Reassurance on CT radiation please?

[MadamMuck]

Two months ago my husband accidentally fractured our five month old son’s femur. While I will forever be extremely unimpressed by this I forgave my husband instantly as he’s a great Dad, not angry, no issues etc. Our hospital discharge papers say ‘no concerns re. non accidental’.

The experience in hospital was extremely distressing. We dealt with a trio of doctors, police and social services. Police were very professional and social services ok but our two main doctors were stony, accusing and cynical. I expected them to be gentle and professional.

The fact my son had a fracture caused by my husband is obviously enough to deal with but amazingly this has ended up being a minor detail compared to how I felt I was received by the doctors and the experience I had in hospital. I am still very easily upset about it to the point I have visited my doctor.

One major thing preventing me from getting over it all is the radiation our son got owing to all the tests the hospital did checking for abuse. They have provided this:

CT Head: 1.3 mSv
CT Chest: 1.9 mSv
Skeletal Survey 0.14 mSv
Total: 3.34 mSV.

(The skeletal led to the chest CT as they thought they could see something but it turned out to be nothing.)

The above will exclude the original xray he got at the after hours clinic that revealed the fracture and led us to hospital. The original xray was of his legs, pelvis and tummy and looks like he got two of those with legs in different positions.

Any experts out there who can please tell me what his excess cancer risk is and be honest about it? Or do I need to get a life?

I am still very teary about the experience especially as I knew no other damage would be found. I wasn’t consulted properly about the tests taking place or radiation and I didn’t understand radiation risk properly at the time. I’ve made a complaint about informed consent which looks like it has gone to the top but It’s pretty much eating away at me so any insights would be appreciated. Thanks, from down in New Zealand.

There's honestly more radiation on a airplane trip than you'd acquire in a ct scan
Please try not to overthink it and worry. If it was very very dangerous then ct scanners wouldn't exist

The doctors had a duty of care to be absolutely certain that it was accidental, there’s nothing else they could’ve done and they would not put your child through needless radiation if they felt it wasn’t 100% necessary.

Sorry not able to decipher the figures, but I do know that they have newer CTs now that have less radiation, and that they do try and make them as minimal as possible for kids - pretty good guidelines for kids on radiation exposure and your child did not have to have contrast (which is double CT), and there were only two and not repeated.

Some poor kids with cancer etc do have repeated CT scans and that is when you’d have to be more careful.

And also, the risk generally is still very, very small eg for example say a risk for brain tumor is 1 in 100,000 the CT increase in risk might be 1.5 x but this would still only mean 1.5 chance lifetime risk in 100,000. It’s called ‘absolute risk’ and they do work this out carefully.

The original x rays by the way would be so low risk they wouldn’t really even register.

I couldn't say specifically about the risk of what your child had, but that amount of radiation is the same as natural background radiation in some parts of the world. Children in some parts of the world are exposed to up to 3.5mSV of background radiation every single year including in the womb.

Sending you love as we went through something similar due to a bruise on our child. As a nurse I completely understand their safaguarding procedure but it feels completely horrendous when it’s happening to your family!!! We were also made to feel like we had done something wrong which was just awful
I don’t know too much about the exact radiation but we were reassured that people living in certain areas of the world are exposed to more. It’s certainly not ideal when you know that the CT is unnecessary! Hope you’re all ok x

I can decipher this for you but I don't think it would be helpful on here.
I don't understand why they have given you the effective doses without any context.
If you would like more information on the radiation doses then please ask to speak to a radiologist or better still the radiation protection adviser in that health board/trust and they can help talk you through it with context and answer any questions.
Please be assured there are extremely strict legal frameworks for radiation exposures, especially for children and the doses must be kept low. Eyeballing these doses without knowing the scanner/procedures they do seem low.
The UK average for background radiation is about 2.2mSv per year. So to date, including whilst in utero your child will have been exposed to nearly the same amount as the CT chest. Hopefully this will help reassure you on the levels of risk involved.
But please ask for more information. They actually by law have to provide you with information on the radiation risks.
Hope this is reassuring.

Ah sorry just read you are in NZ but similar governance and safety arrangements would apply I'm sure. Not sure on background radiation there though but they will likely be very similar too.

I do have some experience of industrial radiation protection, although can't advise on cancer risk. In the UK the annual dose limit is 20mSv for adults, and 6mSv for trainees under 18. That's for exposure just at work, so still allowing for background exposure, medical exposure etc in addition. Hopefully that puts your value of 3.3mSv in context. Try not to worry.

They're being careful. My son's fingers and knuckles cracked at school. Asked each time how? At school in fire door.

www.gov.uk/government/publications/ionising-radiation-dose-comparisons/ionising-radiation-dose-comparisons

This website is really helpful - looks like dose was just above the usual yearly radiation we receive and less than living in Cornwall (and you wouldn't worry about that!)

Thanks everyone for your posts, really appreciate the support and have asked the doctors for context thanks to your advice. They had told me the dose was 'low risk' so yes, what does low risk mean!? I don't care how small the increased cancer risk is, they should be stating it upfront. My baby is obviously my treasure so I'll make a mountain out of a molehill about it when I find out and then have to get over it the same as everyone else who has had a similarly horrendous experience! Thankfully I am having days where I hardly think about it now so I know I can put it behind me. X

A dose of 100 mSv or more has been shown conclusively to lead to an increased cancer risk. 10-100 mSv may lead to an increased risk of cancer but the evidence is poor and it's not clear where the limit lies. Below 10 mSv there is no clear link to an increased cancer risk. So with a dose around 3 mSv your baby has no increased risk of cancer.