Smallest patients have highest risk from radiation accidents, doctors warn

Infants, children and teens who are unexpectedly exposed to radiation from nuclear power plants or improper disposal of medical equipment may be more at risk for health problems than adults, U.S. pediatricians warn.

In general, children’s smaller size and developing bodies make them more susceptible to radiation poisoning and more likely to develop short- and long-term medical issues including mental health problems and certain cancers, according to a policy statement from the American Academy of Pediatrics (AAP).

“That children are not little adults is, perhaps, a self-evident fact, but one that is often overlooked,” said lead author of the statement, Dr. Jerome Paulson of the George Washington University School of Medicine in Washington, D.C.

“Small children breath more air, drink more water and eat more food per unit of body weight than an adult does,” Paulson said by email. “Therefore, if what they breath, drink or eat is contaminated with radioactive material, or any other toxicant, they will get a larger does than a similarly situated adult.”

The statement, published today in Pediatrics, emphasizes that children may be exposed to radiation as a direct result of accidents or disasters or by consuming contaminated milk and foods.

While scientists have long understood the potential harms of both direct and indirect exposure, the new policy statement reflects recent research on the long-term health effects of the 1986 Chernobyl nuclear accident in Ukraine and on the impact of the 2011 Fukushima Daiichi nuclear power plant accident in Japan.

In particular, parents and pediatricians should be on the lookout for mental health problems in the wake of nuclear accidents, particularly when children were directly exposed to the disaster or had friends or loved ones who were hurt or displaced.

Potassium iodide may be given to infants and children to protect the thyroid gland in the aftermath of radiation accidents, the statement also advises. Mothers who are breastfeeding may need to pause temporarily if they have been exposed to radiation, but may be able to resume nursing after taking potassium iodide and giving the medication to their infants.

Families should take precautions to prepare for disasters, too, with emergency stores of water, nonperishable foods, medical supplies, and any needed documents. In addition, parents may need to keep families indoors with air conditioners or furnaces off to avoid letting contaminated air into the home.

With nuclear accidents, families should also change clothes and shoes and set them aside in sealed plastic bags, and then take a shower to thoroughly wash the body and hair, doctors advise.

Down the line, children accidentally exposed to radiation should limit their exposure to medical X-rays or MRIs, because these might needlessly increase their cumulative radiation exposure, advised Dr. Masamine Jimba, a researcher at the University of Tokyo who wasn’t involved in the policy statement.

“In case of radiation exposure from medical care, reduce risks by avoiding X-ray examinations. If alternative diagnosis/treatment is possible, prioritize that,” Jimba said by email. “If it necessary for diagnosis, including cases of emergency, tell your doctor to minimize the number of X-rays taken.”