Last update May 16, 2019

Occupational exposure to radionuclides

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

The protection for infants whose mothers work in nuclear medicine services should be the same as that used for breastfeeding mothers who undergo scans or treatments with radionuclides (Almén 2017, Euratom 2014).

For these mothers, the period of halting breastfeeding or of avoiding close contact are calculated so that the infant is not exposed to more than 1 millisievert (1 mSv = 0.1 rem) of radiation (Alén 2017, ARSAC 2019, US.NCR 2016, ICRP 2008, Stabin 2000).
An adult receives between 5 and 10 mSv annually from environmental radiation.

AS A GENERAL STANDARD, any breastfeeding working mother whose infant can be exposed to more than 1 mSv (100 mrem) per year (<0.1 mSv per month) should have her workplace conditions adapted so that this does not occur (Almén 2017 , IAEA 2014).

SPECIFIC CASES (Alén 2017):
Following the appropriate general radiological protection measures, breastfeeding workers can handle drugs with TC 99m, due to the very low exposure, lower than the limits established for infants.

Despite following adequate general radiological protection measures, breast-feeding workers should not handle PET drugs or perform cyclotron operation and maintenance work, because exposure may exceed the limit established for the infant and beyond in the event of an accident.

In spite of following adequate general radiological protection measures, breastfeeding workers should not handle drugs with I-131, because exposure can widely exceed the limit established for the infant, and because iodine compounds are very volatile and are excreted in significant amounts in breastmilk.

Despite following adequate general radiological protection measures, breast-feeding workers should not handle alpha- and beta-emitting drugs, because, in the event of an accident, exposure is very high and may well exceed the limit established for the infant.

Breastfeeding workers should not carry out emergency work, including cleaning after heavy contamination.


See below the information of this related product:

  • Scintigraphy (Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.)

See below the information of this related group:

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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References

  1. ARSAC. Administration of Radioactive Substances Advisory Committee. Notes for Guidance on the Clinical Administration of Radiopharmaceuticals and Use of Sealed Radioactive Sources. Section 7 Conception, Pregnancy and Breastfeeding, p. 53-58. ARSAC Support Unit. Centre for Radiation, Chemical and Environmental Hazards. Public Health England. 2020 Consulted on Dec. 4, 2023 Abstract Full text (link to original source) Full text (in our servers)
  2. IAEA - International Atomic Energy Agency. Radiation Protection and Safety in Medical Uses of Ionizing Radiation IAEA Safety Standards Series No. SSG-46, 2018 Abstract Full text (link to original source)
  3. Almén A, Mattsson S. Radiological protection of foetuses and breast-fed children of occupationally exposed women in nuclear medicine - Challenges for hospitals. Phys Med. 2017 Nov;43:172-177. Abstract
  4. US.NRC - Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards. Apéndice U, Tabla U.3. Consolidated guidance about materials licenses. Program-specific guidance about medical use licenses. Draft Report for Comment. Appendix U, Table U.3. NUREG-1556. Vol.9, Rev 3. 2016 Full text (link to original source) Full text (in our servers)
  5. Euratom. European Commission. Directives council directive 2013/59/EURATOM of 5 December 2013 laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation. Official J Eur Union L 13/1, 2014 Full text (in our servers)
  6. IAEA - International Atomic Energy Agency. Radiation protection and safety of radiation sources. International Basic Safety Standards General Safety Requirements. IAEA Safety Standards Series No. GSR Part 3. 2014 Full text (in our servers)
  7. ICRP. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP Publication 53. ICRP Publication 106. Annex D. Recommendations on breast-feeding interruptions, p. 163-165. Ann ICRP. 2008 Abstract Full text (link to original source) Full text (in our servers)
  8. Stabin MG, Breitz HB. Breast milk excretion of radiopharmaceuticals: mechanisms, findings, and radiation dosimetry. J Nucl Med. 2000 Abstract Full text (link to original source) Full text (in our servers)

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