Radioactivity appearing at landfills in household trash of nuclear medicine patients: much ado about nothing?

The U.S. NRC in 1997 removed its arbitrary 1.11 GBq (30 mCi) rule, which had been in existence for almost 50 y, and now many more patients receiving radionuclide therapy in nuclear medicine can be treated as outpatients. However, another problem has the potential to limit the short-lived reality of outpatient treatment unless nuclear medicine practitioners and the health physics community gets involved. Radioactive articles in the household trash of nuclear medicine patients are appearing at solid waste landfills that have installed radiation monitors to prevent the entry of any detectable radioactivity, and alarms are going off around the country. These monitors are set to alarm at extremely low activity levels. Some states may actually hold licensees responsible if a patient's radioactive household trash is discovered in a solid waste stream; this is another major reason [along with continued use of the 1.11 GBq (30 mCi) rule] why many licensees are still not releasing their radionuclide therapy patients. This is in spite of the fact that the radioactivity contained in released nuclear medicine therapy patients, let alone the much lower activity level contained in their potentially radioactive household wastes, poses a minimal hazard to the public health and safety or to the environment. Currently, there are no regulations governing the disposal of low-activity, rapidly-decaying radioactive materials found in the household trash of nuclear medicine patients, the performance of landfill radiation monitors, or the necessity of spectrometry equipment. Resources are, therefore, being unnecessarily expended by regulators and licensees in responding to radiation monitor alarms that are caused by these unregulated short-lived materials that may be mixed with municipal trash. Recommendations are presented that would have the effect of modifying the existing landfill regulations and practices so as to allow the immediate disposal of such wastes.