European directive will halt use of MRI scans; cancer diagnosis and treatment will suffer

Sep 25 2007

Implementation of the Physical Agents (Electromagnetic Fields) Directive 2004/40/EC in all Member States could effectively halt the use of magnetic resonance imaging (MRI), an important tool in cancer diagnosis, treatment, and research, a scientist told a press conference at the European Cancer Conference (ECCO 14) (Monday September 24).

The Directive is due to be implemented across Europe by April 2008.

The Directive was drafted by DG Employment, with the aim of minimising workers’ exposure to electromagnetic fields (EMF). Currently eight million MRI patient examinations per year are carried out in Europe, said Professor Dag Rune Olsen, who works in experimental radiation therapy at the Norwegian Radiation Hospital, Oslo, Norway, and is chairman of the physics committee of the European Society for Therapeutic Radiology and Oncology (ESTRO). “But these are likely to have to stop, since the Directive sets limits to occupational radiation exposure which will mean that anyone working or moving near MRI equipment will breach them, thus making it possible for them to sue their employers. Even those maintaining or servicing the equipment may be affected,” he said.

A British study into operator exposure to electromagnetic fields from MRI, published by the Heath and Safety Executive in June 2007, and carried out by Professor Stuart Crozier from Brisbane University, Australia, found that anyone standing within about one metre of an MRI scanner in use would breach the exposure limits laid down in the directive. The Commission has accepted this, and said that it will consider the HSE report together with the study it has commissioned itself, and which is due for publication in October 2007, when deciding whether and how to propose amendments to the directive or to extend the implementation period.

“But they may already be too late,” said Professor Olsen. “Slovakia has already implemented the directive, on the grounds that it was based on the assumption that the limits which it sets would have no effect. This would appear to mean that it is now illegal to carry out MRI scanning in the country.”

The directive in its present form poses particular problems to those healthcare staff who care for patients such as children, the elderly, or those who have been anaesthetised, who need help and comfort during scans. It will also stop the use of MRI for interventional and surgical procedures, and will curtail cutting edge research.

A recent Eurobarometer (Europe-wide opinion poll) showed that most EU citizens felt that they were inadequately protected by authorities against the potential health risk posed by electromagnetic fields. More than two-thirds of people interviewed said that they were not satisfied with the information they received on EMF, and one-third said that they had not been informed at all.

However, in the medical field the use of MRI may lead to more exposure to radiation rather than less, said Professor Olsen. “MRI has to a certain extent contributed to a limit in the increase in the use of ionising radiation in medical imaging, for example, in CT scans. This is important with respect to radiation-related cancer mortality risks and is, as such, in line with requirements laid down in EURATOM Directive 97/43 regarding optimisation and justification of medical exposure to ionising radiation,” he said. “If the public were informed of this I am sure that they would be as keen as I am to see that MRI is allowed to continue. The added value that MRI represents to medical diagnostics has been tremendous.

“Policy-making should be based on sound science, and to my knowledge there is no scientific evidence of long-term adverse health effects of exposure to static or fluctuating magnetic fields that are commonly found during MR scanning. Hasty decisions without scientific support will in this case have a severe impact on medical diagnostics and must thus be avoided. I hope that the Commission will allow a delay in implementation to enable it to examine this issue again and that the Directive could be amended to allow an EU-wide derogation for MRI,” he concluded.

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