Given the widespread use of radiation in nuclear medicine and radiation oncology procedures in the United States and around the world, it is likely that crematory operators have cared for the bodies of individuals who have undergone treatments involving the use of radiation.
Understandably, the recent publication of a Journal of the American Medical Association (JAMA) Research Letter titled “Radiation Contamination Following Cremation of a Deceased Patient Treated with a Radiopharmaceutical” has raised concerns among NFDA members and others in the profession about potential exposure and risk. To that point, the American Association of Physicists in Medicine (AAPM) and American College of Radiology (ACR) published the following statement:
“Radioactive materials are used routinely in medical practice to improve human health. The risk of harm to the crematorium operator is so small that it cannot be measured.”
Read the full statement here: https://www.radiologybusiness.com/topics/policy/aapm-acr-radioactive-cremation-radiopharmaceutical.
Many members are also seeking guidance about whether their existing policies and procedures for dealing with this potential exposure or risk are effective. The most up-to-date information from the medical community indicates that the risk of exposure is minimal and supports current handling guidelines. Here is that information:
Low risk of radioactive contamination from cremation when proper safety procedures followed (AAPM): https://www.aapm.org/publicgeneral/LowRiskRadioactiveContaminationFromCremation.asp
Guidelines for Handling Decedents Contaminated with Radioactive Materials (CDC): https://emergency.cdc.gov/radiation/pdf/radiation-decedent-guidelines.pdf
Model Procedure for Medical Examiners/Coroners Handling body/remains potentially contaminated (Dept. of Energy): https://www.energy.gov/sites/prod/files/em/TEPP/2-b-4MedicalExaminer-CoronerGuideforHandlingBody-HumanRemains.pdf
Radiation Protection Guidelines for the Safe Handling of Decedents (CNSC): http://nuclearsafety.gc.ca/eng/acts-and-regulations/regulatory-documents/history/regdoc2-7-3.cfm
Importantly, one of the tenets of the National Funeral Directors Association’s Certified Crematory Operator Program™ is to ensure that crematory operators have the necessary information about the decedent to conduct cremation safely. NFDA guidance on authorizations includes the need to obtain representation that there are no radioactive or other implants, pacemakers or mechanical devices in the remains as they may create a hazardous condition when placed in the cremation chamber and subjected to heat. Typically, the authorization includes detail as to all devices which may have been implanted in or attached to the remains, which may possibly require special precautions before the remains are placed in the cremation chamber and subjected to heat.
The JAMA article concludes: “ … further studies are needed to evaluate the frequency and scope of radiation contamination and health effects of repeated or long-term exposure of employees in crematoriums in the United States … Future safety protocols for radiopharmaceuticals should include postmortem management, such as evaluating radioactivity in deceased patients prior to cremation and standardizing notification of crematoriums.” NFDA will continue to share important updates on this research should it become available.