Blog Post

21
AUG
2014

Probity of Radiographic Exposure for DAE

The legal status of exposing subjects to ionising radiation is occasionally cited by critics of DAE as a justification for abandoning the technique.

The legislation as it relates to DAE has been explored and summarised in a article by Dr Philip Marsden, Forensic Odontologist, London, UK.

This note quotes almost verbatim from that article.

 

The issue of dental age estimation of the living is an uncommon procedure in Forensic Odontology practice compared to identification of the dead, or the analysis of bite marks.  The request for such an assessment most frequently comes in in relation to asylum seekers where the age stated is questioned.

The maturity of such individuals usually means that age estimation can only be based on dental development.  The great majority of disputed ages occurs in young people who look like adults but who claim to be under 18 years old.  Thus the age estimation can only be carried out by using the development of the third molar.  This requires that at least one radiographic exposure.  It is a common misconception that radiographs can only be taken for therapeutic reasons. This is not so. The legislation as it relates to the exposure of radiographs for non-therapeutic reasons.

There are two  significant pieces of legislation. These are:S.I. No 1059 [Health and Safety, “The Ionising Radiation (Medical Exposure)Regulations 2000”] (IRMER) and as amended 2006. http://www.legislation gov.uk/uksi/2000/1059/contents.made   and
S.I. NO 1769, [Health and Safety, Environmental Protection, “The Justification of Practices Involving Ionising Radiation regulations 2004”] as as updated
http://www.decc.gov.uk/assets/deccwhat%20we%20do/uk%20energy%20Supply/energy%20mix/nuclear/radioactivity/justification-gyidance.pdf

It is true essential that the consent of the individual IS required in ALL cases and they are perfectly entitled to refuse consent for a radiograph to be taken. If consent is given, as happens in almost all cases, and assuming the individual (or accompanying carer) is competent to give consent, then the existing legislation already provides for the taking of radiographs as part of a medico-legal procedure.

This is defined in IRMER in 2(1) as “a procedure performed for insurance or legal purposes without a medical indication”.

In 3.(e) it is confirmed that IRMER regulations apply to “the exposure of individuals as part of  medico-legal procedures.”

The notes on good practice for IRMER 2000 are at http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/
dh_064707.pdf   This provides the following explanation:

5.6 ” medico-legal procedure”

5.6.1 This category of exposure will require those required for legal purpose of any kind. e.g. those required in connection with legal proceedings or those required prior to emigration. As with all cases, 7.(7). applies  “the need to keep doses arising form the medico-legal exposure as low as reasonably practicable”.

In 6.(1). (a) it confirms that the exposure  ” … has been justified by the practitioner as showing a sufficient net benefit giving appropriate weight to matters set out in Para 2. (see abocer for relevant section of para 2).

Section 6. (3) states ” In considering the weight to be given to matters referred to in Para 2, the practitioner justifying any exposure pursuant to Para 1a shall pay special attention to –

a) Exposures on medic0 legal grounds;

b) exposure that have no direct health benefit for the individuals undergoing the exposure;

Sufficient net benefit not only applies to the individuals but also;

6.(2). (b) … Benefits to Society … … ”

This aspect is reiterated in the “The Justification of Practices Involving Ionising Radiation regulations 2004.” where section 2 of the forward reads:

“European Union Council Directive 96/29/Euratom (known as the Basic Safety Standards Directive) lays down the basic safety standards for the protection of the health of workers and the general public against the dangers arising from ionising radiation.  The Directive requires Member States to ensure that all new classes or types  of practice

 

 

 

 

 

 

 

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