Questions: Is there any risk in exposing children to x-ray? My child is coughing for last 2 weeks and my pediatrician ordered a chest x-ray for him. Is it completely safe?
Answer: When your child is ill or injured you want to do whatever the tests is needed as soon as possible. Sometimes this test like x-ray or CT scan exposes child to radiation which can link to cancer later in life in some individual, especially the growing child is more sensitive to radiation. There is no doubt that x ray and scan are helpful and even sometime life saving but no one should be expose to radiation that is not wisely ordered and benefit of the test should outweigh the risk of radiation exposure.
So before any imaging study is done for your child you should ask several questions from your doctor:
1. Does this imaging test uses radiation; does he really needs this imaging test? And if yes what type?
2. Are there any options or alternatives like ultrasound rather than using ionizing radiation?
3. If the test ordered is a CT scan which exposes the child to much more radiation compared to a simple x-ray, parents should consider going to a children hospital rather than a general hospital which are more likely to adjust the scanner to deliver a child size dose of radiation for that particular image. It is very important to use the lowest dose possible when scanning a child.
The amount of radiation exposure depends on the type of imaging test used, for example a single chest x-ray exposes a child to about 0.1 mSv (millisieeverts which is a measure of radiation exposure). This is about the same amount of radiation people are exposed to over the course of about 10 days naturally or a mammogram exposes a woman to 0.4 mSv which is the amount of a person should expose in nature over 7 weeks and a CT scan of abdomen or pelvis can expose a person to 10 mSv. Radiation exposure to all these sources can add up over the life time and increases the chance of cancer in future. So in any child that may need to be exposed to radiation or x-ray, is better to reconsider its necessity or at least to see if other imaging test which uses no radiation like sonography or MRI can be substituted. Dental x-ray is one of the lowest radiation dose and a routine exam which include 4 bitewings is about 0.005mSv, which is less than one day of natural background radiation or about the same amount of radiation exposure from a short airplane flight (1-2 hours). American Dental Association also recommends the kids and teens get bitewing x-ray not more frequent than every 6-12 months if they have cavities, of course the frequency depends on medical and dental history and current condition.
One way to lessen repeated exposure of children to unnecessary radiation is to concentrate on clinical skill of the physician like taking a good history of patient, a good physical examination, and sometime keeping the child in the hospital for few hours of observation before submitting him to radiation if clinical situation permits. Follow up of the case during period of observation may also help to choose a better option and save the kid from receiving unnecessary radiation. This type of thinking along with parent not wanting an answer right away and putting too much pressure on the doctor can be very helpful.
