the end of November. He is on seretide to try to prevent any more lung or chest infections. I am worried that he is being over exposed with the xrays.
Please can you advise me if I should be worried. Thank you.
November 4th, 2008 at 11:15 am
Lola:
I don’t think you should be worried. I think this is a good example of where the benefit of the information the x-ray will give for your son’s care far outweighs the infinitesimal risk of the chest x-rays.
January 14th, 2009 at 7:21 am
I am curious to know about the effects on kids regarding abdominal xrays and steriliy? Could you comment?
January 14th, 2009 at 10:59 am
Chris:
We do have data about the dose of radiation that can cause sterility. In men, this is at least 350 rads, in woman about 250 rads. A good estimate for the dose to the gonads of an abdominal x-ray is less than 0.01 rad — 35,000 times or more less than that. These figures are for adults. Because of how the biology of reproduction works, I’d expect the risk to children to be much, much less, especially boys.
As I wrote in the post, most information is about future cancer risk of x-rays and the potential effect on developing embryoes in the early stages of pregnancy. It is standard practice to shield the gonads — testicles in boys and ovaries in girls — when doing x-rays if possible. For abdominal x-rays in girls, of course, this isn’t possible because you would be covering up the area you are trying to see on the x-ray.
To me, the most useful data about radiation risk relate to altitude and background radiation. The Colorado Plateau region (where I live), has a much higher dose of cosmic radiation and ground radiation (since it is relatively rich in uranium and radon). Yet there is no difference in fertility or cancer rates there.
Thanks for your question. Here’s a useful link to the site of the highly respected Hospital for Sick Children in Toronto with more information and references.
http://www.motherisk.org/prof/commonDetail.jsp?content_id=208#four
January 31st, 2009 at 11:35 pm
hi christopher
i m very very tense today coz my 6 mnt old had skull xray today and the person there took seven times skull xray.what effects might me there after this?i m just worried about if my daughter might get head cancer in later life coz she has been exposed to rays 7 times.could you please answer me honestly…or what do u reckon?Thanks a lot.
A tensed mum.
February 1st, 2009 at 9:48 am
The normal way we x-ray the skull does involve several separate views, called a “skull series.” What she got sounds like the standard routine. She’ll be fine. As I wrote above, she’s just gotten the equivalent of the normal background radiation we all receive while living a month or so of normal life.
February 1st, 2009 at 9:02 pm
hi christopher
thnx a lot for your answer.
Regards.
March 13th, 2009 at 1:18 pm
Hello…I was needing to ask you a question. I am so terribly worrying about this, to the point that I cannot think about anything else. My son went for a head ct in January. He is 5 years old and weighs about 42 pds. He would not hold still, so the technician ended up scanning him 4 times. The last time (the 4th) he eventually had to hold him still with his hands while another tech came in and ran the machine in back. He said that this was the last time, that he had enough. SO when I came home I began to worry. I got on the internet and what I read was horrifying! Everything it told me was awful, that a child should never have any more than one scan, and about cancer risks and everything. So I got on the phone and called the hospital and talked to the tech that did the scans, I told him where my son was scanned so many times that i was worried about the radiation, and he said to not worry, that there was nothing to worry about, that there are people that come in there and have ct scanned every day for up to five days. And I asked him was the machine turned down to child size.And he said that they have to use a pediatric protocol every time they scan and it sends into the computer. I dont really know what he meant by protocol. I asked around and found out that the guy who did the cts was over the entire radiation department of the hospital, so I thought that maybe being the head of the dept. he prob knew what he was doing.
I asked my sons pediatrician also about all the scans and the radiation, and I dont know if she knew what she was talking about, she said that the amount of radiation he received during each scan was very small. That a chest x ray was more. I know that it says on here that a ct scan equals so many hundred chest x rays, so maybe she was talking about a adult chest x ray. I just worry about the fact he was scanned 4 times. Please help me……
March 14th, 2009 at 9:48 am
Louise:
I think the best way to answer your question is to think a little bit about risk — what it means in practical terms. Consider an event that has a one-in-a-million chance of happening. What if I told you now that thing was, instead of having a one-in-a-million chance, now had a two-in-a-million chance of happening. That’s a 100% increase, a doubling in risk!! But what is its real-life meaning? The real meaning is that something with an infinitesimally tiny chance of happening has changed into . . . something that still has an infinitesimally tiny chance of happening. In practical terms, there is no difference — it hasn’t changed at all.
Let’s think about a practical example — the chances of being hit by lightning. That also is a low risk event. But we know there are some things we can do to make it even lower — for example, don’t climb mountains in the afternoon, don’t play golf in a thunderstorm, and don’t be out in a metal boat during a thunderstorm.
The risks of x-rays are like that. The risks are very low, but there are still things we can do to make them even lower, like using a different technique with CT scans for children. But the very most important thing we can do to reduce risk is to make sure, when we do the CT scan, that the benefit of the information we get from the scan outweighs the tiny risk of doing it. For example, if a child hits his head after a fall from a high place we often really, really need to know if the accident caused any bleeding in his head — the benefit to the child of getting this information far outweighs the tiny risk caused by the radiation itself.
Bottom line — if your doctor wants to do a CT scan on your child, ask what the risks would be of NOT doing the scan, of not having the information the scan will give. Then you can decide. Also understand that very likely your child will have a greater risk of harm driving with you to the CT scanner (from an auto accident) than he will experience from the radiation of the scan.
I hope this is helpful to you. In some ways it’s a really complicated question, but in another way it’s very simple — compare the risk of doing the scan with the risk of not doing it. In your case, assuming there was a good reason for doing them, I wouldn’t worry about the CT scans. Life has many risks, but radiation from CT scans, by comparison, is one of the very tiny ones. Not zero, but very tiny.
March 29th, 2009 at 9:57 pm
Sir,
My daughter is ten years old. Today she had 2 x_ray [one chest and PNS xray]. I am worried that what kind of risk she has now for future. She suffer from Cough and cold problem.
March 30th, 2009 at 1:18 pm
That amount of x-rays should give her no increased risk of future problems from them.
April 2nd, 2009 at 12:06 pm
When I was around 19-20 weeks of pregnancy, I had severe kidney stones. Both my OB/GYN and the urinologist said that I needed an IVP of the abdomen. So, I ended up getting 5 x-rays. I am just worried sick that my baby will develop cancer over their lifetime. Please help.
April 2nd, 2009 at 6:59 pm
Megan — I’m sure your child will be fine. X-rays beyond the first 3 months of pregnancy are quite safe. And the five x-rays for your IVP carry virtually no risk of later cancer for your child.
April 6th, 2009 at 7:08 am
My little boy had a routine cbc and it came back with a blast on it. The doctor and the hematologist looked at it and said it was “not” cancer. I don’t know what to think. I am so worried about it. I had some x-rays when i was pregnant with him and I don’t know if that has something to do with it. What else could the blast mean? Are they for sure that it is not cancer and that I should not worry?
April 6th, 2009 at 8:44 am
Hi Sara:
The key thing here is that a hematologist, a blood expert, looked at the blood cells and said it was OK. Some times the blood smear (the slide the hematologist looked at) can contain what we call “immature” cells that can resemble cancerous blast cells but really are not cancer. If you are still concerned, though, I would just take your son to see the hematologist and recheck the blood test — have another blood smear made. It’s quite easy to do and the simplest way to answer the question for sure.
April 13th, 2009 at 7:44 am
Hi Dr. Johnson,
I’m about 3 weeks pregnant, and on Friday, 04/10 had a chest x ray. My last period was on 03/13 and I ovulated on 03/26, therefore I was 14 days pregnant when I got the chest x ray. I wore two lead aprons during the procedure. Now, I’m very concerned about the potential effects of the x ray on the embryo. Can you advise on the matter? Thank you!
April 13th, 2009 at 11:16 am
Hi Viviana:
You and your child should be fine. First, the exposure to your lower abdomen from a chest x-ray is very, very low because the beam is quite directed at the chest. Second, you were shielded to catch any stray energy, however faint. Third, the radiation from a chest x-ray is itself very low in comparison to other forms of radiologic studies. So I wouldn’t worry. And congratulations!
April 13th, 2009 at 3:35 pm
Thank you, Dr. Johnson! I really appreciate your promt response!
April 23rd, 2009 at 3:43 pm
baby had a ct scan at 9 months because she was not sitting up. at 11 mnths she had a one picture x ray to determine if she had pneumonia and then at 16 months she fell and had a 3 pic x ray of her face.
I am afraid that she develops cancer
April 23rd, 2009 at 3:45 pm
are the three x rays a safe level of exposure? i am so anxious i can not sleep and i am very worried that i should have said no to at least the last one
April 24th, 2009 at 7:37 am
Davina:
I think you’re child will be fine. That amount of radiation doesn’t increase her risk of future cancer significantly.
The important thing to remember is to get x-rays, and especially CT scans, only when they are really needed. For your child, it sounds as if the x-rays were needed. The CT scan of the brain is important for a child who is behind in motor development, facial x-rays are needed if the doctor is worried about broken facial bones after a fall, and many times a chest x-ray is the only way to find out if a child has pneumonia.
April 29th, 2009 at 11:14 am
Hi,
My 2 year old son fell in Jan and broke his leg, the doctor had to do three sets of xrays (4-5 xrays in each set) to find the fracture, they also did 2 pelvic xrays to check his hip. A month later he had 2 chest xrays (including his stomach). That is alot of radiation and I’m so worried now that the xrays might cause something in the future….like cancer, or something. What risks does he face now? Please help me, Thank you so much.
April 29th, 2009 at 11:17 am
Hi again,
I wanted to add also that he is do for dental xrays next week, is that going to be safe on top of all the other xray he recieved earlier this year?? Thank you so much for your help.
April 30th, 2009 at 11:56 am
Hi Tabitha:
Thanks for your questions. The short answer is that I wouldn’t worry about it if it were my son. But it’s also important to think about the long answer — about why I think that’s a true statement. We need to think about the notion of relative risk.
I would be lying if I told you that x-rays of the kind your son had don’t have any risk at all — they do. But here’s the way to think about that risk: that risk is a very, very, very, very small number. Increasing risk from a tiny number, say one-in-a-million, to a larger, but still tiny number, say two-in-a-million, does represent a doubling of risk. But such a mathematical doubling of risk is, in real-life terms, totally meaningless, because the new risk remains very, very, very small. So, in real-life terms, the new risk is no different from the risk before the x-rays.
Now let’s consider your son’s broken leg, still thinking about risk. Quite often we need several x-rays, often taken from different angles, to identify precisely how a leg is broken. We need those films because it determines what we do about the broken bone. Then, we often need some additional x-rays, taken after the broken bone is fixed (either with a cast or, for the worse breaks, with surgery) to make sure the bone edges are where they need to be to heal properly. What would be the risk of not doing the x-rays? The risk — a high one — would be that your son’s leg would not heal properly because the doctor would have no way of knowing if the bone edges are back together correctly. We would be doing things just like the “bone-setters” of centuries ago did them, and our results would be as poor as theirs were. These days we are trading the infinitesimally small risk of the x-rays for the very real, very high risk that your son could be permanently affected if we don’t get his leg to heal right. In real life, that’s a good trade-off of risks.
The same reasoning applies to the pelvic x-rays. Broken legs in a two-year-old may involve the pelvic bones. There’s no way to tell if this is the case without an x-ray. The risk to a growing child of not finding this out at the time of injury is many, many, many times the risk of the x-ray.
Regarding the dental x-rays — properly done, these have a very low radiation exposure. And, since radiation exposure is cumulative over a lifetime, there’s no difference between your son getting them soon after his other x-rays or waiting. So timing here doesn’t matter.
Here’s the bottom line. Simple x-rays do add radiation risk. But it is infinitesimally small risk. A chest x-ray, for example, is the same as about 10 days of just living a normal life and getting hit by the natural radiation around us. What’s the best way to control even this tiny, tiny risk? Just be sensible about doing the x-rays, always weighing the risk of doing them against the risk of not doing them. So if your doctor wants to do an x-ray, ask him or her to explain the need for it to you in those terms — what’s the risk of not doing it? And never do an x-ray just because you (or your doctor) is simply curious.
Every parent naturally wants to avoid doing risky things to their child. But we easily accept the risks of driving them to school, sending them to summer camp, and buying them a bicycle, because in life we always weigh the risks of doing something against the benefits that doing the thing will bring to the child.
It’s a long and windy answer, I know, but I think it’s a good way to think about x-ray risks.
May 1st, 2009 at 5:24 pm
Thank you so much Dr. I have worried and worried about this time and time again. I have spent many sleepless nights worrying about the long term effects his xrays would cause. Altough I’m a natural worrier and I will probably still continue to worry, your answer has given me some peace with it, THANK YOU SO MUCH FOR YOUR TIME…:)
May 1st, 2009 at 8:03 pm
I’m glad you found my comments useful. Good luck!
May 8th, 2009 at 5:06 pm
Thank you for answering my previous question. In another response you explained that radiation exposure is cumulative. can you explain further, and given an early exposure in her CT Scan and x rays can i do thingss to reduce future radiation exposure.
May 8th, 2009 at 10:06 pm
Davina:
What I mean by cumulative is that radiation risk is spread out over a lifetime. That means there’s no difference between a brief series of exposures and the same number of exposures separated by periods of time.
Remember, though, most of what we know about radiation risk comes from people who have had massive exposures, such as nuclear bombs, reactor accidents, and early workers with radiation, such as Madame Curie. Another source of our knowledge is what happens to people who have received radiation treatment for some disease, typically cancer. These doses are many hundreds (even thousands) of times greater than those of simple x-rays. Our assumptions about medical x-ray risks are to a large part based on what we learned from these kinds of much more severe exposures.
The best way to avoid unnecessary risk from medical x-rays and scans is to emphasize the word “unnecessary.” When a doctor wants to do an x-ray on your child, make them explain exactly what benefit will come to your child from the x-ray. Especially ask them what the risk would be of not doing the x-ray — then you can make an informed, intelligent choice about what to do.
May 10th, 2009 at 4:42 am
i have been asking a lot of questions. But thanks for answering. i recently found out about MRI why in my case didnt the doctor opt for MRI. Baby has a large over bit, and i am worried thinking that she will need another xray for her braces. MRI sames so much safer especially for babies. Can MRI be used for dental imaging.
May 10th, 2009 at 12:40 pm
Davina:
You’re right about MRI being a good way to image the brain. It also has no ionizing radiation. So in that sense it’s safer than CT scans and x-rays. For small children and especially babies, however, MRI adds a different kind of risk — the risks of sedation. MRI is also much more expensive.
MRI scans take much longer than CT scans to perform and virtually no baby will lie still long enough. The scanner is also enclosed in a way that can be scary to children (and adults), and it makes an unpleasant noise. So small children nearly always need to receive some kind of sedative medicine so they will cooperate. Sometimes they need very deep sedation — nearly general anesthesia. That has risks. However, those risks are easily dealt with by making sure that there is a trained physician present to manage the sedation medicines properly and intervene immediately if the child gets into trouble (decreased breathing is the most common potential risk). So, like everything in medicine, we weigh the risks of doing something versus the risks of doing something else, or nothing.
I’m not aware of using MRI imaging for dental purposes — you would need to ask your dentist about that.
June 5th, 2009 at 2:53 am
Dr Johnson,
My 17 year old daughter, who is a small girl, has had two abdominal CT exams in the last year. I was never told about the risks of the radiation and now I am sick about the exposure she has had from these tests. The first CT was actually of the abdomen and pelvis. I have read that an abdominal ct is one of the tests with the highest exposure to radiation. I feel like I will always be looking for signs of cancer if she is ever ill in the future and I feel so guilty that I was foolish enough to think a CT was just a quick x-ray.
Should I ask for her records to see exactly how much radiation she was exposed to so doctors will know what to be aware of for her cancer risk? I feel like I have ruined her future health. Please help me.
June 5th, 2009 at 6:54 pm
Hi Victoria:
Thanks for your question. The fundamental principle of your concern boils down to relative risk — what is it and what does it mean.? I don’t know if you’ve read through any of the other questions and comments on this thread, but many, many parents have the same question you have. CT scans do carry some risk (although that risk is extremely tiny). However, the key to understanding this issue is understanding the practical implications of that risk. Here’s what I mean.
When a doctor orders a CT scan, he or she is weighing the very tiny risk of the scan against the risk of NOT doing the scan. In other words, is the risk of NOT getting the information from the scan more than the very tiny risk of doing the scan? If, for example, a doctor is worried that a child has appendicitis and needs a scan to see if this is true, the risk of NOT doing the scan, and missing the appendicitis, could be very high — far, far higher than the tiny risk the scan itself carries. And missing appendicitis is a bad thing. So it’s really all about balance.
All parents worry about their children — it’s a natural thing. But worrying about your child getting cancer from two CT scans is on the scale of worrying your child will be hit by lightning — it’s very, very unlikely. Not impossible, but very, very unlikely.
I’m not minimizing you concern. In practical terms, I would tell you not to send your child out to play in a thunderstorm with a metal golf club in her hand. That’s just common sense. Regarding a CT scan, I would tell you not to agree to one unless the doctor can explain why the information from the CT scan is important to your child’s health. That’s common sense, too. If there is a good reason for the scan, the tiny, tiny risk of the scan is outweighed by the crucial information the scan gives.
The take-home message is never to get an x-ray because you (or your doctor) is just curious — make sure there’s a good reason. If there is a good reason, then get the scan.
I hope this helps you. But really — I wouldn’t worry about it. There are so many other things to worry about with our children that are much more significant — things like their first solo drive on the interstate highway, or going off to college and going to parties on their own, or traveling across the country on their own, or having friends offering them cigarettes. These are all things for which good parenting can lesson the risk.
June 6th, 2009 at 1:17 pm
Thank you so much for your prompt reply! The CT scans were done because after a virus there was blood in my daughter’s urine (not red blood, but where her urine looked as if a coke had been poured into the toilet- kind of a grayish or brown color.). This continued with other virus bouts. The lateset virus that caused this bleeding was mononeucleosis. She was very ill with the mono, but still, I kept asking the doctors why she would have blood in her urine? The doctors only said that a virus could cause such an episode. (No one doctor was ever the same, as we were at different ERs and her primary doctor had been changed out of a group of doctors- interns.) Finally, I pushed for her latest primary to ask the older, more experienced doctors if a differential diagnosis was an option. I didn’t want to hurt the feelings of the intern, but I could not understand why, out of my seven children, this daughter would have blood in her urine when all my other children came through the viruses fine? Finally, we got a preiliminary diagnosis of IgA nephropothy. Please understand, my daughter did not have any abdominal pain with the bleeding. It was the look of her urine that was distressing and to me-it being not normal. This is why I took her to the ER. I wonder now if the CTs were needed and this causes my distress.
I so appreciate your help. You have helped to reassure me. I am upset enough by the diagnosis and then to think it may have been my actions that prompted the doctors to do the ct scans- this thought has caused great guilt for me. I have to say, I am somewhat angry that I was not told the risks of the CT. But since learning about the risks I have already been able to spare my daughter a third CT by letting the doctor know about the last two. The primary said it was just fine not to do a third, as long as we don’t put off coming back in if things seem to be worsening. Our next stop is the nephrologist. I feel now that I will be better able to make decisions with this doctor about further tests.
I am so grateful for your help. I’m picking up everything you have written and have told all my friends and family about your help. I wish all doctors could be as forthcoming as you!
June 7th, 2009 at 6:09 am
I’m glad you found this website helpful. Certainly if your daughter has IgA nephropathy it is best for her to be seeing a nephrologist for that problem — they’re the experts on that condition.
Good luck to both of you!
July 2nd, 2009 at 2:21 pm
Dr. Johnson
Hello, my 4 month old son recently had a barium swallow to determine the degree of his acid reflux. I’m worried about the safety of radiation he received, do you think its safe at his age to have had a barium swallow performed. Thanks
Judi Gilliland
July 4th, 2009 at 1:20 pm
Hi Judi:
The key question with any test, especially x-rays, always is: is the tiny risk of radiation worth the importance of the information we get from the test? The degree of acid reflux in small children is often key information to have because knowing it affects very much what we do about the problem, which can range all the way from medicines to surgery. So in your son’s case — yes, I’d get the test. I would if he were my son.
I hope this helps you.
July 15th, 2009 at 5:41 am
What is the increased risk from having multiple barium swallow studies? My daughter (born with esophageal atresia) has had 2 and they want to do another. She has also had 2 esophagrams. I’m concerned about the cumulative amount of radiation she has been exposed to and long term cancer risk. Thanks.
July 15th, 2009 at 6:28 pm
Hi Holly:
It’s true that muliple barium swallows do increase radiation exposure. But I think the way to look at the situation is that the long-term risk is still very, very tiny. Two times a tiny, tiny number is still a tiny, tiny number.
As with any test, we need to balance the risk of the test against the importance of the information the test gives us. For a child who had esophageal atresia, barium swallows are often pretty important to their care because the results can significantly affect what the doctor does next.
I can’t give you specific advice because I’m not your doctor, but I think if you’re really worried about it you should should simply share your wories with your doctor. Caring for any child is a partnership between parents and medical staff. Ultimately, though, the decision is yours to make.
August 18th, 2009 at 11:35 pm
Dear Christopher
I had a Ct Scan head last month for the first time after a car accedent. I am 30 years old and my sex is male. Would you mind explaining me what will be the negative repercussion of this CT with regard to infertility and cancer. Thank you in advance.
August 19th, 2009 at 12:01 pm
Hi:
There are no repercussions regarding fertility, since only your head gets the radiation exposure.
The added future cancer risk of the single head CT, that is, in addition to whatever your background risk already is, is infinitesimal. It is not zero, but it is so nearly zero that I would not be concerned about it at all.
I hope this helps
October 14th, 2009 at 6:53 pm
my son had upper G.I x-ray that was about 26 x-rays , is that a normal amount for a barium test?
October 14th, 2009 at 8:50 pm
Kim:
I think that’s probably more than the average, but not an outrageous amount — sometimes the radiologist needs to take quite a few snapshots to see what is going on. It depends somewhat upon what the study was done for, what question the radiologist was trying to answer. If you’re concerned about why it took that many, I’d just ask your doctor about it. All the doctors I know would rather have their patients ask us those kinds of questions than worry about them without letting us know.
October 19th, 2009 at 3:14 am
Hi … I am wondering about the long term affects of having almost a dozen xrays and ultrasounds on my daughter. She is 7 now and had several at 1 for a hip condition than again when she was 2 and 4 than 2 today -some were convering her ovaries and half were not. Will this affect her fertility? Reading some of your earlier comments - most of these I feel were necessary although I think sometimes (angrily) that the people taking the xrays just take another one if the first not completely readable or how they would like it not thinking of the patients long term welfare which infuriates me to no end. Please advise…. Thanks in anticipation for your comments as this matter regarding her later fertility options upsets me to no end - not to mention any other risks…
October 19th, 2009 at 10:10 pm
Tracey:
Ultrasounds carry no risk because they have no radiation. Regarding your question about the x-rays, I don’t think that number of plain x-rays will affect her future children. I’m not an expert on that question, but here is a link to the website of the Health Physics Society where an expert answers pretty much the same question — what the risk is to a child’s ovaries of hip x-rays taken when they are not completely shielded.
http://hps.org/publicinformation/ate/q2703.html
You many want to spend some time scanning their answers to other questions about radiation safety because it’s a good and reliable source.
November 4th, 2009 at 11:32 pm
I found your site as a result of the same worrying that has plagued so many parents here. My son received a chest x-ray after swallowing some excrement during birth. Given the length of the labor, or how commonly they perform x-rays on newborns, they did not consult us on the decision or offer for us to come along. He turned out to be fine, but I often wonder about the long-term effects of the radiation on his first day of life…and, since we were not invited to observe, what exactly the procedure involved (multiple images, safety precautions, etc.) So, if you have a moment and wouldn’t mind indulging my paranoia: how vigilant are radiographers in dealing with higher-risk patients, in general? And does modern x-ray equipment take the sensitivity of a newborn into consideration by default, or is it the responsibility of the tech or nurse?
November 5th, 2009 at 8:28 pm
Hi KR:
To answer your first question, the risk to a newborn baby of a chest ray such as your son received is as near to zero as is possible. As I mentioned upthread, the radiation exposure of a film like that is the equivalent of about a week or so of the background radiation (from the earth and from cosmic rays from the universe) he gets in his normal daily life, or of a medium-distance airplane flight.
To answer your larger question, it is the routine to adjust the amount of radiation according to the size of the person. X-ray technicians are quite vigilant about that. The reason is not simply safety — it’s also to get a good quality film. The settings used for an adult will not give a good picture of a baby’s lungs.
Finally, meconium aspiration (the fancy name for the problem your son had) nearly always needs a chest x-ray to see how extensive it is. Like everything we do in medicine, we need to weigh the risk of doing a test against the risk of not doing it, that is, of not getting the information the test gives. In your son’s situation, we weigh the truly infinitesimally small risk of the x-ray against the important and useful information the x-ray gives us — the balance overwhelmingly favors doing the x-ray.
I hope these comments are useful to you, and that your son is doing fine. I really wouldn’t worry at all about the effects of the chest x-ray when he was born.
November 13th, 2009 at 7:27 pm
my son had an abdominal xray at 2 weeks for pain, then 2 skull xrays at 5 weeks and a ckull ct at 16 weeks for craniosynostosis, which required surgery. What is the risk from radiation.
November 13th, 2009 at 8:48 pm
Hi Andrea:
The risks of the abdominal and skull x-rays are next to nothing. CT scans do carry a somewhat higher risk. I wrote a post about them here. The link in that post is to a good discussion about it, particularly how doctors probably do too many of them. A CT uses several hundred times the radiation of a plain x-ray, the equivalent of the radiation one gets during several years of normal life, although during the last few years radiologists have been working to reduce the radiation exposure needed.
As I’ve said to several folks upthread, the bottom line is always if the risk of NOT doing the scan is greater than the risk of doing it. Regarding your son, a child with craniosynostosis usually needs at least one CT to make sure he is getting the best care. What I always tell parents to do is ask the doctor what specific, important information the scan will give.
I realize that may sound a little vague, but I’m not aware of any hard and fast numbers we can put on what the risk to a specific child of an individual head CT scan is. I do know that, for a single scan, it is still a very, very small number.
November 14th, 2009 at 1:48 am
the ct scan was done at the childrens hospital by one of the leading craniofacial experts in australia, so I trust that the scan was needed. I just do not want to be thinking “what if he gets cancer from it”. It is very draining worrying about the possibility
November 14th, 2009 at 8:19 am
Andrea:
I understand. But I think the best way to think about it is that life, even for a child, is full of risks, large and small. Having a CT scan does carry a tiny increased risk, but it truly is tiny in comparison to the other risks we take with our children and think nothing about it — driving in a car, flying in a plane, sending them off across town on the bus by themselves for the first time. My message parents about CT scans is just make sure they are really needed, which, as you say, I’m sure was the case with your son.
Good luck
December 4th, 2009 at 10:43 am
dr christopher
my son had to do an elbow x ray while i was about 8 weeks pregnant with the second one.i told them at the radiology deptt., & stood outside the room.but my son wouldn’t go in alone so the tech,called me into the room thrice to assure him. i would assume the x ray machine wouldn’t be turned on at that time. finally he yelled thru the x ray as he took it alone,while i sttod outside the entry of the room,without a view into it. i think they did 2 x-rays on him,becoz the sign ‘ xray in use ‘was aglow twice.
i’m worried sick since for the fetus,becoz of all the internet articles abt x rays being harmful from 8- 25 weeks,also abt radiation scatter as i stood outside 3 rooms taking sperate x rays each.PLZ REPLY..THNX IN ADVANCE
December 4th, 2009 at 11:43 am
Priya:
Don’t worry about it — really. The x-ray rooms have shielded walls and doors so you didn’t get any exposure at all.
December 4th, 2009 at 2:25 pm
thnx a ton for the prompt reply,u almost lifted a big burden off my chest, however i’m worried abt the 3 times i entered the x ray to calm him down & make him sit in place.although i didn’t stay in long,but was close to the equipment,which i believe was not turned(coz i think the room needs to be closed for it to be on).is that the case
also what is the amt.of radiation in rads used for an elbow x ray?
i hope u can understand my being worried as the second one is coming along after a long time & very rough patch of time & losing someone very close…..we just wouldn’t want anything to go wrong .
December 4th, 2009 at 3:20 pm
Again, don’t worry — I’m sure the radiation source was turned off when you were in there comforting him so you weren’t exposed to any.
Regarding your other question, an x-ray of an arm or a leg delivers roughly the same amount of radiation as your son gets from the background radiation from just a normal day of life. (We get background radiation constantly from outer space and from the earth beneath us.) So that’s nothing to worry about, either.
Here’s a listing of the radiation exposure of many common x-rays from a reliable source:
http://www.radiologyinfo.org/en/pdf/sfty_xray.pdf
And congratulations on your pregnancy!
December 4th, 2009 at 3:25 pm
thnx again..i wish all that u say turns out true,& the baby comes along fine..THANKS
December 9th, 2009 at 8:08 am
Dr. Chris,
My son had a pain on his upper left thigh. They gave him pelvic x rays without a shield to the reproductive organs. they got two images that were clear but they had taken two images before that had to be taken again. Also they did two side images of the left leg that were also taken before twice. They had to be redone because they were too dark. i was told I couldnt stay in the room and I realized that the shield was not used afterwards. I am worried sick, blame myself for it and can not even think of anything else. My son is 7. Will this affect him in his future? I don’t know what to do. Please help.
December 9th, 2009 at 8:28 am
Dr.Chris,
I also want to add that this facility was not a pediatric doctor
orthopedic but an adult doctor orthopedic. Was the x ray strength used appropriate for my seven year old son? I am worried sick, I can’t even sleep. I am so upset with myself for letting them perform the x ray. I can’t think straight of why I let them but I was worried sick that something else might have been wrong because the doctor had mentioned hip problems and I just didn’t think right at that moment. If I could take it all back I would. I’d rather be putting myself under such a situation than my child and I feel that I did the wrong thing. I feel terrible, anxious and upset. Why did I let them take this x-ray?
December 9th, 2009 at 2:17 pm
Hi Debby:
Don’t worry about the x-ray — really. Don’t worry. First off, I’m sure the settings on the x-ray machine were the correct ones for a child. The doctor actually doesn’t order those exact settings — they are set by the technician taking the film, and x-ray technicians know what settings to use. This is not only a matter of safety; if you use the wrong settings, such as those appropriate for a larger person, you won’t get a good picture of the bones. The total radiation used in these films is also quite small — the equivalent of just a day or two of normal life. You can see my link to a list of what radiation doses are found in various kinds of x-rays in my answer to Priya upthread a few comments.
Also don’t worry about the shield issue. Yes, we should use them whenever possible. Seven-year-old boys, however, don’t have any sperm yet in their testes, so there’s nothing there for the x-ray beam to affect. (This makes boys a bit different from girls — a girl’s supply of eggs is already made and waiting in her ovaries.)
I hope this helps you.
December 9th, 2009 at 3:54 pm
Doctor Christopher,
Thank you so much for your prompt reply.
I feel so much better right now!
I spend the whole day worrying. Even my kids were telling me not to. Thank you again!
Best Regards,
Debby
December 14th, 2009 at 8:01 pm
Hello doctor I just wanted to say thanks for all your answers. I have a 5 yr old son who broke both his legs about 4 months ago and has had 7 sets of x-ray (about 4-5 xrays in each set) and i was worried about the risk but your answers have been very helpfull but i do have one more question. I live in Mexico and my sister in the US says that her 1yr old had xrays and the doctor covered his private parts (penis) with something and she asked the nurse and the nurse said it was just safer but with my 5yr old son in mexico they have never covered his private parts and he has had alot of xrays. does all these xrays have any effect on his privates. I was very worried but your answers to others have been very helpfull. thank you
December 15th, 2009 at 8:56 am
Hi Estaban:
We do generally cover the genital area with a shield if possible. For a five-year-old this is more important for girls than for boys, since boys are generally is not making sperm yet but a girl’s eggs are already made. I think your son will be fine with that number of films, but I would ask that his genital area be shielded in the future.
December 21st, 2009 at 7:00 pm
What is the earliest a baby can get an x-ray?
December 22nd, 2009 at 6:28 am
Hi Morgan:
Sometimes we need to get x-rays immediately after a baby is born. A newborn baby with any breathing problems, for example, usually needs a chest x-ray.
December 30th, 2009 at 9:47 am
Hi
I am worried about the side effects from the number of xrays and tests my daughter has had. This started when she was 3 weeks old when she was admitted to the ED of our local hospital because of an unknown infection (turned out to be Strep B) but at the time to diagnose her they took abdominal xrays. Then 6 months later she also had to have a follow us Renal Cortex scan to check her kidneys (due to a urinary tract infection she also had when she had the Strep B) then ontop of all this, she was also diagnosed with Hip Displasia. She has had up to 6 xrays of her pelvis due to this already and she is only 18 months old. Then to add to my growing concerns, last week she broke her leg so had yet another set of xrays (5 xrays) for this and no doubt will need more to follow up on her leg. None of her xrays have had anything to shield her ovaries so I am concerned about her future fertility and even more concerned about cancer risk. She is only 18 months old. Thank you.
December 31st, 2009 at 12:36 pm
I understand your concern about cancer risk, and x-rays do increase the lifetime chances of getting cancer. But — and it’s an important but — that increase is very, very small — infinitesimally so. As I mentioned in a comment above, plain x-rays of the bones carry about the same increased radiation as the normal background radiation of an extra day of normal life. That’s not zero, but it is tiny.
For another example, I live at over 7,000 feet in altitude. Along with everybody else in town, that fact increases the background radiation I experience over that which people get at sea level. Put another way, I and my neighbors receive the equivalent amount of radiation as a plain x-ray every couple of days or so. (CT scans are another matter.)
The key notion is that of relative risk. A child with group B strep needs a chest x-ray to receive good care, as do children with congenital dislocation of the hips and broken legs. The risk of not getting those films (and getting poorer management of their problem) far, far outweighs the tiny risk of getting them. Nothing we do is risk-free. It’s all about choices.
My own daughter received nearly a hundred chest x-rays as an infant. She needed them at the time. I wish she didn’t have to have them, but I don’t worry about it now.
It’s a tough question, and telling a parent not to worry never works. But still, if I were you I wouldn’t worry about it.
December 31st, 2009 at 4:24 pm
Hello doctor
My 13month old son just had a chest x ray, they thought he may possibly have pneumonia, but it turned out only to be a chest infection.
I knew in my heart he was ok and now I am very worried that he had an unneccessary x ray. I have just read on another website that just one x ray can cause the dna of cells damage and cause cancer and that babies should never have x rays.
I am sick with worry, I had many ultrasound scans throughout pregnancy from early on - I know this is not ionizing radiation bit it seems there is some argument over whether they are safe, he also had a difficult birth. I am so so worried about the effect that all this may have on him, i am bfinding it difficult to sleep and worry all the time. I wish i hadnt agreed to the xray.
Do you think he is at risk of cancer?
Many thanks
January 2nd, 2010 at 8:35 am
Hi Sophie:
Your question is one that many parents have, and quite a few have asked me what you’ve asked back up the blog comments trail. I think if you read their questions and my answers to them you’ll find your question answered, too.
January 2nd, 2010 at 2:22 pm
Very sorry - I wrote it without reding the rest as I was in a rush and a panic! Many thanks.
January 5th, 2010 at 9:58 am
I have had one CT scan of my head and two CT scans of my abdomen in the past month. I have had tingling in my head and body as well as mono. I begin having pain under my left rib and went to the ER worried it was my spleen. They did a CT scan. Spleen was fine. Then I begin having pain under my right rib and my Dr. said it could be my liver, gallbladdar, bowels. So she ordered another CT scan of my abdomen. I told her that I had already had one. She said that it would be ok, but I have been worried sick since I began reading about CT scans on the Internet. Everything turned out to be fine. They did find sludge around my gallbladdar and a cyst on an ovary. I am 29 and have a 2 yr. old. I can’t go through my daily routine without constantly worrying that I might get sick down the road from these scans.
January 5th, 2010 at 1:44 pm
I forgot to add in the earlier post. Will my chances of getting pregnant again be slimmed due to the scans in my adominal area?
January 5th, 2010 at 5:36 pm
Hi Christy:
It sounds to me as if you needed the scans — without them, your doctors wouldn’t have known what to do. I wouldn’t worry about it. They also should have no effect on your future fertility. As always, the key thing to ask about when considering CT scans is: what is the risk of NOT doing it, of not getting the information the scan provides.
If you’re really worried, though, I’d talk to your doctor about it. That’s usually the best way to straighten things out and avoid misunderstandings.
January 12th, 2010 at 5:02 am
Hi Doctor
One question that has always baffled me is - if a chest x ray is the equivalent to a long haul flight in cosmic radiation exposure, why do they say it is safe for pregnant women to fly, especially during the first trimester, yet would not give an x ray at this time due to increased risk of chldhood luekaemia?
I am very worried as I flew long haul twice throughout my pregnancy and am now very worried if my baby daughter needed an x ray, that she would have been exposed to too much radiation, so I would have to think very carefully and be very worried abou the risks.
I wonder if yu can help me with this issue?
Thank you
January 12th, 2010 at 9:06 am
Hi Becca:
You ask a good question. I don’t take care of pregnant women, but it seems to me that the logically consistent thing to do would be to tell women about the very tiny (but still not zero) increased risk of flying, since we do that with x-rays.
Overall, though, the risk remains tiny. I can’t find the citation, but there have been studies of airline pilots and cancer risk. I believe the largest of these comes from Scandinavia — no increased risk for cancer was found, in spite of all the air miles these pilots had. Of course that’s a somewhat different question than pregnant women, but it was reassuring that the pilots had no increased incidence of cancer.
January 18th, 2010 at 9:46 pm
Dear Doctor,
I have 22 month old daughter how has Congenital TTP. When she was born she had pnemonia so they did a lot of chest x rays on her for that and they did a CT scan on her brian. Since then we have had to x ray her port three times and her kidneys three times. I’m worried about her exposure to radiation, do I have reason to worry?
Thank you for your time,
Shari
January 19th, 2010 at 9:43 am
Hi Shari:
Here’s the way I would look at it. Your daughter has received radiation that, statistically speaking, may raise her risk of future cancer by a very, very tiny amount over what her risk would have been without the x-rays. BUT — and it’s a key but — TTP, as you know, is a serious, complicated and potentially severe illness. Her TTP is far, far more likely to cause her future trouble than the radiation from the x-rays. So I would say the best way to proceed is to get whatever studies her doctors need to manage her TTP in the best way. Of course it is always a good idea when doctors want to do an x-ray to ask just what important information the x-ray will give them and why they need it to give her the best care at that moment.
February 5th, 2010 at 10:21 am
Dear Doctor,
From previous posts, I’m assuming my son’s situation is similar to others but I wanted to check. When he was 11 months old, the pediatrician ordered a chest x-ray to rule out pneumonia. As most 11 months are, he was difficult to stay still, even with me holding him. They had to try five times to get a clear image. I am assuming the technician wouldn’t make as many x-ray attempts if it was unsafe, but I wanted to check with you. Thanks!
February 5th, 2010 at 11:19 am
Thanks for your article on safety of x-ray on children.
I read your comments above on high altitude radiation risks and I happen to live in Denver. I would like to read more on this. Can you please point me to any links that has more info on this.
Thanks again!
February 5th, 2010 at 10:10 pm
Lisa:
You’re correct about that
February 5th, 2010 at 10:11 pm
Ram:
I’m traveling just now and away from my home computer. I’ll post some links next week.
February 19th, 2010 at 9:40 am
Here’s a good link about the relationship between radiation and altitude:
http://www.radiologyinfo.org/en/pdf/sfty_xray.pdf
March 7th, 2010 at 5:59 am
Hi Doctor
Only just seen your reply to my query some time ago- thank you. I was also wondering this - if you have a chest x ray, which, according to the link you gave to another persons query, is the equivalent of 10 days worth of radiation - is it more harmful to have this 10 days worth all at once, as opposed to spread out over 10 days? As for example, sun exposure at a large dose at once can cause burning, but the same amount spread out over days is not harmful? Also is the equivalent for a childs chest x ray less than this? Many thanks again, this site is very interesting and informative.
March 7th, 2010 at 9:29 am
Hi Becca:
As a general statement, it’s safer to spread out the radiation dose, but that effect is not significant when we’re talking about diagnostic x-rays like chest x-rays.