Radiation Protection through Agencies

- Production and use of atomic energy shall be controlled by the State to ensure
fulfilment of international obligations to protect health and safety of workers

Local Agencies
1. Department of Health
o ensures basic public health service to all Filipinos
o Dr. Francisco Duque III

2. Bureau of Health Devices and Technology (BHDT)

o Regulating health technologies, medical and health devices, radiation
devices and facilities
o Agnette Peralta

3. Department of Science and Technology

o Provide central direction, leadership and coordination of all scientific and
technological activities to support national development
o Fortunato Dela Pena

4. Philippine Nuclear Research Institute (PNRI)

o Mandated to undertake research and development activities in the
peaceful uses of nuclear energy, institute regulations to protect health and
safety of radiation workers and public
o Alumanda M. de la Rosa Ph.D

International Agencies
1. International Commission on Radiological Protection
o Independent, provides recommendations and guidance on radiation
protection

2. International Commission on Radiation Units and Measurements

o Use of quantities and units of ionizing radiation and its interaction with
matter (biological effects)

3. International Atomic Energy Agency

o Promote peaceful use of nuclear energy to inhibit its use for any military
purpose including nuclear weapons

Fundamental Safety Principles

- Radiation risks to workers, public and environment have to be assessed and
controlled.
- Medical use, nuclear installations, production and transport of radioactive waste
must be subjected to standards of safety

Principle 1: Responsibility for safety

- Responsibility must rest on the person or organization responsible for facilities
and activities that give rise to radiation risks

Principle 2: Role of government

- Effective legal and governmental framework for safety must be established and
sustained

Principle 3: Leadership and management for safety

- Leadership and management must be established and sustained

Principle 4: Justification of facilities and activities

- Must yield an overall benefit

Notes by: Kathleen Claire Frias

Principle 5: Optimization of Protection
- Protection must be optimized to provide highest level of safety that can be
achieved

Principle 6: Limitation of Risk to individuals

- No individual bears an unacceptable risk of harm

Principle 7: Protection of present and future generations

- Present and future must be protected against radiation risks

Principle 8: Prevention of accidents

- All efforts must be made to prevent and mitigate nuclear or radiation accidents

Principle 9: Emergency preparedness and responses

Principle 10: Protective actions to reduce existing or unregulated radiation risks

Classification of Radiation Working Area and Working Limits

1. Controlled Area
o limited access area which occupational exposure of personnel to radiation
is under the supervision of an in charge of radiation protection.
o Access, occupancy and working conditions are controlled for radiation
purpose
o These areas are immediate areas where x-ray equipment is used
o X-ray Room

2. Supervised Area
o Occupational exposure conditions are kept under review even though
specific protective measures and safety provisions are not normally
needed.
o Dark Room

3. Uncontrolled Areas
o All other areas in the hospital or clinic
o Occupied by px, visitors and employees who do not work routinely with
or around radiation sources
o Receiving Area

Cardinal Principles of Radiation Protection

- Basis for dose limit: linear, non-threshold

1. Time
o dose of an individual is directly related to the duration of radiation
exposure
o if time is doubled, radiation is doubled

Time = Exposure rate x Exposure time

o kept to a minimum to reduce blur, patient and personnel radiation

exposure
o fluoroscopy has on/off foot switch instead of continuous exposure
o earliest fluoroscopy used phosphor screens where transmitted x-
ray caused scintillations that were viewed directly
 Parts of Image Intensifier

1. input phosphor - converts the X-ray image into a visible light

image

2. photocathode - placed in close proximity to the input phosphor,

and it releases electrons in direct proportion to the visible light
from the input phosphor that is incident on its surface

3. output phosphor - electrons are steered, accelerated and

multiplied in number by the electron optic components, and finally
impinge upon a surface coated with a phosphor material that
glows visibly when struck by high-energy electrons.

o 5-minute reset timer reminds the radiologist that a considerable amount

of fluoroscopic time has elapsed

2. Distance
o As distance increase, radiation exposure decreases
o Stated in inverse square law

𝐼1 𝐷22
=
𝐼2 𝐷12

I is the intensity at distance.

o Intensity decrease because x-ray is divergent

3. Shielding
o Reduction of level of radiation exposure
o Lead is use because of high atomic number
o Half-value layer - is the thickness of absorbing material necessary to
reduce the x-ray intensity to half of its original value
 o Aprons contain 0.5 mm Pb, equivalent to 2 HVL which should reduce
exposure to 25%

Occupational Radiation Monitoring

- level of exposure depends on the type and frequency of activity

- this device is instituted to estimate the amount of radiation received by
individuals who work in a radiation environment
- required when an individual will receive more than 1/10 of the
recommended dose limit
- offers no protection against radiation exposure

3 types of personnel monitors

1. Film Badges
o 1940s
o Similar to dental radiography film
o Optical density is measured
o Less than 10 mR (100 micro Gy) are not measured by film badge
monitors
o Vendor will report only that a minimum exposure was received
o Advantage: inexpensive, easy to handle, easy to process,
reasonably accurate
o Disadvantage: cannot be reused, cannot be worn longer than 1
month because of fogging caused by temp and fogging

2. Thermoluminiscence Dosimeter
o Lithium fluoride in crystalline form (sensitive material) or small
chip approx. 3 mm square and 1 mm thick
o When expose, TLD absorbs energy and stores it in the form of
excited electrons
o When heated, these excited electrons fall back to their normal
state with the emission of visible light
o This visible light is measured with a photomultiplier tube or
photodiode and is proportional to the radiation dose received by
the crystal
o Advantage: more sensitive and more accurate than film badge,
can measure 50 microGray (5 mR), does not suffer from heat or
humidity
o Disadvantage: costly

3. Optical Stimulated Luminescence Dosimeter

o are worn and handle like film badge and TLDs, same size
o Advantage: more sensitive measures 10 microGray (1 mR)

- Personnel monitors are worn in front of waist or chest level because it is

convenient to clip the badge over a belt or a shirt pocket
 - When participating in fluoroscopy, it is positioned on the collar above
the protective apron

Protective Apparel
- Operating console is usually fixed positioned behind protective barriers
- Gloves and aprons are constructed of lead impregnated vinyl, some with
tin or other metals
- Normal thicknesses are 0.25 (at least) 0.5 (normal) and 1 mm of lead

- 0.5 mm lead equivalent apron represent a workable compromise

between unnecessary weight and desired protection
- Protective aprons for interventional should be wrap around type
- When not in use, must be stored rack
- At least once a year, should be fluoroscoped to ensure that no such
cracks appear
- If fluoroscopy is not available, high kVp radiography can be used (120
kVp, 10 mAs)

Patient Positioning and Patient Holding

- Mechanical immobilization devices should be available for infants, elderly and

incapacitated patients
- Otherwise, a relative or a friend who accompanies the patient should be asked
to help
- As last resort, other hospital employees and orderlies may be used occasionally
to hold patients providing protective apparel
- During fluoroscopy, all patient should remain as far from the patient as possible
keeping the front of the apron facing the radiation source at all times
- X-ray tube in fluoroscopy is located below the table to avoid exposing the upper
part of the workers’ body
- After loading spot films, RT should take a step or two backward from the table
when presence is not required
- Radiologist should use dead man foot switch sparingly
Pregnant Patient
- Period most sensitive to radiation exposure occurs before birth
- The higher the radiation dose, the more sever radiation will be

Time Dependence
- Least hazardous time for irradiation is first 2 weeks when expectant mother is
unlikely to know her condition
- First 2 weeks is resorption of the embryo and therefore no pregnancy
- 2nd-10th week – period of major organogenesis
- Early – most likely associated with skeletal abnormalities
- Later – neurologic deficiencies
- If a response occurs after diagnostic irradiation during the latter two trimesters,
response would be malignant disease during childhood which requires a very
high radiation dose before risk happen, no less than 250 mGy, yet possible

Dose Dependence
- After utero radiation dose of 2 Gy, effects will happen
- Unlikely in diagnostic radiology
- Spontaneous abortion during first 2 weeks is unlikely with less than 250 mGy
- 0.1% of all conceptions would be resorbed after 100 mGy
- Absence of radiation exposure, approx. 5% of all live birth exhibit congenital
abnormality
- First trimester - relative risk 5-10
- Third trimester – relative risk 1.4

Notes by: Kathleen Claire Frias