Isotope crisis shows need for better balance, communication: report
29.07.2008 16:01
Health
- Source: cbc.ca
Avoiding a situation like the Chalk River shutdown and the subsequent shortage of medical isotopes requires a better balance between public safety and the health of patients, says a report released Monday. As well, there should be preparations to manage supply problems should they arise, along with better communications between the medical community and the public. An ad hoc group composed of health experts which was assembled following the isotope shortage late last year released the report Monday. Its recommendations aim to prevent a crisis in the delivery of medical tests, which occurred when the Chalk River reactor was shut down in November 2007. The reactor, which provides two-thirds of the world's radioisotopes, essentially stopped supplying nuclear material essential for medical imaging and diagnostic scans for fractures, cancers and heart conditions. It was restarted on December 16. The report says that during the isotope shortage, there was no communication between Atomic Energy of Canada, which produces the raw materials of most tests performed in nuclear medicine imaging facilities, the Canadian Nuclear Safety Commission, the federal safety commission which oversees it, and the federal government. "The most disconcerting issue of all for all concerned was the fact that the nuclear medicine community could not properly plan an appropriate response to the crisis," reads the report. Failure to communicate"No process or mechanism was in place to facilitate effective communication." It also says that "during the recent crisis, it was apparent that the absence of communications planning had a detrimental impact on patient care." To prevent this from happening again, the report calls on all parties involved to disclose how operation stoppages would affect the supply of isotopes, to ensure that all parties in the supply chain are informed of any interruptions in a timely manner. It also suggests that serious threats to the supply of generators to nuclear medicine facilities, both national and international, be reported immediately. Another recommendation is that physicians be active in the decision-making process to ensure patients' medical needs aren't compromised. The report says their input wasn't considered during the Chalk River crisis. Reserve of raw materialsThe report also suggests a reserve of raw materials should a shortage occur, and wants more reactors opened to create isotopes. "Canada needs reactors that are designed to expand their production capabilities quickly in response to an emergency," it reads. It recommends that nuclear medicine facilities have access to back-up generators in emergency situations, that Health Canada fast track generator products that are currently not approved but might be useful, or that nuclear medicine facilities explore using partially spent generators or ones past their expiry dates if needed. It also suggests that nuclear medicine facilities work overtime in cases where there are isotope shortages, to maximize usage of existing isotopes. "The nature of radioisotope generators is that 20 per cent of their capacity is lost every day," the report says. Lastly, it recommends the establishment of a "clear and appropriate alignment of authority and accountability for the management of medical radioisotopes," which involves Health Canada, CNSC, and AECL developing best practices for the management of medical shortages. The report, Lessons Learned from the Shutdown of the Chalk River Reactor, has been submitted to federal Health Minister Tony Clement. 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