Answer to Question #7767 Submitted to "Ask the Experts"

Category: Nuclear Medicine Patient Issues — Therapeutic Nuclear Medicine

The following question was answered by an expert in the appropriate field:

Q

My sister is receiving 2775 MBq 131I after having a total thyroidectomy. Her doctor suggested she stay in a hotel during her isolation period of four days and she is seriously considering this idea. I have expressed concerns about hotel workers (who may or may not be pregnant) cleaning the room and future hotel guests (who may or may not be pregnant or may or may not be children) staying in the room or rooms adjacent. After what point would her hotel room be safe to be cleaned by a housekeeper or used by a guest, and is it ethical that a doctor even suggest that she stay in one?

A

Although federal regulations do not expressly prohibit the release of a radioactive patient to a location other than a private residence, the Nuclear Regulatory Commission strongly discourages this practice because it can result in radiation exposures to members of the public which may not be in compliance with the regulations and may result in doses which are not as low as reasonably achievable (ALARA).

When patients who would be eligible for release to a private residence select an alternative location (e.g., hotel, motel, etc.) as their post-therapy destination, and the physician is aware of the destination, the physician must estimate the likely cumulative exposures to other members of the public (e.g., hotel workers and guests) and direct appropriate protective measures.  In any case, if the potential dose to third parties would exceed 1 mSv, the physician must provide specific instructions highlighting the steps the patient must follow to assure that, if followed, the dose to members of the public meets the ALARA requirement.

Practically speaking, the best place for her to go is to her residence.  If your sister has no choice but to go to a hotel, she should bring her own pillow and towels as these are the most likely to be contaminated.  The vast majority of the 131I will be eliminated through her urine.  Good hygiene, including washing her hands each time she uses the bathroom or eats, will avoid contamination.  If she showers before bed, the sheets should not be an issue.  In addition, she could tell the staff that she needs no housekeeping during her stay.   

Linda Kroger, MS
Radiation Safety Officer

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