Radiation Exposure from X-rays in Children

X-rays are a kind of imaging technique that provides your healthcare provider with information about structures inside the body. These tests expose children to low doses of radiation.

X-rays are forms of radiant energy, similar to light or radio waves. X-rays have more energy than rays of visible light or radio waves, and they can penetrate your body. This allows the radiologist to get X-ray pictures. You can then view these pictures on a photographic film or on a computer monitor.

You may be concerned about exposing your child to radiation. But, it’s important to understand that radiation is around us all the time. Every day, we take in small amounts of radiation from the sun and other sources. People who live at high altitudes or who take many flights are around even more radiation exposure.

However, radiation can damage living tissue and alter DNA, especially in large doses. In very large doses, it can cause severe sickness and death. Medical tests use much, much smaller doses of radiation and don’t cause such problems. These lower doses of radiation may not be completely risk free, though. The main concern is that radiation exposure may slightly increase your child’s risk of cancer later in life. Some of this radiation exposure might come from natural sources, but some of it can come from certain medical tests, like X-rays.

Certain kinds of X-ray imaging expose your child to more radiation than others. Continuous X-ray (called fluoroscopy) may expose your child to more radiation than a single X-ray. A computed tomography scan (CT) is another type of imaging test that uses X-ray technology. A CT scan exposes your child to significantly more radiation than a single X-ray image (called a radiograph).

Your child might need X-rays for a number of different health problems, from a broken bone to stomach pain. X-rays are particularly good at providing information about the hard tissues in the body, like bones. In some cases, X-rays can help with other medical procedures, like guiding the placement of a tube in the body, or providing continuous information about anatomy during surgery.Radiation exposure from an X-ray itself will not cause any symptoms.

Increased radiation exposure may increase your child’s risk for future cancer. Different types of X-ray tests use different amounts of radiation. For example, a standard X-ray of the chest provides about the same amount of radiation that you would normally get from background environmental radiation in 2 to 3 days. This is not very much radiation—less than you get on an airplane flight. This is why most healthcare providers don’t worry much about radiation exposure from a single X-ray.

In contrast, a standard chest CT might provide several hundred times that amount of radiation. This is roughly equivalent to the amount of radiation exposure you would normally get in a couple of years.

Not surprisingly, X-rays that cover more of the body expose your child to more radiation than X-rays over a smaller part of the body. Shielding can help reduce radiation exposure. (This involves using a device, like a lead apron, to shield other parts of your child’s body from the X-ray.)

Each additional radiation exposure, depending on the type, strength, and other factors, adds to your child's total risk of developing cancer in the future. Overall, a child who has had dozens of CT scans is at a higher risk of problems from radiation than a child who has had only a few X-ray radiographs.

As scary as the risks of radiation exposure may sound, it is important to consider the benefits of X-rays and other tests that may expose your child to radiation. Your child’s healthcare provider will consider how important the testing is to try to avoid unnecessary tests.

Each X-ray, fluoroscopy, or CT scan provides a certain amount of radiation exposure. If you know the medical tests your child has had, you can get an estimate of the amount of radiation exposure he or she has had from X-rays and other medical testing. It is important to understand, however, that small amounts of radiation over a long time are much safer than a single large exposure.

Once the radiation exposure has happened, there is no way to treat it. You can only work towards minimizing the amount of radiation your child receives.

Of course, if your child gets cancer later in life (possibly partly due to radiation exposure), this would need its own treatment.

The main risk of radiation exposure is developing cancer later in life. Researchers still aren’t quite sure how much radiation exposure increases your child’s future risk of cancer. For most children, radiation exposure to X-rays probably only increases their risk of cancer a very small amount, if at all.

The chance of getting cancer increases with the amount of radiation exposure. A child who has had a few X-rays may not have any increased risk. A child who has had many CT scans is at greater risk of future cancer (though this may still be a relatively small increase in risk). Keep in mind that people get cancer for many reasons. Your child might get cancer later in life even if he or she hasn’t had any radiation exposure from X-rays.

Theoretically, radiation exposure from X-rays might damage reproductive cells. This could theoretically cause a mutation that future generations may inherit. These risks are probably very, very small.

People exposed to large amounts of radiation all at once may get very sick and even die. (This might happen during a nuclear accident or bomb.) Radiation levels from medical tests (including X-rays) are much, much lower than this, and don’t cause such effects.

Sometimes, X-rays are necessary and of clear medical benefit. In these cases, the risks of not having an X-ray are clearly greater than any small risks of the X-ray itself. Still, it makes sense to minimize the amount of radiation your child receives. To do this:

• Talk with your healthcare provider if you are worried that your child is receiving too many X-ray tests
• Only allow X-rays, fluoroscopy, or CT scans when there is a clear medical benefit to your child
• Use the lowest amount of radiation possible (based on your child’s size) to get the needed images
• Only X-ray the area needed
• Use shielding when possible (especially for very sensitive areas, such as the thyroid gland and genitals)
• Do not repeat scans unless necessary

Don’t be afraid to work with your healthcare provider to meet these goals. Your radiologist should have good training in these areas as well.

It is important to consider the risks and benefits of any testing that may expose your child to radiation to help avoid unnecessary exposure.

Don’t be afraid to ask your healthcare provider if another test, which uses less radiation, could provide the same information. (Ultrasound, for example, does not use any radiation, and a low-dose CT provides less radiation than a standard CT.)

Remember that there are many times when the very small risks from X-ray imaging are well worth it.

X-rays are a form of radiant energy. Simple X-ray radiographs, fluoroscopy, and CT scans are tests that use radiant energy. This radiation exposure may pose some risks, so your child should only have these tests when they are necessary:

• Radiation exposure from X-rays may slightly increase the risk of later cancer, especially in children who have had many tests with high radiation exposure.
• Radiation exposure from X-rays does not pose any short-term problems. Long-term problems are very small.
• Simple X-ray radiographs provide very little radiation exposure and therefore provide very little, if any, risk.
• CT scans provide much more radiation exposure and may pose more risk.
• Although risks from radiation exposure from X-rays can add up over time, this still only increases the overall risk of cancer to your child slightly.
• Work with your healthcare provider to minimize your child’s X-ray exposure. Remember that these tests are sometimes very beneficial.

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.