{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:05:53Z","timestamp":1753884353159,"version":"3.41.2"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"1119","license":[{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>A thyrotoxic paediatric patient with incontinence, autism and Down\u2019s syndrome was referred for radioiodine therapy. Here, the risk assessment methodology and measures taken to deliver a legally compliant treatment that was acceptable to the family are described.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>Prior risk assessment indicated that the most active incontinence waste would require decay storage until it could be transported for disposal. The Health and Safety Executive (HSE) indicated that school staff would be occupationally exposed under the Ionising Radiations Regulations (2017) based on the patient\u2019s retained activity. To avoid the need for HSE registration, it was advised that the patient\u2019s return to school may need to be delayed slightly. Post-treatment, confirmatory waste and patient dose rate measurements were made to refine the advised time scales.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>Domestic waste disposal resumed at 28 days. The patient recommenced schooling a few days after their school reopened after the summer break. The school underwent HSE notification.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>Careful planning allowed us to provide a safe, compliant treatment regarding waste management and occupational exposure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge:<\/jats:title>\n                  <jats:p>Incontinent 131I outpatient treatments require detailed, patient specific waste management. The HSE considered school staff as occupationally exposed by the patient well after normal social restrictions had ended.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1259\/bjr.20200813","type":"journal-article","created":{"date-parts":[[2020,12,2]],"date-time":"2020-12-02T19:48:51Z","timestamp":1606938531000},"source":"Crossref","is-referenced-by-count":1,"title":["The challenges of radioiodine treatment for incontinent paediatric patients with complex care needs"],"prefix":"10.1093","volume":"94","author":[{"given":"Nathan","family":"Dickinson","sequence":"first","affiliation":[{"name":"Medical Physics and Clinical Engineering, Nottingham University Hospitals , Nottingham , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Poveda","sequence":"additional","affiliation":[{"name":"Medical Physics and Clinical Engineering, Nottingham University Hospitals , Nottingham , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Greaves","sequence":"additional","affiliation":[{"name":"Medical Physics and Clinical Engineering, Nottingham University Hospitals , Nottingham , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charnie","family":"Kalirai","sequence":"additional","affiliation":[{"name":"Medical Physics and Clinical Engineering, Nottingham University Hospitals , Nottingham , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Smith","sequence":"additional","affiliation":[{"name":"Medical Physics and Clinical Engineering, Nottingham University Hospitals , Nottingham , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,2,15]]},"reference":[{"key":"2024050215135662700_b1","article-title":"The environmental permitting (England and Wales) regulations 2010","volume":"675","year":"2010","journal-title":"Statutory Instruments"},{"key":"2024050215135662700_b2","article-title":"The ionising radiations regulations 2017","volume":"1075","year":"2017","journal-title":"Statutory Instruments"},{"key":"2024050215135662700_b3","article-title":"The ionising radiation (medical exposure) regulations 2017","volume":"1322","year":"2017","journal-title":"Statutory Instruments"},{"key":"2024050215135662700_b4","first-page":"1","article-title":"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, and repealing directives 89\/618\/Euratom, 90\/641\/Euratom, 96\/29\/Euratom, 97\/43\/Euratom and 2003\/122\/Euratom","volume":"57","author":"The Council Of The European Union","year":"2014","journal-title":"Off J Eur Union"},{"key":"2024050215135662700_b5","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1097\/00006231-199106000-00003","article-title":"Radiological protection guidance for radioactive patients--new data for therapeutic 131I","volume":"12","author":"Hilditch","year":"1991","journal-title":"Nucl Med Commun"},{"key":"2024050215135662700_b6","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/00006231-199303000-00003","article-title":"Radiation dose rates from adult patients receiving 131I therapy for thyrotoxicosis","volume":"14","author":"O'Doherty","year":"1993","journal-title":"Nucl Med Commun"},{"key":"2024050215135662700_b7","article-title":"The carriage of dangerous goods and use of transportable pressure equipment regulations 2009","volume":"1348","year":"2009","journal-title":"Statutory Instruments"},{"key":"2024050215135662700_b8","article-title":"European agreement concerning the International carriage of dangerous goods by road","author":"United Nations","year":"2019","journal-title":"ADR"},{"key":"2024050215135662700_b9","unstructured":"Institute of Physics and Engineering in Medicine\n          \n\u00a0ADVICE NOTICE: Excretion Factors: the percentage of administered radioactivity released to sewer for routinely used radiopharmaceuticals [Internet]\n.\n2018\n. 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