Answer to Question #2006 Submitted to "Ask the Experts"

Q

In July 2001 I started working in a cardiac catheterization laboratory. In Febuary I started experiencing flushing with white dots on my forearms and lower legs bilaterally. This often spreads to my upper legs and sometimes upper torso. This flushing with white dots is red when I am warm and purplish when I am cold but always with the white dots. These white dots vary in size and are usually smaller and more prevelent when the burning is at its worst. I also have been experiencing left flank dull discomfort, irritated with movement but constant. I also get a feeling like I have to stretch all my muscles at times. The flushing also is felt on my face and left ear at times. All my lab results and tests have been normal, including a urine for metanephrine, 5HIAA, 2 d echo heart (occasional palpitations), MRI brain (occasional myoclonus but not experienced in two months). My MD is unwilling to test further at this time and has referred me to an endocrinologist, but the appointment is three months away. These symptoms appear to be worse when I am working and present but not as bad on the weekend when I am not working. Have you heard of this type of problem associated with radiation exposure?

A

There have been no published reports of conditions such as you describe arising from radiation exposure. You did not state whether you wear a personal radiation monitor ("film badge"), but it is assumed that your dose is within established occupational dose limits (50 mSv per year). There is a radiation dermatitis, but it is a scaly rash and occurs following large doses (several Sv). The neurological symptoms you describe also require large doses. If you received a dose sufficient to produce the dermatitis, you would have exposed the whole-body response, resulting in symptoms of radiation sickness (fatigue, diarrhea, nausea, vomiting, etc.). There have been no ill effects reported in recent years from occupational doses within established limits. Conclusion: It is essentially impossible for your occupational radiation exposure to have caused the symptoms you describe. Their onset shortly after you started working in the catheterization lab may be coincidence. Is your job stressful? The only occupational insult that comes to mind that might be implicated is stress. S. Julian Gibbs, DDS, PhD