Breast Cancer Care’s response re Body Scanners
There has been a furore over introduction of Body Scanners in the States. The crass mistakes made by U.S. security staff, meant John Pistole, America’s head of the TSA, had to go on TV to apologise. So this makes Breast Cancer Care (BCC)’s response to a survey on these scanners very timely.
Their members were asked to comment on the ‘Code of Practice for the acceptable use of advanced imaging technology (body scanners) in an aviation security environment.’
Research led to questions about how exactly the scanners work and what will be seen on screens. Those who took part requested clarification from the Department for Transport, but when BCC asked for a response, “no definitive answer could be provided to us”.
Survey showed that just over half of women would not mind if an implant was detected (56%), but the fact that the Department is not able to provide a categorical answer is worryingbecause it signals a lack of in-depth knowledge as to how the scanners will work in practice. Passengers should have access to clear and straightforward information.
BCC urges the Department to do further investigations into the scanners to ascertain a more detailed picture of what they reveal.
Breast Cancer Care decided to respond to this consultation after surveying women who have been affected by breast cancer as to their views on how best this system should work. The response only covered the issues relevant to this group, particularly in terms of having had breast surgery following diagnosis, and how body scanners will impact on them.
Majority of respondents felt that this technology was the same as, or preferable to, a traditional ‘pat down’ search (64%) and safety was the most important consideration.
However, concerns were raised
- about the training airport security staff would receive
- the cumulative effects of radiation having already undergone radiotherapy
- infringement of their privacy
- how to declare a prosthesis in the most discrete manner.
There was a range of feelings amongst the group of survey respondents with regards to this security approach:
“I do not feel any safer because of the use of these scanners. Over-dependence on scanning all
passengers rather than making sensible judgements about who presents most risk leads to
intrusion for all passengers. The use of such scanners and the time taken to go through all these
procedures plus the indignity of almost stripping off (belts/shoes etc) at the entry points makes
me increasingly reluctant to travel by air.”
“Personally I think that passenger safety is of paramount importance – far more important than
being shy about an implant etc. If the scan is done with dignity and sensitivity I don’t see a
problem. I have had the “pat down” method at an airport (before having breast reconstruction)
and was treated disgracefully. So it’s all down to how you speak and treat people.”
BCC would not want to see people who have undergone treatment for breast cancer unduly penalised. Their various conditions should be fully understood by airport security staff so as not to need long and laboured
explanations by passengers.
Any kind of medical disclosure should be viewed in the context that it can be very difficult to do so for
some people, and that there may be psychological issues attached to such a disclosure in a non-clinical setting with non-clinical security staff.
Many survey respondents were worried about the additional radiation they would undergo with the backscatter scanner. While this will be expanded upon further in this response, the millimetre wave scanner was preferable among our respondents in light of the fact that no ionising raditaion is involved in its use.
However, this would be dependent on its efficacy, which was an issue raised by Ben Wallace MP, who was formerly involved in a project by a leading British defence research firm to develop the scanners for airport use. Trials were said to have shown that low-density materials went undetected, with the millimetre-wave scanners picking up shrapnel and heavy wax and metal, but missing plastic, chemicals and liquids. How will the new Government now proceed with these
scanners in light of this evidence?
Recently University of California and Los Angeles (UCLA) issued two reports in safety of radiation from these scanncrs.
First report said that there was NO safety risk
Next day another report was issued – saying, YES – there was a risk.
Did safeguards outlined in the interim code of practice address all potential privacy concerns?
If not, what else should be included?
Survey respondents said: Yes 54% No 34% Don’t know 12%
Most survey respondents agreed that this approach would be effective in safeguarding privacy, reiterating the importance of having the option of a female staff member as screen reader. BCC hoped that a choice would also exist for a female airport security member to whom the prosthesis is disclosed.
A significant minority of women felt that having to disclose medical information to non-medics was an infringement of their rights.
With Department for Transport guidance (FAQ document) to disclose prosthetics or anything that may show up on the scanners to staff prior to entering the scanner, the thought of disclosing personal medical information to a female staff member was preferable to a male member of security staff.
While the majority (53%) of respondents felt that the possible embarrassment or uncomfortable nature of such a disclosure was worth it for safety’s sake, there was still a preference for having such conversations out of earshot of fellow passengers and even their own family. This is especially the case for women with children, who may not want them to overhear.
Those women who did not feel they could make such a disclosure to airport security staff, the idea of having some sort of card or letter from a GP that they could just hand over at the appropriate time was a better option. Could the
Department for Transport endorse this in the Code of Practice to ensure that staff are aware that this is a viable alternative to verbal disclosure?
“Due to the continued threat of terrorism it is vital that these scanners are used. Life is very precious. It would be a good idea to obtain a letter from the breast oncologist to verify breast cancer surgery for those women who have fear/concerns of using body scanners.”
“If I could carry an official card stating that I had had breast surgery due to breast cancer, I know I
would feel a lot more comfortable about going through a body scanner.”
People mentioned their worries about staff, despite the assurance of employing vetted and trained personnel in the Interim Code of Practice. For reassurances sake, a robust and accessible complaints procedure should be in
- Option to have a female security officer as the non-screener as well as screener
- Disclosure and discussion to take place out of earshot of other passengers
- Option of (prosthesis) disclosure to be done in written form, not verbally
- Robust and easily accessible complaints procedure in place
Although images should be deleted, in the USA, the Transportation Security Agency TSA)
acknowledged that images on body scanner machines would be recorded for
“testing, training, and evaluation purposes.”
As Liberal Democrat MP Chris Huhne, said in January this year: “Safeguards
must also be put in place to prevent staff members from copying or putting on the
internet pictures of children, celebrities or those with strange body shapes. These
assurances should be enshrined in a statutory code, rather than a mere code of
Questions will need to be answered as to how data protection will be policed and
what procedures are in place if this is breached.
- Data protection assurances should be enshrined in a statutory code rather than a code of practice.
- Questions around saving capability of scanners should be answered by the Government, as well as how data protection will be policed and what procedures are in place if this is breached.
Health and safety
Worries were expressed about effects of the radiation. For people who have had a cancer diagnosis their subsequent treatment, which often includes radiotherapy, can leave them with a heightened awareness of the effects of radiation on their bodies, and anxious about exposing themselves to more ‘unnecessary’ radiation.
“Why should I have to go through extra radiation and NOT being given the choice?? I really do not need extra radiation and are happy to strip down instead. I feel this is very wrong that we do not have the choice to refuse, and terror is winning over civil rights.”
“Would be worried about the exposure to any more X-rays as I have had maximum radiation
allowable on some areas, so therefore would prefer the millimeter wave scanner.”
“I would like to know if there is the option to ask for a full body search rather than be exposed to
“As cancer occurs as a result of multiple events the cumulative doses within the breast area might be important here
compared to general population.
There needs to be the information on the dose for people previously exposed to radiotherapy or pregnant
ladies clearly identifiable at the scanners so they can make choices.”
BCC say this fear is not unfounded, despite the reassurances of safety from the government. Ionising radiation is an established risk factor for breast cancer.
- Option to have a thorough pat-down search instead of going through a body scanner
- Use of scanner that does not use ionising radiation (i.e. millimetre wave although this is subject to efficacy)
- Appropriate staff training to include information about peoples’ medical conditions so intrusive questioning is not required
So many respondents had sensible queries about training, that it begs the question, ‘how good is today’s current training?’
Not very good, according to respondents.
BCC believes that best results can be practically achieved by having patients involved. A large proportion of respondents believe that either patients or cancer charities should deliver some of the training.
“I don’t want to be questioned in the airport queue and made to announce to all and sundry that I
have a breast implant in order to proceed through security.”
On a personal note, when asked to take off shoes, I look around to see where elderly passengers can sit, especially if they have lace-up shoes. I have NEVER seen a chair placed for passengers’ convenience. Instead you see people wobbling on one leg, clearly an accident waiting to happen. So much for Dept. Transport’s reassurance “we take disabled passengers’ needs into consideration”.
America’s TSA was caught on the hop, and made to make humiliating apologies on TV, to world’s press, and to passengers involved. Before this happens here, Ministers need to make sure they address the public’s concerns.
Pompous security officials at Airports, Ports and Stations must be made to undergo training in courtesy and understanding of disabled issues. Most do a good job on minimal wages, but there are some who need to be taken aside and told that alienating passengers builds up resentment.
I have written the book on ‘Working in Aviation’, with a large proportion on working in Security; I have worked at Airports, and when a passenger, my training helped me identify a slip that enabled Customs and Excise to apprehend a very wanted person. But I am not happy that the Dept.Transport understand or has addressed the issues surrounding screening of those with disabilities, prosthesises, etc.
After the first worries about the way they were treated, concern in America has shifted to doubts about the scanners – were they thrust on the public by lobbyists employed by security companies? The first two contracts to supply scanners have netted two companies $160 million each.
We need to get passengers on the side of law enforcement – not indignant at their treatment.
For more info from BCC – contact Ms. Kiran Dhami, Policy Officer, Breast Cancer Care