核醫檢查病人的尿布導致垃圾輻射異常事件之改善模式

Radiation Alert Caused by Diapers from Nuclear Medicine Patients, and Improvement on the Issue

張家豪(Chia-Hao Chang) ； 黃慧娥(Hui-O Huang) ； 張雅蓮(Ya-Lien Chang) ； 陸建華(Chien-Hua Lu) ； 吳麗君(Li-Chun Wu) ； 陳育婷(Yu-Ting Chen) ； 洪佑昇(Yu-Sheng Hung) ； 李將瑄(Chiang Hsuan Lee) ； 吳志順(Chih-Shun Wu)

《核子醫學暨分子影像雜誌》 28卷4期 (2015/12) Pp. 150-154

https://doi.org/10.6332/ANMMI.2804.002

摘要

背景：本院廢棄物在2013年1月至2013年11月清運至焚化廠處理時，共發生34起焚化廠進廠輻射異常而被遭告知的情形，故本文將就針對此問題進行探討並提出改善模式。方法：本科病人會產生輻射廢棄物主要來自碘-131治療病房廢棄物及核醫造影病人排泄於尿布上的情況。而碘-131治療病房廢棄物要丟棄之前均有進行輻射偵測，故唯一剩下的來源即是核醫檢查病人的尿布，本科就此訂定尿布回收流程以求改進，由科內護理師、放射師及輻防人員一同執行。結果：自2013年12月開始執行尿布回收，至2015年6月共檢查5,632人次，有註記尿布者163人次，扣除沒有解尿者以及含解便尿布後應回收114人次，實際回收106人次，總回收率92.89%，本院廢棄物輻射異常事件因此大幅降低，從2013年12月起至2015年6月只發生7起。結論：醫院廢棄物進入焚化廠處理時，若因核醫科病人尿布而造成輻射異常，除了被告知之外且有可能垃圾將被退運之情事，造成焚化廠及醫院困擾，藉由此改善模式且認真執行確實能改善此一狀況，亦可提供為同儕醫院參考。

關鍵字

尿布 ； 焚化廠 ； 輻射異常

並列摘要

Background: From January to November 2013, our hospital was informed by the incineration plant that 34 events of radiation alert were detected in medical waste garbage. This article describes the finding of a possible cause for the radiation alert, and the procedure to improve the issue. Method: Radioactive medical waste in the Nuclear Medicine Department mostly came from Ward I-131 and diapers used by examination patients. The waste from Ward I-131 was always detected before discarding. Therefore, the only suspect which could cause radioactive waste alert was the diapers used by examination patients. We made a new procedure for diaper disposal, which would be carried out by nurses, technicians, and radiation protection personnel. Result: The diaper disposal procedure was carried out from December 2013 to June 2015. Among the 5,632 patients who underwent nuclear medicine studies, there were 163 patients who used diaper. After the exclusion of diapers without urine and diapers with stool, the diapers of 114 patients should be retrieved; however, the diapers of only 106 patients were actually retrieved. The total retrieval rate was 92.89%. In the meantime, the number of events of radiation alert from our medical waste had largely decreased to only 7 events from December 2013 to June 2015. Conclusion: In case of a radiation alert induced by the diaper of a patient from the Nuclear Medicine Department, the hospital should be informed by the incineration plant, and even the medical waste might be sent back to the hospital. It could be big trouble for the incineration plant and the hospital. This new procedure improved this issue and it could be a good reference for other hospitals.

並列關鍵字

diaper ； incineration plant ； radiation alert