MRI: ESMRMB response to press release of Commissioner Spidla

Vienna (pts030/10.01.2006/14:00) The ESMRMB is the premier scientific society in Europe for basic and clinical scientists working in the field of MRI. As a scientific society we are convinced of the need for a proper legal framework for scientific research and medical practice, however, a number of elements in the Press release of Commissioner Spidla are incorrect, and if unchallenged could have serious implications for medical care within the EU. A press release from the European Commission, made public on September 21, 2005 contains a statement by Commissioner Spidla on allegations regarding MRI:

Some articles today published allegations that the directive on electromagnetic fields or so-called physical agents directive (2004/40/EC) prevents doctors and nurses from giving proper treatment to patients. It was also claimed that parents will no longer be allowed to hold the hand of their child during surgery. This is completely false.

ESMRMB comment. The EU directive will prevent nurses and doctors (but not parents) sitting next to MRI scanners during scanning thus making pediatric MR imaging less patient friendly.

1. The directive is designed to protect workers against excessive exposure to MRI (Magnetic Resonance Imaging) and electromagnetic fields which scientific experts agree is dangerous for health.

ESMRMB comment. MRI devices result only in an exposure to magnetic fields (rather than combined electric and magnetic fields). There are no known long term effects of exposure to magnetic fields. This is not to argue that there should be no limits on exposure, rather that exposure limits should be based on current scientific knowledge. As our ability to generate strong static and time-varying magnetic fields increases, so does our understanding of the effects of these fields. Exposure limits are set according to the degree of exposure and the associated risk. Blanket statements such as that MRI is dangerous for health are thus not compatible with the principles according to which limits are set, and certainly are not representative of any body of scientific opinion.

2. The directive limits exposure to MRI and other radiation for workers. It was drafted by the Commission based on the results and recommendations issued by ICNIRP (International Commission for Non Ionizing Radiation Protection), an independent world wide recognized organisation using the expertise of technicians, scientists and doctors working in the field.

ESMRMB comment. ICNIRP is indeed the international body responsible for setting limits. ICNIRP itself has recognised that its current limits for occupational exposure to all electromagnetic fields are in need of review, a process that is currently taking place.

3. The European Parliament and all Member States - including the UK Government - agreed in April 2004 that it is essential to have the same standards for the health and safety of workers regarding electromagnetic fields since the risk is the same for nurses and doctors throughout Europe. The directive was adopted unanimously and has to be implemented by April 2008.

ESMRMB comment. This is a laudable aim and ICNIRP should be encouraged to finalize their revision before April 2008.

Commissioner for Employment, Social Affairs and Equal Opportunities Vladimir Spidla commented: "The risk of MRI is a real one for everybody who is exposed to it regularily, NOT to parents or their children undergoing treatment. I am concerned that those who are protesting are underestimating the radiation of MRI at the expense of the health of their employees. I am glad that this directive will give a solid protection to doctors and nurses exposed to MRI."

ESMRMB comment. Risk assessment and research into safety aspects of electro-magnetic fields is taken very seriously by the European and international MR community. Progress in the understanding of the bioeffects of magnetic fields is regularly discussed and reported at numerous scientific meetings as well as at dedicated workshops. There are three types of magnetic field associated with an MRI examination. The static field: this can cause transient effects such as vertigo, but despite considerable effort, no long term effects have been identified. Switched magnetic fields: current safety limits for these are designed to avoid painful muscle stimulation in patients, but there is no evidence that prolonged sub-threshold exposure is harmful. Finally the patient is exposed to radiofrequency fields: current safety limits for patient exposure prevent tissue heating, personnel are hardly ever exposed to these fields and they are hence not relevant to the current debate.

The commissioner should also bear in mind that those protesting are not unscrupulous employers intent on exploiting their workforce come what may, but responsible scientists who regularly expose themselves to these fields and hence have a maximal interest in working in a safe and well regulated environment.

In conclusion, the ESMRMB would like to point out that inflammatory and incorrect statements such as contained in the commissioner's statement do not contribute constructively to the resolution of the current debate about safety regulations for MRI. Statements such as this can make it more difficult to recruit health workers to work with MRI and erroneously lead the public to believe that MRI is in some way dangerous. A major factor in the extremely rapid development of MR has been the fact, that it is (to all current knowledge and with all due precaution) harmless and thus can in many instances replace examinations with ionizing radiation. The fact that despite considerable effort no long term harmful effects of MRI could be identified, which of itself makes legislation difficult, should not be misrepresented to create a perception of insecurity or danger. The result can be that more patients are examined with ionising radiation which has definitely known harmful side-effects.

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