Effective dose equivalent and associated risks from mass chest radiography in Kuwait.

Area of Science:

• Radiological Health
• Public Health
• Medical Physics

Background:

• Mass chest radiography was widely used in Kuwait, peaking in 1982 with over 185,000 examinations.
• Miniature radiography (70 mm) constituted over 90% of these examinations, with large film technique used for the remainder.
• The study questions whether the prevalence of asymptomatic tuberculosis justifies the scale of population exposure.

Purpose of the Study:

• To calculate the effective dose equivalent from both miniature and large film mass chest radiography in Kuwait.
• To estimate the associated risks of fatal malignancies per examination.
• To assess the annual collective effective dose equivalent and potential excess fatalities.

Main Methods:

• Calculation of effective dose equivalent for miniature (283 μSv) and large film (35.5 μSv) radiography.
• Estimation of fatal malignancy risks: 3.37 x 10⁻⁶ for miniature and 0.422 x 10⁻⁶ for large film.
• Assessment of annual collective effective dose equivalent (38-48 man-Sv) and projected excess fatalities over 25 years.

Main Results:

• Miniature radiography yielded significantly higher effective dose equivalents and cancer risks compared to large film.
• The annual collective effective dose equivalent ranged from 38-48 man-Sv between 1977-1983.
• An average of 0.5 additional fatal malignancies per year, totaling 12 over 25 years, were projected if current examination levels persist.

Conclusions:

• The predominant use of miniature radiography in Kuwait's mass chest x-ray program contributes to the majority of calculated excess fatalities.
• The findings suggest a need to re-evaluate the necessity and methodology of mass chest radiography in Kuwait.
• Radiation exposure and associated cancer risks from mass chest radiography warrant careful consideration in public health strategies.