RADIATION

PROTECTION
Prof. Mark Jayson Gutierrez, RRT, MAEd
Dean/Chair, St. Dominic College Of Asia
Program Director, Top Rank Review Academy
RADIATION PROTECTION
Effective measures employed by radiation workers to
safeguard patients, personnel, and the general public
from unnecessary exposure to ionizing radiation.
Agencies Involved in Dose-Response Evaluations

1.International Commission on Radiological

Protection (ICRP)
 Conducts research and provides recommendations on radiation
protection to the worldwide community based on fundamental
scientific principles
 Has no legal power
 Most countries have radiation protection legislation on ICRP
recommendations
2. National Council on Radiation Protection and
Measurements (NCRP)
 Formulates and publishes scientifically researched
recommendations on radiation protection and measurements in the
United States
3.Nuclear Regulatory Commission (NRC)
 Enforces radiation protection standards relating to radioactive
material at the federal level
NCRP Report #116
1. Occupational exposure – annual effective dose limit is
50 mSv
2. Occupational exposure – annual equivalent dose limit
for deterministic effects
a. Lens of the eye – 150 mSv
b. Localized areas skin, hands, feet – 500 mSv
NCRP Report #116
3. Cumulative effective dose (CEfD) limit = Age (in years)
x 10 mSv
4. Students (older than age 18) – annual effective dose
limit same as occupational exposure limit
5. General public – annual effective dose limit for frequent
exposure is 1 mSv
NCRP Report #116
6. General public – annual effective dose limit for
infrequent exposure is 5 mSv
7. Embryo-fetus – total equivalent dose for gestation is 5
mSv
8. Embryo-fetus – equivalent dose limits per month is
0.5 mSv
PATIENT EXPOSURE AND
PROTECTION
• The heart of radiation protection for the patient lies in the concept of
ALARA. It is primarily the radiographer’s responsibility to see that
ALARA is in practice so that patients are properly protected.
• Beam Limitation
• Filtration
• Gonad Shielding
• Exposure Factors
• Processing
• Film – Screen Combination
• Grid
• Repeat Exposure
Beam Limitation
Beam limitation protects the patient by limiting the area of
the body and the volume of tissue being irradiated.
A. Collimator
B. Cylinder Cones
C. Aperture Diaphragm
A. Collimator

1. Variable aperture device

2. Contains two sets of lead shutters placed at right
angles to each other
3. Higher set of lead shutters is placed near the x-ray
tube window to absorb off-stem (off-focus) radiation
4. Lower set of lead shutters is placed near the bottom of
the collimator box to restrict the beam further as it exits
A. Collimator

5. Accuracy of the collimator is subject to strict quality

control standards
6. Collimator should be no larger than the size of the
image receptor being used
7. Collimator that automatically restrict the beam to the
size of the image receptor have a feature called
positive beam limitation (PBL), also called automatic
collimation
B. Cylinder Cones
1. Metal cylinders that attach to the bottom of the
collimator
2. Used to restrict the beam tightly to a small circle
3. Diameter of the far end of the cone determines field
size
4. Cones may be extended an additional 10 to 12 inches
by a telescoping action for even tighter restriction of
the beam
B. Cylinder Cones
5. Cones may be used for examination of the os calcis,
various skull projections, and cone-down views of
vertebral bodies
6. Use of cones results in a restriction of the x-ray beam
by cutting out a major portion of the beam
7. When cones are used, mAs must always be increased
to make up for the x-ray
C. Aperture Diaphragm
1. Flat piece of lead with a circle or square opening in the
middle
2. Placed as close to the x-ray tube window as possible
3. Has no moving parts
FILTRATION
 A filter is placed in the x-ray beam to remove long-
wavelength (low-energy) x-rays.
 Low-energy x-rays contribute nothing to the diagnostic
image but increase patient dose. As low-energy rays
are removed, the beam becomes “harder”
(predominantly short-wavelength, high-energy).
FILTRATION
 This process of removing low-energy rays result in a
lower patient dose.
A.Inherent Filtration
B.Added Filtration
C.Total Filtration
Note: The radiographer never adjusts added filtration; if
it is suspected that the filtration has been altered,
the x-ray tube must not be used until checked by a
radiation physicist.
GONADAL SHIELDS
 Gonadal shields are used to protect gonads from
unnecessary radiation exposure.
 They should be used whenever they do not obstruct the
area of clinical interest.
A. Gonadal shielding may reduce female gonads dose by up to
50%
B. Gonadal shielding may reduce male gonads dose by up to 95%
GONADAL SHIELDS
C.Proper collimation may also greatly reduce gonadal
dose and should be used in conjunction with gonadal
shields
D.Most commonly used gonadal shields
1.Flat contact shield: flat piece of lead or a lead apron placed
over the gonads
2.Shadow shield: suspended from the x-ray tube housing and
placed in the x-ray beam light field; requires no contact with
the patient; especially useful during procedures requiring
sterile technique
EXPOSURE FACTORS
Exposure technique determines the quantity and quality
of x-rays striking the patient.
A.Use optimal kVp for the part being radiographed
B.Use the lowest possible mAs to reduce the amount
of radiation striking the patient
EXPOSURE FACTORS
C.The part being radiographed should be measured
with calipers
D. A reliable technique chart should be consulted to
determine the proper exposure factors to use
E. Use of automatic exposure controls (AEC) reduces
the number of repeat radiograph
PROCESSING – IF USING
The automatic processor should be a constant in the production of a
visible radiographic image. Elimination of repeat films because of
optimal processor performance reduces the dose to the patient and the
radiographer.

A.Subject to strict quality control standards to eliminate retakes

caused by processor malfunction
B.Exercise care in loading and unloading cassettes
C.Prevent unnecessary exposure of film to safelight
FILM-SCREEN
COMBINATION – IF USING
Faster film-screen combination reduce patient dose by
allowing the use of fewer x-ray photons (i.e., lower mAs)
to produce a diagnostic image.

A. Use fastest practical film-screen combination for imaging a

particular body part.
B. Take into account the region of the body being irradiate,
age of the patient, and requirements for recorded detail.
GRID

A. Result in an increase in patient dose because

increased mAs are required
B. Use appropriate type and ratio of grid for part being
radiographed and examination being performed
REPEAT EXPOSURE
A. Always result in an increase in radiation dose to the patient
B. Must be kept to a minimum
C. Should be tracked via a departmental repeat exposure analysis
D. Reasons for repeat exposures should be documented
E. In-service education for areas of frequent repeat exposures
should be conducted by qualified radiographers or radiologists
SPECIAL CARE
A. Pediatrics: children needed to be carefully protected from
unnecessary exposure; high-speed image receptors should be
used along with adequate immobilization
SPECIAL CARE
B. Pregnant patients
1.It is the responsibility of the referring physician to determine
whether a diagnostic examination involving x-rays is necessary;
the benefit should outweigh the risk; if the abdomen or pelvis is
involved, the radiologist should communicate the risk of the
examination to the referring physician and the patient
2.Most diagnostic x-ray examinations have fetal doses of less than
5 rad
3.Radiation doses of less than 10 rad to the embryo or fetus are
considered low risk; the NCRP states that fetal doses greater
than 15 rad carry increased risk
RADIATION WORKER
EXPOSURE AND PROTECTION
 Cardinal Principle of Radiation Protection
 Sources of Radiation Exposure
 Protective Barriers
 X-ray Tube Housing
 Fluoroscopic Equipment
 Portable Radiographic Equipment and Procedures
CARDINAL PRINCIPLE
A. Time: amount of exposure is directly proportional to duration of
exposure

B. Distance: most effective protection from ionizing radiation

1. Dose is governed by the inverse square law
2. The greater the distance from the radiation, the lower the
dose
CARDINAL PRINCIPLE
3. Dose varies inversely according to the square of the
distance; for example, if the dose of radiation is 5 R at a
distance of 3 feet, stepping back to a distance of 6 feet
causes the dose to decrease to how many R?mR?
4. The inverse square law should always be used during
fluoroscopy in which close contact with the patient is not
required and during mobile radiography and fluoroscopy
C.Shielding: lead-equivalent shielding absorbs most of the energy of
the scatter radiation
1. A lead apron of a least 0.25-mm lead equivalent must be worn
(0.5-mm lead equivalent should be worn) during exposure to
scatter radiation; a thyroid shield of at least 0.5-mm lead
equivalent should be worn for fluoroscopy
2. The radiographer should never be exposed to the primary
beam
3. If exposure of the radiographer to the primary beam is
unavoidable, the examination should not be performed
4. Family members of the patient, non-radiology employees, or
radiology personnel not routinely exposed should be the first
choices to assist with immobilization of the patient for an
examination when all other types of immobilization have
proved inadequate
5. The radiographer should be the last person chosen to assist
with immobilization during an exposure
6. Radiographers and student radiographers should not be
viewed as quick and easy-to-use immobilization devices
SOURCES OF RADIATION
EXPOSURE
A. Sources of radiation exposure to the radiographer is scatter
radiation produced by Compton interactions in the patient
B. Greatest exposure to the radiographer occurs during
fluoroscopy , portable radiography, and surgical radiography
C. Scattered beam intensity is about 1/100th the intensity of the
primary beam at a 90-degree angle at a distance of 1m from
the patient
SOURCES OF RADIATION
EXPOSURE
D. Beam collimator helps reduce the incidence of Compton
interactions, resulting in decreased scatter from the patient
E. The use of high-speed image receptors may reduce the amount
of scatter produced further because of decreased quantity of
radiation needed for exposure
PROTECTIVE BARRIERS
A.Primary protective barriers
1.Consists of 1/16-inch lead equivalent
2.Located where primary beam may strike the wall or floor
3.If in the wall, extended from the floor to a height of 7 feet
PROTECTIVE BARRIERS
B.Secondary protective barriers
1.Consist of 1/32-inch lead equivalent
2.Extend from where primary protective barriers ends to the
ceiling, with ½-inch overlap
3.Located wherever leakage or scatter radiation may strike
4.X-ray control booth is also a secondary protective barrier
a. Exposure switch must have cord short enough that the
radiographer has to be bind secondary protective barrier to operate
the switch
b. Lead window by control booth is usually 1.5-mm lead equivalent
C. Determinants of barrier thickness
1.Distance: between the source of radiation and the barrier
2.Occupancy: who occupies a given area 1= Office,
1/5=corridors, lounges and 1/20= Restroom/storage area
a. Uncontrolled area: areas where personnel are not provided
radiation exposure monitors or radiation safety training; should be
shielded to ensure an effective dose limit to the general public of
0.1 rem
 b. Controlled area: occupied by persons trained irradiation safety
and wearing personnel monitoring devices; shielded to keep
exposure under the annual effective dose limit of 5 rem
3.Workload: measured in mA minutes per week (mA min/wk);
takes into account the volume and types of examinations
performed in the room
4.Use factor: amount of time the beam is on and directed at a
particular barrier. 1=Floor, 1/16=Walls, 0=ceiling
X-RAY TUBE HOUSING
A. X-rays may leak through the housing during an exposure
B. Patient and all others present in the room must be protected
from excess leakage radiation
C. Leakage radiation may not exceed 100 mR per hour at a
distance of 1m from the housing
FLUOROSCOPIC EQUIPMENT
A. Exposure switch: must be dead-man type
B. Protective curtain: minimum 0.25-mm lead equivalent
C. Bucky slot shield: minimum 0.25-mm lead equivalent
D. 5-minute timer with audible alarm
PORTABLE RADIOGRAPHIC
EQUIPMENT AND PROCEDURE
A. Exposure switch must be on a cord at least 6 feet long
B. Lead aprons must be worn if mobile barriers are unavailable
C. Least scatter is at a 90-degree angle from patient
D. Apply the inverse square law to reduce dose by using exposure
cord at full length
PORTABLE RADIOGRAPHIC
EQUIPMENT AND PROCEDURE
E. Radiographer should never hold the image receptor in place for
a portable examination because of possible exposure to the
primary beam

E. Commercial image receptor holder, pillows and sponges should

be used to hold the image receptor in place
MONITORING PERSONNEL
EXPOSURE

A. Optically stimulated luminescence (OSL) dosimeters

1.Use aluminum oxide to recorded dose
2.Radiation absorbed causes electrons to be trapped
3.Aluminum oxide layer is stimulated by a laser beam after
wear period
4.Electrons release energy as visible light
MONITORING PERSONNEL
EXPOSURE

5. Light is in direct proportion to the amount of radiation

received
6.Sensitive to exposures of 1 mrem
7.Relatively unaffected by temperature and humidity
8.Can be worn 3 months at a time
9.Can be reanalyzed multiple times, if necessary
B. Thermoluminescent dosimeters (TLDs)
1. Use lithium fluoride crystals instead of film recorded dose
2. Electrons of crystals are excited by radiation exposure and
release this energy on heating
3. Energy released is visible light, which is measured by a
photomultiplier tube
4. Light is in direct proportion to the amount of radiation
received
5. TLDs are used mainly in ring badges worn by nuclear
medicine technologists
6. Sensitive to exposures of 5 mrem
7. Relatively unaffected by temperature and humidity
8. Can be worn for longer periods than film badges
9. TLDs and equipment used to read them are expensive
C. Film badges – not often used
1. Consist of plastic case, film, and filters
2. Plastic case holds film and filters and provides a clip for
attaching to clothing
3. Film used is similar to dental x-ray film and measures doses
of 10 mrem
4. Film is sensitive to extremes in temperature and humidity
5. Filters made of aluminum and copper measure intensity and
type of radiation striking the film badge
6. Film badges are usually developed monthly, with readings
returned to the institution via a film badge report
7. Film badge report indicates wearer’s name, ID number, and
radiation dose (expressed in millirem for deep and shallow
doses)
8. Badge reading of M indicates exposure below sensitivity of
film
PRINCIPLE OF JUSTIFICATION
 Justification is defined in the ICRP 60 publication as
'no practice involving exposures to radiation should be
adopted unless it produces sufficient benefit to the
exposed individual or to society to offset
the detriment it causes'.
PRINCIPLE OF OPTIMIZATION

 Optimization can be stated as '..a process or method used to

make a system of protection as effective as possible within the
given criteria and constraints..
 'With respect to radiation protection the ICRP 60 publication
basically states '.consider how best to use resources in reducing
radiation risks to individuals and populations ... so far as is
reasonably achievable, social and economic factors being taken
into account'.
 Radiation protection uses optimization to reduce exposures
below dose limits
PRINCIPLE OF DOSE LIMITATION
Limitation, together
with justification and optimization , are used as the
basis of radiation protection internationally.

 Limitation is defined in ICRP 60 as '..effective dose

to individuals shall not exceed the dose limits
recommended..'. ICRP requires that deterministic
effects are avoided and that probabilistic
/ stochastic effects are as low as reasonably
achievable (ALARA).
Do not let this Book of the
Law depart from your
mouth, meditate on it day
and night so that you may
be careful to do everything
that is written in it then you
will become prosperous
and successful.
- Joshua 1:8