favorably than nuclear power because of the perceived benefits associated with medicine and the relatively strong trust in the medical profession. Public perception, however, is not free of anxieties associated with radiation's risk of subsequent cancer. In view of the psychological profiles discussed above, strong public reaction to incidents of overexposure is not surprising. Small incidents can cause major ripple effects, and these in turn may prompt calls for stricter regulation.
Further studies are clearly necessary to understand some of the perceptions of radiation medicine risk. There is a distinct need to develop appropriate strategies for dealing with these perceptions. Effort should be placed on trust-building strategies that ease the "dread" and "unknown" aspects of radiation risk. The major medical benefits of radiation medicine must be emphasized. Furthermore, the perceptual linkages among nuclear power, Three Mile Island, and radiation medicine must be uncoupled.
This chapter has explored several aspects of the risks involved in the use of ionizing radiation in medicine. Having set out basic concepts necessary to understanding the regulation of these risks, including the linear, no-threshold model currently used by U.S. regulatory agencies, the chapter then goes on to look at what is known about the actual incidence of adverse events in radiation medicine. Although comparisons between misadministrations involving NRC-regulated materials and adverse events in other medical modalities are imperfect, the committee felt that such a broad contextual view helped it in its assessment of the risks arising from use of byproduct materials. Finally, recognizing that regulation is often as much a response to public pressure as it is to scientific opinion, the committee has included a look into what is known about the public's perception of ionizing radiation.
Allan, E.L., and Barker, K.N. Fundamentals of Medication Error Research. American Journal of Hospital Pharmacy 47:555–571, 1990.
Anonymous. Deaths During General Anesthesia: Technology-Related, Due to Human Error or Unavoidable? An ECRI Technology Assessment. Journal of Health Care Technology 1(3):155–175, 1985.
Anonymous. Thousands of Nursing Homes Do Not Follow Drug Orders. American Journal of Hospital Pharmacy 46:426–434, 1989.
Bates, D.W., Cullen, D.J., Laird, N., et al. Incidence of Adverse Drug Events and Potential Adverse Drug Events. Journal of the American Medical Association 274:29–34, 1995.