LAX security x-rays a cast, options?
 

Unfortunately I have a broken arm. The two times I flew out of LAX (not OGG, LAS, SNA, etc) they had to x-ray the cast. They take 4 "pictures" to view all sides of the cast. The x-ray is strong enough to see the bones. I asked the TSA agent why only LAX, she said that any airport that has the machine has to use it. I asked her how safe it was, she said it can only x-ray the cast. When I showed her the bones in the x-ray, she just smiled. How can I find out if this is dangerous and if I have the right to ask for a swab (as in the other airports) instead of the x-ray? I know this isn't a common question but when you never know when you too could trip over luggage on a German train and break your arm. Thanks for any information.

How would a swab on the outside prove you don't have something on the inside? Of course, it would be odd if the AA checkpoint at LAX is the only palce where this would be an issue. What's the point of having an xray for casts if your aren't going to xray them?

OMG, if your cast is on your arm, don't let these employees who have *not* been to radiology or medical school x-ray your arm.

Tell them to go pound sand and to use ETD. They are not medical staff and have no business x-raying humans. EVER. :mad:

You should consider bringing charges against the miscreants who practiced medicine or performed radiology without a license. :mad: :mad:

Do you know how ETD works? If there are explosives on the inside of a cast, ETD *will* (not might) alarm if one swabs the exterior and edges of the cast.

What if there is something in the cast other than detectable explosives?
Seriously... If using swabs would resolve the issue, why would they even buy the x-ray equipment?
(Heck, maybe he is hiding a 101 ml bottle of shampoo up there.)

Are you saying your cast was x-rayed with the machine that's used to check bags?

Ionizing radiation, like x-rays, affect the dividing cells of your body: bone marrow (not to be confused with actual bone cells called osteocytes), GI tract, etc. Although your bone is currently dividing to repair its self in your arm, osteocytes are particularly resistant to radiation. That coupled with the fact that you have a cast over your arm, and the x-rays they use (I imagine) are no where near as powerful as medical x-rays, you really have nothing to worry about.

Also, on a side note x-rays pass through things. Therefore, there would be no such xray that only went through the cast and not your entire arm. How else would the photo paper/detector on the other end of the x-ray beam actually see anything? I understand your worries, but really you have nothing to worry about. I think you always have the option for a visual/physical inspection (like you do with film rolls or anything else you don't want xrayed). I think I'd go with the xray, the last thing I'd want is someone poking and picking at my cast, that I believe would be more dangerous than the x-rays.

In all my times through LAX, I've never seen a specific device for xray of a cast.

I wouldn't let them do it. They're not medical professionals, and they can cause harm and long-term exposure issues. There have been a couple of cases where the TSA has x-rayed pets and babies - to great consternation of everyone.

I see no reason that they can't run a handheld metal detector along the cast and do an explosives trace to clear you.

Don't let this one go - I'd be howling loudly at the checkpoint, even to the point of leaving, flying from another airport, getting this in the press (along with some expert commentary on the damage it can cause), and visiting my congressional offices.

http://www.tsa.gov/approach/tech/castscope.shtm

TSA has begun using the new CastScope screening system and will deploy CastScope to 11 airports in 2008. CastScope deployment to airports will be based on the airport’s proximity to military hospitals or large rehabilitation facilities that serve amputees, sports events for disability groups, vacation destinations utilized by amputees and in airports that see large volumes of military severely injured.

The airports selected for the technology are San Antonio, Denver, Minneapolis, Atlanta, Washington-Dulles, Reagan National, Orlando, John. F. Kennedy, Los Angeles, Baltimore-Washington, and Phoenix. Among them they will receive 34 CastScope machines.

TSA piloted CastScope in 2007 at San Jose International Airport, Tampa International Airport, Nashville International Airport and Reagan National Airport. In the pilot phase, passengers with prosthetics, cast, or a brace participated on a voluntary basis.

TSA worked closely with special interest groups like the Amputee Coalition of America and others to determine best practices, operational suitability and modify the technology so that it best meets the needs of the traveling public.

CastScope provides security officers with a means to ensure that a cast or prosthetic does not contain a concealed threat while maintaining the dignity and privacy of the passenger.

To learn more about the CastScope, please see the frequently asked questions below:
Frequently Asked Questions

Q: What is the CastScope X-ray?
A: The CastScope uses backscatter technology to produce an X-ray image of casts, braces, heavy bandages, and/or prostheses, allowing TSA to quickly and non-invasively identify any potential threats.

Q: What is backscatter technology?
A: Backscatter scans a narrow, low-energy x-ray beam over the body surface. The reflection, or backscatter, of the beam is detected, digitized and displayed on a monitor. The high contrast image generated allows TSA to differentiate between articles such as braces, prosthetics, and external medical devices, and prohibited items.

Q: What is the purpose of the CastScope X-ray?
A: The CastScope was designed to supplement the walk-through and hand-held metal detectors for passengers with casts, braces, heavy bandages, or prosthetics that may alarm because of the metallic components of the devices by providing an X-ray image for TSA to assess concealed threats.

Q: How long does it take to be scanned by the CastScope?
A: Multiple scans will be necessary depending on type of device, location of device, size of device, and number of devices worn by the passenger. These factors will determine how long the scanning process will take, each scan takes approximately 3 seconds.

Q: What is the difference between backscatter x-rays and medical x-rays?
A: Backscatter x-rays only penetrate approximately ¼ of an inch before the rays are scattered, whereas medical X-rays transmit completely through the body. For comparison, the CastScope emits less than 10 microRem of radiation per scan and a typical medical X-ray emits 10,000 to 100,000 microRem per scan.

Q: How much radiation exposure is produced from 1 scan of the CastScope? Is it safe?
A: One scan is equivalent to approximately 10 microRem of radiation. This is equivalent to the exposure each person receives in about two minutes of airplane flight at altitude or each person receives every 15 minutes from naturally occurring background radiation.

The American National Standards Institute (ANSI) developed a standard for X-raying human subjects for security purposes using back-scatter X-ray technology. The National Council on Radiation Protection (NCRP) states that a person receiving 1000 microRem (100 scans) per year is still considered a negligible individual dose. In addition, the Food and Drug Administration (FDA) and NCRP have advised that the CastScope is safe to use on anyone ages 5 and up regardless of gender or any medical condition.

Q: How is it verified that the CastScope X-ray is in compliance with safety standards?
A: The device was designed to comply with the ANSI/HPS N43-17 standard and recommendations of the National Council on Radiation Protection and Measurement. Both standards detail procedures for measuring the radiation emissions from the source (scanning head). Certified personnel check the radiation emissions periodically per the procedures outlined by the ANSI and NCRP standards and recommendations.

Q: Can the radiation exposure from the CastScope X-ray cause cancer?
A: Exposure to low levels of ionizing radiation not exceeding those from the environment has not been shown to affect human health.

Q: Is screening using the CastScope intrusive?
A: Not at all. It is not necessary to raise or remove any article of clothing that may be covering the cast, brace, or prosthesis to image the area where the prosthetic, cast, or support brace are worn.

Q: Can the CastScope damage an advanced prosthetic (with integrated circuitry)?
A: No, the CastScope will not damage mature or state-of-the-art devices.

Q: Will CastScope screening damage implanted medical devices such as pacemakers, defibrillators, or bone growth simulators?
A: No. The CastScope does not emit a magnetic field and will not cause any adverse medical consequences to implanted medical devices or any other disability-related equipment.

Q: Who manufactures the CastScope?
A: The CastScope was designed by Spectrum San Diego, Inc. located in San Diego, CA.

Q: Has TSA consulted with any passengers with disabilities or disability-related organizations during the development or fielding of this technology?
A: Yes. As with all aspects that affect the disability population, TSA continues to work with its Disability Coalition of over 73 disability-related groups and organizations to ensure the CastScope integrates the needs of persons with disabilities. TSA has extended outreach efforts to include: preoperational studies by National Safe Skies Alliance and the Amputee Coalition of America (ACA), an ACA demonstration in Minneapolis, and a pilot demonstration in Reno in coordination with the Veterans of Foreign Wars Conference.

I suppose that in 20 years we'll see class action lawsuits representing a TSA employee cancer cluster from operating these machines ?

Yes, it's dangerous, especially if they are taking 4 views each time you go through!

The kicker was that they OP could see his bones on the image. That isn't backscatter levels of radiation exposure.:mad:

As to the class action law suits by TSOs in around 20 years for damage due to excessive on the job exposure to ionizing radiation? Well, they were warned by travelers that daily exposure to on the job x-ray exposure wasn't good for them and they chose to ignore those travelers.:(

Do you accept as truthful everything the TSA puts up on its website?

Please note this:
the OP doesn't sound like it was voluntary. And the TSA site section on disabilities does not mention the use of X-ray for casts.

However, both TSA and the manufacturer claim that the x-rays penetrate no more than 1/4" into the skin.

Correction:
Note it does not say "into the skin". Assuming the cast is 1/4 inch thick the x-rays should never reach the skin. If this is producing enough x-ray to see bone after going through the cast, skin, and muscle it is penetrating more than 1/4 inch.

What is your expertise in the xraying of human subjects?

Who would be assuring that this xray device is properly maintained and does not emit dangerous levels of radiation?

Aren't xrays cumulative and prudence suggest limiting exposure to only when absolutely required?

OP, you have NO IDEA what that machine is spewing out. The specs are probably a security secret. Plus it is being operated by untrained idiots. I'm no expert but if it can see your bones I don't understand how it can be a low dose backscatter. DO NOT allow this!

Thanks, TK, for catching that.

Backscatter, as used in WBI, picks up shin and knee bones.

I just checked my shin bone and it seems to be closer to the surface than 1/4. Of course I have chicken legs so you mileage may vary.

I would not submit myself to this cast X-ray routine, basically because it is not helping me in any manner, and you cannot be sure it is doing no harm. In fact, many diagnostic and therapeutic equipments have delivered wrongful doses in the past (see this).

ETD would be appropriate.

I am a trained professional and a qualified expert in this field. If you can see b ones on this scan, then you have received an x-ray. In states (4) where I am licensed, you may not use use a machine to expose a human being to x-rays unless that machine is registered with the state bureau that tracks radiation generators used in human exposure, and in one of these states, any machine that generates any ionizing radiation.

Assuming California is ahead of the curve, which they usually are on such things, this is likely true there as well. Next, in each of these states, one is not allowed to operate an x-ray machine for the purpose of x-raying humans unless a written directive (prescription) has been provided by a licensed physician. Second, the operator of such machines must be trained, usually meaning holding at least an Associate degree and unless under direct supervision, holding a certificate in diagnostic or therapeutic radiology (AART). Further, at least in states I'm familiar with, each operator may not use them until they are registered and a detailed Radiation Safety Plan is in place, with a designated Radiation Safety Officer.

Further, most of these machines must be inspected on a regular basis by a qualified medical physicist to insure safety and quality of imaging.

I would not let a stranger in an airport x-ray me for any reason unless they present acceptable credentials in any state.

On the physics of x-raying casts. IF the cast is plaster, it primarily gypsum which is mostly Calcium, (same stuff as bones). Backscatter won't work very well since calcium is a strong x-ray absorber. That means more dose to get an image. If the cast is fiberglass (most are these days), then backscatter may work, I don't know.

In any event, much more information is needed to know exactly what is going on here. I suggest you report your experience to the appropriate state radiation regulatory agencies in California, copy the California Medical Board and ask them what their position is, on the x-raying of humans sans prescription. I would also write a letter of inquiry to the American College of Radiology informing them of your experience.

As far as the TSA comment that there is no proof that low level radiation is harmful, I agree. However, according to recognized standards, the NCRP and ICRP (National and International Commissions on Radiation Protection) both use, as a standard for the protection of the general public from potential harmful effects of ionizing radiation, the linear-no threshold theory of radiation effects: There is no safe threshold below which radiation exposure is completely safe. Scientifically, TSA is right, in my opinion and that of many radiobiologists. But from a regulatory perspective, they are wrong. Further, the proper standard advocated by both commissions is ALARA. As low as reasonably achievable. We should not be x-raying populations indiscriminately, willie-nillie.

I didn't know they used backscatter, as a result there would be no need for full transmission. So what I said earlier is not correct in regards to this type of x-ray device. However, knowing that now, depending on your girth seeing bone at 0.25inch is not out of the question.

i got to experience the cast-scope at jfk and subsequently at lax and "it doesn't show bones" but more of an outline along the lines of the nude-o-scope tho not as detailed. etd of my shoes and then pictures and that was it

Ask the TSO to be X-rayed so you can see how it works....then play dumb and tell him you didn't see it work...get the TSO to do it again....then tell the TSO how that thing gives you cancer and you would not get near one let alone work next to one...then make comments like..."boy, hope you don't plan on having any kids.." or "...hey, that mole looks really bad, I'd have that looked at right away..." or "...man, my uncle worked with one of those at the shoe store and lost all his body hair..."

THANK YOU FOR THE INFORMATION!!
First, being that I had already done this a few weeks before, I asked for a swab since that is how the other airports handle it. It would not be allowed since they have the cast machine.
Second, when she said that it could only xray the cast, I showed her the bones in my hand and asked why it was peneterating that deep. For the parts of my arm that weren't covered by the cast you could DEFINITELY see the individual bones in my hand.


If someone was concerned about something being inside the fiberglass cast, there are parts of the cast that are more than 1/2 inch deep so the machine would not detect it? Also, I go through the metal detector with no beep. What more could I be hiding in a cast 7 inches long that someone couldn't hide in their pants pocket? It seemed to be one of those situations that if I wanted to get on the plane, I have to do the 4 x-rays.
Thanks again for all the responses. I will be following up with the recommendations you had. It seems the only safe solution is to get the cast off before the next LAX flight or change to a different airport.

Sounds like it is all for the convenience of the TSA, not the public. Not a word in the PR piece about if the cast scope is voluntary, or the alternative screening methods, if any, if a pax refuses to use it for whatever reasons. Or is it a "You ain't gonna fly today" if you refuse to have your cast scanned at the 11 airports that have it? Obviously other airports without this latest terror-industrial $$$$ gizmo must have screening SOP for casts.

You might also consider using the TSA "Got FeedbacK" line of communication. Might learn if this is required or optional. Might also question who/what/where these equipment and operators are certified.

https://contact.tsa.dhs.gov/gotfeedb...tFeedback.aspx

This is typical, and to be expected, since TSA does not care about the convenience or safety of the public.

+1

I had a dental x-ray yesterday and while I was waiting for the result I saw a sticker on the x-ray machine that listed all of what you mentioned. So it appears that California has the same rules.

There are things that could be hidden in fiberglass casts or other places that might escape the type of imaging described. I will not go into details for obvious reasons, but I assume that anyone with a modicum of brains, and a minimum of knowledge of imaging physics could figure it out, and probably have. So this is yet another example of the TSA doing something for show, with little or zero increase in security and due to complacency, possibly a net decrease in security. Good luck.

TSA told me that Cast Scope is NOT optional
 

This was from their public affairs office.

I also asked them if I refuse Cast Scope, can they require me to complete the scanning, in much the way they can require you to complete scanning if you decide you don't want them to touch your "junk" midway through the procedure. They did not seem to know but confirmed that Cast Scope is NOT optional.

Cast Scope according to TSA's website requires 4 images to be taken, Popular Mechanics reports it's 10 on average if you *don't* have a mechanical knee --more if you do (yikes).

I asked TSA's public affairs if I felt the number of xrays they were taking was excessive (say more than 10 when I their website says four) could I stop the screening and exit the airport. They did not know the answer to that.

They are using these machines on 6 year old kids (or at least their website says they are "safe" on anyone over age 5.

I think TSA would claim a bullet to the head was safe.

I am not often left speechless and totally flabbergasted, but this information makes my blood boil. These x-ray machines are making specific targets of severely injured military members, most of whom owe their injuries to serving our nation. It makes me want to tear my hair out.

These military members, with casts, braces, bandaged areas where their arms and legs used to be, etc. have no doubt already been x-rayed too many times in the course of their diagnosis and treatments. Now they're going to airports where untrained, uncertified people will be exposing them to x-ray machines that have no maintenance schedules????

Where is the press, why aren't they leaping all over this story? The VFW and other veterans' organizations should be all over this! Where, exactly, does this fit in with TSA's own "Military Severely Injured Program?" There is a whole page on TSA's website about assuring respect and dignity for injured military. This is how the injured are respected - by forcing them to submit to x-rays at airports?

So the message to the bad guys is: Make sure you pack your fake cast with 2 pounds of PETN because you will be forced to go through the Cast Scan and therefore get a free pass past the ETD swabber that would detect it. You could drive a 787 through the loopholes in this policy.

I concur with everything Dianne47 says, but since the TSA does consider every traveler a criminal, I am not surprised that the TSA treats every wounded warrior as the next Tim McVeigh.

We've Got To Go After This Machine As Aggressively As The NoSs
 

Radiation is radiation. We've got to get this machine out there in the public eye as well. It affects only a small percentage of those already incensed by the rest of what's going on at the checkpoint, so, it's not gotten the proper publicity. We've got to make sure both are eliminated.

greentips - Kudos for being an actually informed radiologist willing to comment. (Also, for using the term "/dev/null".)

OP - Tell all medical/radiology regulatory agencies, like greentips said. It's a serious population health violation.

This is what the Amputee Coalition of America (ACA) had to say about it. Now this is an organization that whose mission it is to advocate on behalf of amputees (many of them veterans). Now read what they've written and ask yourself: does this organization think there's anything wrong with subjecting amputees (their members) to x-rays? Because they seem to be happy with more TSA training and more TSA safety messages about CastScope (which say it's safe). The ACA blew this one BIG time and I elected not to donate to them because of this and until they get it right.

"Re-examination of the CastScope X-ray procedure. The ACA has concerns about the amount of radiation to which people are exposed. TSA will increase the frequency of their training and will develop user-friendly information about its safety. TSA and the ACA will partner in disseminating information about this procedure."

http://www.amputee-coalition.org/abs...sp?a=1244&z=34