Details are important when developing messages. However, too many details can confuse the message or otherwise not make it as effective. When communicating technical subject matter such as that associated with a radiological incident, it’s important to have a good team to effectively communicate messages to the public.
Recently, I was approached by a friend asking about the radiation effects that may be associated with a medical procedure he had not long ago. This isn’t the first time that this has happened, nor do I expect it to be the last time it happens. This time, however, it made me start thinking about how we talk about radiation – not only with respect to medical procedures, but in general. In this particular instance a four gray radiation dose was delivered to the finger in 6 different treatments that happened over a several week time period.
Radiation Terminology
Now, let’s take a timeout for a little health physics lesson. The term ‘radiation dose’ refers to how much energy is deposited into something. Its unit of measure is the rad (used in the US) or the gray (used internationally). Radioactive materials emit various types of radiation, and when that radiation interacts with something (tissue, for example) it deposits its energy into it. This isn’t dissimilar from when someone flicks your ear…when their finger interacts with your ear it deposits energy to the area it impacts.
So, now, back to the question at hand: Is the four gray radiation dose from the medical procedure something my friend should be worried about? Before I get to the answer, let’s frame the question a little more generally without the details: Should I be worried about a radiation dose of 4 gray? That doesn’t sound like it’s a very different question, does it? Well, it is…and the details matter.
There are several things we need to know before we can answer the question the way it is presented in the general way, above. I always ask myself three questions when trying to figure out what the potential effects of a radiation dose may be:
How Much?
The first question is, “How much?” Early (or acute) radiation effects are largely driven by how much radiation dose was delivered in conjunction with the answers to the other questions.
How Fast?
“How fast?” is the second question. The rate at which the radiation dose is delivered – or the time over which it’s spread – is important. A radiation dose that may result in early effects if delivered over a short period won’t necessarily result in early effects if it’s delivered over a longer period of time.
Where?
The third question is, “Where?” Getting flicked in the ear may be annoying, but getting flicked in the eye hurts. So, the same “flick” to a different area makes a difference. In other words, where the energy is delivered is important. A four gray (How much?) dose delivered to the blood forming organs in the gut over a short period of time may very well be be fatal without medical intervention. A four gray dose delivered over a short period of time to the back of the hand may result in some short-term hair loss in the affected area, but it wouldn’t be life-threatening. As you can see, the “Where?” question is very important and results in a very different outcome.
Physicians regularly deliver cumulative doses much greater than four gray to cancer patients via methods including external beam therapy and high dose rate brachytherapy. Those doses are fractionated over the course of the treatment largely for patient survival reasons. If the four gray dose to the back of the hand described above was protracted or delivered in fractions, temporary hair loss would not likely be of concern. Both of these examples are associated with the “How fast?” question.
So, to answer the question posed by my friend: Since the dose was delivered to the finger incrementally over a period of time, and it’s below the threshold where I would expect to see anything serious even if the dose was delivered all at one time, I don’t think he has to worry about early effects. Because the dose was delivered to a very small area, and taking his age into account, I think the risk for long-term concerns are exceedingly small. His physician told him essentially the same thing.
When it Comes to Radiation, Details Matter
So, let’s get to the meat of this blog. If you are responsible for communicating information about radioactive materials or radiation, it is essential you understand the impacts details can have on the message.Too often I see articles or hear reports about radiation incidents – big and small – that make me wonder if the person delivering the message really understands the issue. Oftentimes, it’s probably due to an incomplete understanding of the situation and the effect small details may have. Likely, public information professionals may not know to ask the detail-oriented questions unless they have established a relationship with a technical expert to assist with public messaging.
It’s simple to search the internet for – in our example – the biological effects of a four gray dose. However, a simple question such as “Is a four gray radiation dose dangerous?” can have different answers based on the details of the situation. It’s not necessarily so simple to understand what your search results may turn up or whether the information is reliable, or not. Good public communications require more than simply ensuring a message is reviewed by the public affairs office or doing a quick internet search to gather “facts.” When the topic is something like potential radiation effects, it requires the integration of subject matter expertise into the message development process to ensure the message is appropriate for the situation.
And let’s be honest, in general, technically oriented people such as health physicists, engineers, etc., aren’t necessarily known for their communication skills. It is easy to overlook the fact that for a radiation protection professional to be effective at helping a communicator, he/she should receive training related to the public communications strategy. Details matter, but some matter more than others as one moves through the message development and public communication process.
Integrate Radiation Experts Early
Yes, details matter, but it’s easy to fall into the trap of trying to be 100% correct yet losing “understandability.” Keep in mind an effective message must not only be correct, but understandable. A key question to ask is “How correct is correct enough?” I encourage radiation protection professionals who may be tasked with assisting communicators to seek out training and/or to further hone their communication skills. Equally importantly, if not more so, I encourage those public affairs and public information professionals responsible for communicating radiological information to identify radiation professionals who can assist and integrate them into the communication process by setting expectations and providing necessary training. This should not be done after “it’s hit the fan,” but well before so that determinations can be made about your radiation expert’s ability to provide proper communications assistance or to identify areas where further training may be needed.
Our brains crave meaning before detail. Details are important, but oversaturation of technical jargon and concepts may negatively affect the understanding of your message by a non-technical audience. Addressing questions such as, “Will it hurt me?” or “Am I in danger?” come first before the technical details. A well-rounded communications team can help ensure your messages are not overly technical and remain understandable. A good internal team consisting of both public information professionals and radiological subject matter experts can most effectively communicate your messages to the public.
Steve Sugarman
VP of Operations & Corporate Health Physicist
