Doctors and their patients in many countries are facing increasing problems receiving lifesaving isotopes for treating a range of illnesses. The isotopes are used in nuclear medicine for diagnosis and therapy.
A meeting of experts at the IAEA recently reviewed the situation, finding a growing incidence of denials or delays in international shipments of needed radioactive material, including short-lived isotopes used for medical diagnosis and treatment. Security and economic issues are among concerns driving the problems.
Most countries around the world import isotopes commonly used in medicine, such as those used to treat cancer, diagnose heart attacks or sterilize medical equipment. Hospitals and clinics depend on these international shipments to arrive on time, particularly if the isotope has a short half-life and must be sent by air.
Industry representatives have told the IAEA of increasing difficulties in delivering lifesaving isotopes that require urgent international transport. The precise number of denials occurring worldwide is not known.
"If an airline or other transport provider refuses to take a shipment, or is unable to take a shipment, then this increases the prospect of someone missing a cancer treatment," Mr. Michael Wangler, IAEA Unit Head, Safety of Transport of Radioactive Materials Unit, said.
"There is a risk that if more airlines do deny, particularly where few airlines serve key regions, then this does raise a serious issue. It potentially means that medical clinics and hospitals in specific areas are at risk from being denied essential medical supplies," Mr. Wangler said.
Shipments of medical and industrial radioactive material are regulated by countries and the airline industry in accordance with the IAEA´s international Regulations for the Safe Transport of Radioactive Material. "Radioactive material is very safely transported, based on standards developed by the IAEA which have been operating for 43 years. What the current regulatory system lacks are enhanced efforts or separate treatment to facilitate the rapid distribution of medical isotopes when warranted," Mr. Wangler said.
Across the globe, he said that some airlines have policies against carrying any radioactive material. In other instances, a country´s regulatory controls may make it very difficult for the airlines to meet needed requirements, creating bottlenecks that have effectively blocked shipments. In cases involving isotopes with short half lives - such as iodine used to treat and detect thyroid tumours - it is rendered useless, or if it has missed the flight and gets on another one, its use is more limited.
The July meeting at the IAEA is part of international fact-finding to gauge the problem, improve the flow of information, and formulate solutions. Participating were representatives from regulatory authorities, producers of radioactive sources, airlines, shippers and other transport operators, and international organizations. Previous meetings were held in January 2004.
International transports of radioactive sources shipped by sea were also said to be experiencing delays and denials. This involves a wide range of radioactive material used for everyday applications, from pacemakers, medical equipment and electricity generation, to improving the safety of food, checking for hairline fractures in pipelines or controlling disease laden insects. Recommendations and actions stemming from the January and July meetings will go before the IAEA´s General Conference in September 2004 for adoption.