Among the problems outlined in Markey's letter:
• Two states, Maryland and Massachusetts, say they have a compounded problem of radioactive contamination of waste management facilities such as landfills disposed by households of patients treated with I-131.
• In Illinois, a patient was released to a hotel in 2007 and contaminated the bed, linens and other items in both her room and throughout the hotel, radiation that was "only discovered because two nuclear power plant workers who were equipped with radiation monitors subsequently stayed in the same hotel and set off alarms when reporting to work."
• State inspections in 10 states, Arizona, California, Illinois, Maryland, New Jersey, New Mexico, Ohio and Pennsylvania, revealed that licensees were not performing required dose calculations to ensure they would not contaminate those they came into proximity with after their treatments. The destinations for those patients after treatment were never recorded.
• Patients in many states said they went directly after radiation treatment to buildings where they used bathrooms or bedrooms they shared with pregnant women or children, and "may have exposed these vulnerable populations through their use of taxis or public transportation."