***REVISED***

NRC ISSUES NEW GUIDANCE ON RELEASE OF PATIENTS

FOLLOWING IODINE TREATMENT FOR THYROID CONDITIONS

The Nuclear Regulatory Commission has advised medical licensees who conduct outpatient treatment of thyroid patients with iodine-131 (I-131) that recommending patients stay at 

hotels immediately after treatment is strongly discouraged.

In new guidance to licensees, NRC also reminded doctors of their responsibilities to 

consider a patient’s intended destination and provide instructions on how to limit potential 

radiation exposures to the public following treatment.

The NRC is responding to continuing concerns that thyroid patients, who typically 

remain radioactive for a few days following administration of I-131, sometimes check into hotels 

or motels instead of going home, raising the potential that other people – especially hotel 

workers and guests – may unknowingly be exposed to radiation.

“The administration of radioactive iodine provides essential medical therapy to thousands 

of seriously ill patients, and outpatient procedures can increase access to this treatment without 

significant health or safety risk to the public,” said Robert J. Lewis, director of the NRC’s 

Division of Materials Safety and State Agreements. “However, it is the NRC’s goal to limit 

unnecessary radiation exposure to anyone to the greatest degree possible, and it is the doctor’s 

responsibility to carefully evaluate patient release to other locations and communicate to the 

patient additional radiation safety precautions that may be appropriate for such locations.”

NRC regulations allow I-131 patients to be released following treatment when the 

radiation dose to third parties is not likely to exceed 500 millirem. (An average person receives 

about 300 millirem each year from natural and background radiation.) The regulations assume 

the dose would apply principally to the patient’s family or other caregivers during the first few 

days the patient spends at home following treatment. Accordingly, doctors are required to 

consider the patient’s living conditions and provide instructions for avoiding unnecessary 

exposure to others.

NRC NEWS

U.S. NUCLEAR REGULATORY COMMISSION

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E-mail: opa.resource@nrc.gov

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No. 11-024 February 14, 2011
NRC also reminded doctors to inquire about the patient’s intended destination following 

treatment so that appropriate instructions may be given on how to manage exposure to others. If 

a patient is adamant on not being hospitalized or not going to a private residence, and plans to go 

to an alternative location such as a hotel, doctors must still provide adequate instructions on how 

the patient can keep radiation doses to others as low as possible.

The guidance is contained in Regulatory Issue Summary 2011-01, dated Jan. 25, and 

available on the NRC website at 

http://www.nrc.gov/reading-rm/doc-collections/gen-comm/reg-issues/2011/index.html. In 

previous guidance issued in 2003 and supplemented in 2009 (both at 

http://www.nrc.gov/reading-rm/doc-collections/gen-comm/info-notices/2003/), the agency 

discussed how patients might trigger homeland security radiation alarms. And in guidance issued 

May 12, 2008

(http://www.nrc.gov/reading-rm/doc-collections/gen-comm/reg-issues/2008/index.html), the 

NRC discussed precautions to protect young children who may come into contact with I-131 

patients.

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