CHAPTER 40

OCCUPATIONAL RADIATION DOSE MANAGEMENT

Radiation Absorbed Dose  Rationale: higher levels of

 It measures the radiation energy absorbed as scatter & leakage radiation
a result of radiation exposure
 It is used to identify irradiation of patient It is best to position the x-ray tube under the
 Units: rad or Gyt patient during mobile & C-arm fluoroscopy!

Radiation Exposure Remote Fluoroscopy

 Radiation intensity in air  It results in low personnel exposures
 Units: roentgen or Gya o Rationale: personnel are not in the x-
ray examination with the patient
Effective Dose
 It identifies the biologic effectiveness of the Interventional Radiology
radiation energy absorbed  Personnel receive higher exposures
 It is applied to occupationally exposed o Rationale: longer fluoroscopic x-ray
persons & to population exposure beam-on time
 Units: rem or Sv  Contribute to Higher Exposure:
o Absence of protective curtain
Rem o Use of cineradiography
 The unit of effective dose  Dose Limit: 500 mSv/yr
 It is used for radiation protection purposes
Extremity monitoring must be provided for
OCCUPATIONAL RADIATION EXPOSURE interventional radiologists!

Radiologic Personnel Mammography

 Dose Limit: 50 mSv/yr  Personnel exposures are low
o Rationale: less scatter radiation due
 Occupational Exposure in General X-ray
to low kVp operation
Activity: not exceed 1 mSv/yr
 Protection:
o Long exposure cord
OCCUPATIONAL RADIATION EXPOSURE
o Conventional wall
OF RADIOLOGIC PERSONNEL
o Window wall
Exposure Category Value
 It does not require protective shielding
Average whole-body dose 0.7 mSv/yr
o Rationale: mammographic x-ray
Those receiving less than the
53% units have personnel protective
minimum detectable dose
barriers
Those receiving <1 mSv/yr 88%
 Composition: lead glass, lead
Those receiving >50 mSv/yr 0.05%
acrylic or plate glass
Fluoroscopy
Computed Tomography
 It contributes to the highest occupational
136
 Personnel exposures are low
exposure of diagnostic x-ray personnel
o Rationale:
 Personnel exposure is related directly to the  CT x-ray beam is finely
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x-ray beam-on time collimated

 X-ray Tube Over The Table  Only secondary radiation is
o Advantage: in terms of image quality present in the examination
o Disadvantage: higher personnel room
exposures
STEWART C. BUSHONG SUMMARIZED BY: MEYNARD Y. CASTRO
 CHAPTER 40
OCCUPATIONAL RADIATION DOSE MANAGEMENT

Surgery 2. Equivalent Annual Dose For Tissues &

 Occupational exposure for nursing personnel Organs
& other working in the operating room & a. Lens of the Eye: 150 mSv
intensive care unit is near zero b. Thyroid, Skin, Hands & Feet: 500
 It is not necessary to provide occupational mSv
radiation monitors for such personnel B. Public Exposures (Annual)
1. Effective Dose, Frequent Exposure: 1 mSv
Mobile Radiology 2. Equivalent Dose For Tissues & Organs:
 It contributes to the highest occupational a. Lens of the Eye: 15 mSv
exposure of diagnostic x-ray personnel b. Skin, Hands & Feet: 50 mSv
 Wear Occupational Radiation Monitor: C. Education & Training Exposures (Annual)
o Radiologic technologist 1. Effective Dose: 1 mSv
o Anyone who is required to 2. Equivalent Dose For Tissues & Organs
immobilize or hold patients a. Lens of the Eye: 15 mSv
o Personnel who regularly operate C- b. Skin, Hands & Feet: 50 mSv
arm fluoroscope D. Embryo-Fetus Exposure (Annual)
o Personnel who regularly in the 1. Total Equivalent Dose: 5 mSv
immediate vicinity of C-arm 2. Equivalent Dose in 1 Month: 0.5 mSv
fluoroscope E. Negligible Individual Dose (Annual): 0.01 mSv
 Dose Limit: 50 mSv/yr
 Average Exposure: <1 mSv/yr Current DLs are based on a linear,
nonthreshold dose-response relationship; they
RADIATION DOSE LIMITS are considered to represent an acceptable level
of occupational radiation exposure!
Maximum Permissible Dose (MPD)
Occupational Exposure
 The dose of radiation that would be
expected to produce no significant radiation  It is described as dose equivalent in units of
effects mSv or mrem
 It has been replaced by dose limits
Dose Limit
Dose Limit (DL)  It is specified as effective dose (E)
 Maximum permissible occupational
radiation dose WEIGHTING FACTORS FOR VARIOUS
 It is specified only for occupational TYPES OF RADIATION
exposure Radiation Weighting
Types of Energy Range
 Current DL: 1 mSv/week Factor (Wr)
X-rays & gamma rays,
1
DLs imply that if received annually, the risk of electrons
death would be less than 1 in 10,000! Neutron, energy
5
137
<10 keV
Whole-Body Dose Limits 10 kEv-100 keV 10
>100 keV-2 MeV 20
 Annual Dose: 50 mSv
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>2 MeV-20 MeV 10

A. Occupational Exposures
>20 MeV 5
1. Effective Dose
Protons 2
a. Annual: 50 mSv
Alpha Particles 20
b. Cumulative: 10 mSv x age

STEWART C. BUSHONG SUMMARIZED BY: MEYNARD Y. CASTRO

 CHAPTER 40
OCCUPATIONAL RADIATION DOSE MANAGEMENT

Effective Dose (E) Guidelines for Reducing Occupational Exposure

 Formula: E = Radiation Weighting Factor  During Mobile Radiography
(Wr) x Tissue Weighting Factor (Wt) x o Wear an apron
Absorbed Dose o Maintain maximum distance from
the source
Radiation Weighting Factor o Never direct the primary beam
 It depends on the LET of the radiation toward oneself or others
 During Fluoroscopy
Tissue Weighting Factor o Minimize x-ray beam-on time
 It accounts for the relative radiosensitivity of o Step back from the table if not
various tissues & organs needed
 Higher Value of Wt: more radiosensitive o Use shielding
 Apron, curtain, Bucky slot
Collar Monitor-Reported Value cover & the radiologist
 Conversion factor: 0.3  During Radiography
o Apply to estimate the effective dose o Stand behind the control booth
o Never direct the primary beam
Dose Limits For Tissue & Organs toward the control booth barrier
 Whole-Body: 50 mSv/yr
 Skin: 500 mSv/yr Each mobile x-ray unit should have a
protective apron assigned to it!
 Extremities: 500 mSv/yr
 Lens of the Eye: 150 mSv/yr
The exposure cord on a portable x-ray unit
Public Exposure must be at least 2 m long!
 General Population: 1 mSv/yr
 Hospital Workers: 1 mSv/yr The useful beam should never e directed
o Not radiology employees toward the operating console!
 1 mSv/yr: the DL that medical physicists use
when computing the thickness of protective
Occupational Radiation Monitoring
barriers
 It refers to procedures instituted to estimate
 Area Occupied By General Public: <1 the amount of radiation received by
mSv/yr
individuals who work in a radiation
 Area Occupied By Radiation Workers: <10 environment
mSv/yr
 Three Types: film badges,
thermoluminescence dosimeters (TLD) &
Educational Considerations optically-stimulated luminescence
 Students <18: <1 mSv/yr dosimeters (OSL)
 Whole-Body: 20 mSv/yr
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Level of Occupational Exposure
REDUCTION OF OCCUPATIONAL  Depends on the type of activity
RADIATION EXPOSURE  Depends on the frequency of activity
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Fluoroscopy & Mobile Radiography

 They contribute to 95% of occupational
radiation exposure

STEWART C. BUSHONG SUMMARIZED BY: MEYNARD Y. CASTRO

 CHAPTER 40
OCCUPATIONAL RADIATION DOSE MANAGEMENT

Occupation radiation monitoring is required  Fluoroscopy: positioned on the collar above

when there is any likelihood that an the protective apron
individual will receive more than 1/10 of the  Pregnancy: wear more than one radiation
recommended dose limit! monitor

Control Monitor
The occupational radiation monitor offers no  It measures background exposure during
protection against radiation exposure! transportation, handling & storage

Film Badge Protective Apparel

 Pack of photographic film used for  It must be worn during fluoroscopy &
approximate measurement of radiation mobile radiology
exposure to radiation workers  Thicknesses:
 It is the most widely used & most o 0.25 mm Pb – required
economical type o 0.5 mm Pb – normal
 Metal Filters: aluminum or copper o 1 mm Pb
 Advantages:  Protective Aprons: wrap-around type
o Inexpensive
o Easy to handle It is known than 0.5 mm lead equivalent
o Easy to process protective aprons represent a workable
o Reasonably accurate compromise between unnecessary weight &
o They have been used for several desired protection!
decades
 Disadvantages: Position
o Not reusable  Remain as far from the patient as possible
o Sensitive to temperature & humidity  Keep the front of the apron facing the
o Can’t be worn for >1 month radiation source
 Rationale: possible fogging  Take step or two backwards from the table
due to temperature & when it is not required
humidity  Use the dead man foot switch
TLD Patient Holding
 Composition: lithium fluoride (LiF)  Use mechanical immobilization device
 Advantages Over Film Badge:  A relative or a friend should be asked to
o More sensitive & accurate help
 As low as 5 mR  Last Resort: hospital employees may used to
o Not sensitive to temperature & hold patients
humidity
o Can be worn for 1 year Radiology staff should never hold patients!
139
 Principal Disadvantage: cost
Pregnant Technologist/Radiologist
OSL  Dose Limit: 0.5 mSv/month
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 Advantage Over Film Badge & TLD:  DL for Fetus: 5 mSv

o More sensitive
 He/she should be provided with a second
 As low as 1 mR personnel monitoring device positioned
Wearing of Occupational Radiation Monitor under the protective apron
 General Use: in front at waist or chest level
STEWART C. BUSHONG SUMMARIZED BY: MEYNARD Y. CASTRO
 CHAPTER 40
OCCUPATIONAL RADIATION DOSE MANAGEMENT

o Red: collar badge

o Yellow: waist level

MANAGEMENT PRINCIPLES

Three Steps into the Radiation Protection Program

 New employee training
 Periodic in-service training
 Counseling during pregnancy

Under no circumstance should termination or

an involuntary leave of absence occur as a
consequence of pregnancy!

Emphasize
 Effective DL
o 50 mSv/yr or 5000 mrem/yr
 Environmental Background Radiation
o 1 mSv/yr
 Occupational Exposures
o Closer to the latter than the former

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STEWART C. BUSHONG SUMMARIZED BY: MEYNARD Y. CASTRO