Are X-Rays Safe for Kids? Radiation Risks in Pediatrics

Is it harmful for children to have X-rays?

A 1.5-year-old child bumped their temple against a chair, resulting in a swelling.
They were taken to the emergency room, where the doctor arranged for two head X-rays, but the neck was not protected with a lead apron.
Later, a 3-year-old child experienced abdominal pain, and the doctor also ordered an X-ray, which revealed constipation.
Is there a radiation risk to the children? I've heard that children's thyroid glands, eyes, and gonads are particularly sensitive.
Another child, at age 4, had a persistent cough, leading to two chest X-rays within four days.
At age 5, due to severe coughing, the doctor also ordered an X-ray (not sure how many images were taken).
Additionally, due to dental issues, this child had four X-rays of the upper left teeth and one full-mouth X-ray within three months.
During the full-mouth X-ray, the lead apron was an adult size, leaving the chest unprotected and the neck without any shielding.
I am currently very concerned about potential harm and whether there may be future issues arising from this exposure.

Weixiao, 30~39 year old female. Ask Date: 2020/09/09

Dr. Pei Rensheng reply Pediatrics

Hello! The International Commission on Radiological Protection (ICRP) recommends using the Sievert (Sv) to quantify the potential harm of radiation to the human body.
The average background radiation dose in Taiwan is approximately 1 to 2 millisieverts (mSv) per year.
The dose from general X-rays, such as those of the chest, skull, and extremities, is relatively low, mostly below 0.1 mSv.
However, X-rays of the neck, abdomen, and pelvic region require higher energy to penetrate more organs and soft tissues, resulting in doses ranging from 0.2 to 0.7 mSv.
The radiation dose from a head computed tomography (CT) scan is about 2 mSv, while doses from chest, abdomen, or pelvic CT scans are even higher.

Children, being in a growth and development phase with active cell division, are much more sensitive to radiation than adults, and the younger they are, the more sensitive they become.
Therefore, when undergoing high-dose radiation examinations, it is beneficial to implement lead shielding for specific areas.
Since the doses from chest, abdomen, and oral X-rays are already low, additional protection is generally not necessary (most hospitals do not provide special shielding).
Wishing you all the best! Sincerely, Ren Sheng.

Reply Date: 2020/09/09

More Info

When it comes to the safety of X-rays for children, it's essential to understand the balance between the medical necessity of imaging and the potential risks associated with radiation exposure. X-rays are a valuable diagnostic tool that can help identify various medical conditions, but they do come with some risks, particularly for young children whose bodies are still developing.

Children are more sensitive to radiation than adults for several reasons. Their cells are rapidly dividing, which increases the risk of radiation-induced damage. Additionally, they have a longer life expectancy, which means there is more time for potential radiation-related effects, such as cancer, to manifest. The organs that are particularly sensitive to radiation include the thyroid gland, reproductive organs, and eyes.

In your case, the child who underwent two head X-rays at 1.5 years old and another X-ray at 3 years old for abdominal pain, as well as the 4-year-old who had multiple chest X-rays and dental X-rays, raises valid concerns about cumulative radiation exposure. However, it's important to note that the radiation dose from a single X-ray is relatively low. For instance, a typical chest X-ray exposes a patient to about 0.1 mSv (millisieverts), while a head CT scan can expose a patient to about 2 mSv. In comparison, the average person is exposed to about 3 mSv of natural background radiation per year.

The International Commission on Radiological Protection (ICRP) suggests that doses below 100 mSv are unlikely to cause any significant clinical harm. Therefore, while multiple X-ray exposures can accumulate, the individual doses from standard X-ray examinations are generally considered safe when medically justified.
Regarding your concerns about the lack of lead shielding during these procedures, recent guidelines from organizations like the American Association of Physicists in Medicine (AAPM) indicate that the use of lead aprons may not always be necessary and can sometimes interfere with imaging quality. The focus is on minimizing radiation exposure while ensuring that the diagnostic quality of the images is maintained.

If you are worried about the cumulative effects of these X-rays, it is advisable to keep a record of your child's imaging history and discuss it with your pediatrician or a radiologist. They can help assess the necessity of future imaging and explore alternative diagnostic methods that do not involve radiation, such as ultrasound or MRI, when appropriate.

In terms of flying, the radiation exposure from cosmic rays at high altitudes is indeed higher than that from a single X-ray. However, the risk associated with flying is generally considered low and does not pose a significant health threat to children.

In summary, while there are risks associated with X-ray exposure, the benefits of obtaining necessary medical information often outweigh these risks, especially when the imaging is performed judiciously and for valid medical reasons. It is crucial to maintain open communication with healthcare providers about the need for imaging and any concerns regarding radiation exposure.

Similar Q&A

Concerns About Radiation Exposure from X-rays in Young Children

Hello, doctor. My 2-year-old child has a slight inward walking pattern that sometimes appears and sometimes does not. We visited the orthopedic department at National Taiwan University Hospital, where the doctor examined the walking posture and recommended X-rays. When we arrived...

Dr. Wang Yifen reply Radiology
On April 2, 2019, the American Association of Physicists in Medicine (AAPM) issued a position statement recommending the cessation of the use of patient gonadal and fetal shielding in routine X-ray diagnostic imaging. This is due to the potential for such shielding to obscure org...

Is X-ray Safe for My Toddler? Understanding Risks and Concerns

Hello, doctor. My child is currently 1 year and 4 months old. He had a fever previously, which came and went, and we took him to the emergency room of a large hospital twice. Both times, he had a chest X-ray (the second one was taken 14 days after the first). I would like to know...

Dr. Xiao Kaiwen reply Pediatrics
With the advancements in medical technology, the amount of radiation exposure from a standard X-ray is very low, and undergoing two standard X-rays does not have any adverse effects on the body. In fact, we are exposed to natural background radiation every day, so there is no nee...

Understanding the Impact of X-rays on Children's Health: A Parent's Concern

Hello Doctor, I would like to ask about my daughter, who is in the first grade. During the school health check-up, it was found that she has scoliosis. The school advised us to take her to a medical facility for further examination. We took her to an orthopedic hospital, where ...

Dr. Sun Shengyi reply Radiology
Hello Mr. Huang: Generally, the radiation dose from standard spinal X-rays (which typically consists of two images) does not exceed 1 millisievert (mSv). When the frequency of these X-rays is low (a few times within a year), this dose is not likely to cause any significant harm. ...

Is Frequent X-Ray Exposure Safe for Children’s Health?

Hello, doctor. I apologize for the interruption, but I would like to ask about my child who frequently gets sick (coughing, nasal congestion, nosebleeds, etc.). Each time we visit the doctor, they request X-rays for my child, totaling about two for the head (nose) and four to fiv...

Dr. Wang Yifen reply Radiology
Hello, the necessity of X-ray examinations is considered without limiting the number of tests or the dosage. Whether an X-ray is necessary is determined by the attending physician based on clinical judgment. Children, due to their developing organs and longer life expectancy, are...