Radiation Contamination at Crematorium Traced to Deceased Patient With Cancer Who Underwent Radiotherapy

Radioactivity was detected at an Arizona crematory after a deceased man with pancreatic cancer was incinerated there. The man had undergone radiation therapy days before his death and subsequent cremation. A research letter published in JAMA highlights the case.

Radiotherapy leads to contamination

According to the case report, a 69-year-old man with a pancreatic tumor was treated with lutetium-177 dotatate, a radioactive treatment, at the Mayo Clinic in Arizona in 2017. He died days later at a different hospital and was cremated five days post-treatment. The hospital where he died reportedly did not notify the crematorium about his radiation treatment. After learning of the patient’s death, a safety officer from the Mayo Clinic notified the crematorium. The crematorium was surveyed one-month post-treatment with a Geiger counter. A urine sample from an employee was also analyzed.

Radiation exposure

Incineration “volatilizes” radiopharmaceuticals in a dead body, according to the researchers, and radioactive contamination can be “inhaled by workers (or released into the adjacent community) and result in greater exposure than from a living patient.”

The Geiger counter picked up a range of radioactivity—primarily the isotope contained in the medicine the patient received—on equipment in the crematorium, including the oven, vacuum filter, and bone crusher.

In addition, a different isotope was detected in the employee’s urine, and because he had not undergone a medical procedure using radiopharmaceuticals, the researchers believed that he inhaled the radioactive contaminant while incinerating other bodies.

There are no federal regulations regarding the cremation of patients who have received nuclear medicine, and state regulation vary. “Radiopharmaceuticals present a unique and often overlooked postmortem safety challenge,” the authors noted.