Radiation health protection manual

In addition, 10 CFR The administered dose must be small so as not to produce any harmful radiation effects to the patient. The most commonly used radioactive materials in nuclear medicine studies is technetiumm 99m Tc , a gamma emitter with a half-life of 6 hours or fluorine 18 18 F , a gamma emitter with a half-life of 2 hours. There are also many other short lived radioactive isotopes used for nuclear medicine imaging studies.

In many of these studies, especially bone and renal studies, the radioactive compounds are removed from the body in the urine and occasionally in the stool. Most of the radioactivity is gone after 24 hours. With minor therapies, such as radioiodine for treatment of hyperthyroidism, the amount of radioactivity administered is sufficiently small to permit outpatient treatment of these patients.

Based on confirming Geiger counter measurements made from these patients, known dosimetry results over many years to the most exposed occupational workers nuclear medicine staff and published research, there are very small exposures to other hospital workers from these patients. While the exposure is not zero if the diagnostic study patient is seen within a few hours of their nuclear medicine scan, there is very little radiation exposure or contamination exposure to hospital staff associated with patients receiving radionuclides for minor therapies or diagnostic studies.

Radiation warning signs are not posted for these patients and there are no regulations monitoring their movements, because the small exposures do not warrant such actions.

Health Physics offers consultation and evaluation of job responsibilities for pregnant nursing staff who work with these patients to ensure that their exposure stays under regulatory limits. Contact Health Physics to determine whether radiation levels in your working area could cause a fetus to receive 0. Health Physics makes this determination based on personnel exposure monitoring reports, surveys, and the likelihood of an incident in your work setting.

If the patient must be held by an individual, that individual shall be protected with appropriate shielding devices such as protective gloves and apron and he shall be so positioned that no part of his body will be struck by the useful beam.

The interpretation of this regulation is that occupational workers shall not routinely hold a patient, but can, in unusual cases, provided that they are protected with appropriate shielding. There is some flexibility in the regulations on how an emergency would be defined. Exemption issued by California for positioning a patient or fluoroscopy Equipment. For patients, the gonads may or may not need to be in the primary x-ray field.

If the gonads are not in the primary field, the radiation exposure drops off rapidly. In practice, the patient may be provided with a leaded apron anyway, because the staff has been trained to do that or it provides reassurance to the patient.

For situations where the gonads are in the primary radiation field, shielding should be employed as long as the areas of interest are not blocked by the shielding. An example might be to image the pelvis to evaluate the heads of the femur bones.

For males, the testes are easily shielded by special shields that are in contact with the body. Alternately, shadow shields can be used.

These are typically triangular pieces of lead that are suspended by flexible arms like those for desk lamps from the x-ray tube housing. Since the collimator light field is aligned to the x-ray field, the shadow cast by the suspended piece of lead will show what area is being shielded from the x rays produced.

For females, the gonads are not visible or generally localized in the abdomen. As such, shielding is seldom employed for females, but the x-ray field collimators may be used to shield the center of the abdomen. A typical 0. Thyroid shields are designed for fluoroscopy x-rays and can not shield radioisotopes such as I or 18 F. There is some potential for contamination with these procedures, although it is not excessive and it depends on the administered activity and the length of time from the administration to the dialysis procedure.

Administering the radioiodine immediately after dialysis will maximize the time for elimination of the excess radioiodine from the body prior to the next dialysis. These are the same precautions that are used to protect against contamination from radioactivity. Flushing of the waste from the dialysis tubing directly to the sanitary sewer line and collecting the dialysis tubing and filter as radioactive waste is appropriate. Contact Nuclear Medicine or Health Physics to collect the dialysis tubing and filter.

Because Sm is mostly a beta particle-emitting radionuclide and beta particles are effectively shielded by the human body, Sm does not present an external radiation hazard. However, Sm is excreted through the urine for up to three days.

Use universal precautions when handling collected urine or urine soiled linens. Urine can be disposed of in the sewer. A resident or fellow working under the supervision of a Certified Fluoroscopy Supervisor physician does not need to be themselves certified. Radiation exposure from nuclear medicine patients to hospital staff varies depending on the type of radiopharmaceutical, how much was administered and when it was administered.

The half-life of nuclear medicine radiopharmaceuticals, that is the time it takes for the radioactivity to drop by half, is typically in the two-to-six-hour range, although the half-life can be longer. Sonographers work in close proximity to patients which is why it is reasonable to ask what kind of radiation exposure they might be getting from nuclear medicine patients.

Because nuclear medicine patients might undergo additional examinations, other hospital staff might also be exposed. The conclusion was that the radiation exposure to the sonographer was usually minimal; if there is daily contact with nuclear medicine patients, radiation risks should be assessed. Monitoring for several months may be appropriate. Scheduling patients several hours after their nuclear medicine procedure is a good practice as well as asking the patient to void before the secondary examination.

Radioactive material packages delivered directly to Nuclear Medicine contain radionuclides that will be administered to patients for diagnostic and therapeutic procedures. Direct deliveries may arrive on any day and at any time of the day. Upon receipt, all radioactive material packages will be entered into the Nuclear Medicine drug receipt database. The exterior surface of the package shall be surveyed swiped over an average of cm 2 for removable contamination.

Inert gases e. Health Physics will assure that appropriate technical assistance and guidance is provided for achieving compliance with the above. The room where the inert radioactive gas is used must be under negative pressure.

The exhaust from the room where the inert gas is used shall be directly vented to the environment. Fresh air may be mixed with the exhaust stream so as to reduce the concentration of radioactive inert gas.

Health Physics shall approve machines used for the administration of radioactive inert gases to patients. The machines must feature:. In the event the patient experiences breathing difficulties or other medical problems, the patient will be immediately disconnected from the machine. Appropriate first aid measures shall be conducted. As soon as practicable, the machine shall be shut off with the priority directed towards the well-being of the patient.

This guidance has been prepared by the Clinical Radiation Safety Committee CRSCo to help ensure a careful, complete, and timely review of research projects that include human use of ionizing radiation. It meets quarterly. Health Physics reviews the application for completeness and accuracy. If, for an adult, the effective dose is less than or equal to mrem to compare the effective dose to the annual radiation worker and the organ equivalent dose is less than or equal to the value derived by dividing 5 rad by the associated weighting factor see table below , the Health Physics RSO or designee can approve the application.

If the effective dose is greater than mrem or the organ equivalent dose is greater than the value derived by dividing 5 rad by the associated weighting factor see table below , before the next CRSCo meeting by the Chairman or his designee, the Radiation Safety Officer RSO or his designee, and one physician faculty member, or be approved at the next CRSCo meeting.

Note: The approval levels listed below are for adults. All of these approvals are reported to CRSCo at its next meeting; it can re-open and revise the approvals.

There are also organ dose limits associated with each category. Dose limits: whole body, active blood-forming organs, lens and gonads 3 rem per study and 5 rem total; other organs 5 rem per study and 15 rem total. See 29 CFR This radiation is in addition to what you may get as part of your regular medical care. The additional amount of radiation is comparable to the radiation exposure from natural sources like the sun, ground and water.

The average yearly background effective dose in the United States is 3 mSv. This amount of radiation involves minimal risk and is necessary to obtain the research information desired. This additional amount of radiation involves minimal risk and is necessary to obtain the research information desired. You will be exposed to radiation during this research. Statistics represent averages and do not predict what is going to happen to you.

They do not take into consideration individual risk factors including lifestyle smoking, diet, exercise, etc , family history genetics or radiation exposure. The dose to your skin will be about X rads. This dose may result in temporary or permanent hair loss and possible skin changes or damage. For a research protocol involving Ionizing Radiation on human subjects at a facility not affiliated with Stanford and when the x-ray usage has been approved by that facilities official IRB e.

Copyright Complaints. Consult with the Radiation Safety Officer at for specific information. Download full manual 1 Introduction 2 Introduction to Radiation Exposure 2. A wavelength graph is shown below. Background Radiation People are constantly exposed to small amounts of ionizing radiation from the environment as they carry out their normal daily activities; this is known as background radiation.

Terrestrial There are natural sources of radiation in the ground, rocks, building materials and drinking water. Internal Our bodies also contain natural radionuclides. X-ray Machines Any electronic device that has fast-moving electrons is a potential source of ionizing radiation.

X-rays X-rays are a type of radiation commonly found in the hospital. Sealed Sources Many devices use sealed radioactive sources because they provide a convenient, inexpensive source of ionizing radiation.

Beta Radiation Beta radiation is electrons with a range of energies. Radioactive Decay Radioactive decay is the process that changes an unstable atom to a more stable atom. All signs, labels, and signals will be posted in a conspicuous place.

Collection of Dosimeters All badges and rings are collected by the designated department or location contact to be processed by a contractor.

How to Wear Badges are to be worn at the collar. Dosimetry Requests Dosimetry requests can be made on this website. Records of Prior Exposure Each individual having a previous or on-going radiation exposure history with another institution is required to submit an Authorization to Obtain Radiation Exposure History form. Lost Dosimetry If you have lost your dosimeter, a lost monitor report is required. Failure to Use Dosimeter as Required Failure of an employee to use a required badge may result in appropriate disciplinary action.

Bioassays Bioassays determine the quantities, and in some cases, the locations of radioactive material in the human body, whether by direct measurement, called in vivo counting, or by analysis and evaluation of materials excreted from the human body.

After declaring her pregnancy, the employee will then receive: An evaluation of the radiation hazard from external and internal sources. Counseling from Health Physics regarding modifications of technique that will help minimize exposure to the fetus.

A fetal monitoring badge, if appropriate. Who needs a dosimeter? Contact the Dosimetry Coordinator at or your health physicist to confirm if new employees needs a dosimeter. Who can request a dosimeter? All requests need to come from the department representative listed for your location. Identify who needs to be badged by position e. Identify how many people need to be badged compared to the number that want to be badged.

What kind of radiation are they exposed to? Who to Contact about Dosimetry If there are any questions regarding the wearing of these badges or any questions regarding radiation monitoring, please contact the Stanford University Health Physics Department Dosimetry Coordinator at In general, alpha, beta, gamma and x-ray radiation can be stopped by: Keeping the time of exposure to a minimum, Maintaining distance from the source, When appropriate, placing a shield between yourself and the source, and Protecting yourself against radioactive contamination by using proper protective clothing.

The lead apron can cause stress and pain in the back muscles; to protect back strain often a skirt style apron covering the lower abdomen is adequate. For fluoroscopic procedures a lead apron of at least 0. Note: In cases where the x-ray operator steps away from the patient to turn on the beam, as in the case of a chest radiograph or mammography, a lead apron is not necessary. The recommended apron inspection policy is as follows: Annually perform a visual and tactile inspection Look for visible damage wear and tear and feel for sagging and deformities.

During fluoroscopic examination, use manual settings and low technique factors e. Do not use the automatic brightness control, as this will drive the tube current and high voltage up, resulting in unnecessary radiation exposure to personnel and wear on the tube.

Lead aprons can also be examined radiographically. Fluoroscopic lead aprons are to be discarded if inspections determine: A defect great than 15 square mm found on parts of the apron shielding a critical organ e. A defect greater than square mm along the seam, in overlapped areas, or on the back of the lead apron.

Thyroid shields with defects greater than 11 square mm. Description of the machine and its proposed use. X-ray Tube Serial number 6. Survey for New Machine Installation Unless otherwise specified, Health Physics must survey the installation of radiation-producing machine s , whether newly acquired, relocated, modified, or repaired to determine the effectiveness of health and safety hazard controls.

Warning Signs All devices and equipment capable of producing radiation when operated shall be appropriately labeled to caution individuals that such devices or equipment produce radiation. Transfer to Another User — Health Physics shall be given notice of intent to dispose or transfer the radiation-producing machine to another user in order to notify the State of the transfer or disposal of the radiation-producing machine.

Mammography Machines Mammography machine annual tests are performed by an outside contractor. Therapy Machines Beam calibrations are performed by a Radiation Oncology Medical Physicist before initial operation and at intervals not to exceed twenty-four months. Directly control radiation exposure to the patient during fluoroscopy procedures.

Supervise one or more persons who hold a Radiologic Technologist Fluoroscopy Permit. A Radiography Supervisor and Operator permit allows the individual to do any of the following: Actuate or energize radiography x-ray equipment. Supervise one or more persons who hold a Radiologic Technologist Certificate. Supervise one or more persons who hold a limited permit. Frequently Asked Questions Does a resident or fellow need a fluoroscopy permit?

A physician is not required to obtain a certificate or permit from the State if that physician: Requests an x-ray examination through a certified supervisor and operator.

Performs radiology only in the course of employment by an agency of the Federal Government and only at a Federal facility Note: As a best management practice the Clinical Radiation Safety Committee requires that Veterans Affairs Palo Alto Health Care System comply with the State of California certificate requirements or its equivalent. Faculty members of an approved medical school who are granted a certificate of registration by the Medical Board of California code BPC are exempt from the requirement to obtain a Fluoroscopy Supervisor and Operator permit.

The permitted licentiate shall document all actions the non-permitted individuals will perform. The permitted licentiate shall document the following: Equipment set up and operation; Fundamentals of radiation safety; Significance of radiation dose, to include hazards of excessive exposure to radiation, biological effects of radiation dose, and radiation protection standards; Expected levels of radiation from fluoroscopy equipment; Methods of controlling radiation dose: time, distance, shielding; and Characteristics and use of personnel monitoring equipment.

Fluoroscopy equipment being operated is operated only in the automatic exposure control AEC or automatic exposure rate control AERC mode. The permitted licentiate shall review and approve, before exposure of the patient to X-rays, any changes to the spatial relationship and technical factors that resulted from the actions taken by the non-permitted individual. The RDRC must immediately, but no later than 7 calendar days, submit a special summary using Form FDA to the FDA at the time a proposal is approved that involves: More than 30 research subjects or when a previously approved protocol is expanded to include more than 30 subjects or, Exposure to a research subject less than 18 years of age.

Authorized Nuclear Medicine Physician Clinical use of radiopharmaceuticals : If approved by the Clinical Radiation Safety Committee, nuclear medicine physicians who are authorized users AU may select radiopharmaceuticals in accordance with their professional judgment for the treatment and diagnosis of human beings provided that the radiopharmaceutical is approved for human use by the FDA. Authorized Radiation Oncologist Clinical use of accelerators: If approved by the Clinical Radiation Safety Committee, physicians who are authorized users may use an accelerator for the treatment of humans.

Examples could include: Radiologists Nuclear medicine physicians and technologists Radiation therapy technologists Cardiologists working with fluoroscopy equipment Authorized Users Nurses regularly caring for radionuclide therapy patients Ancillary Workers All personnel who may come in contact with or enter an area that contains radioactive material or sources of ionizing radiation.

Ancillary Worker examples include: Housekeeping Maintenance workers Nursing staff occasionally caring for radionuclide therapy patients Non-Radiation Workers Personnel who would not normally be expected to encounter radioactive material or radiation sources in the course of their employment. Non-Radiation Workers examples include: Administrators and administrative assistants Food service employees Clerical staff 9.

Non-Radiation workers Note: a non-radiation worker is someone who does not directly handle radioactive material, or who is not directly exposed to radiation, but works near posted areas. Keep the following in mind: Perform lifesaving measures. Web icon An illustration of a computer application window Wayback Machine Texts icon An illustration of an open book.

Books Video icon An illustration of two cells of a film strip. Video Audio icon An illustration of an audio speaker. Audio Software icon An illustration of a 3. Software Images icon An illustration of two photographs. Transfers of radioactive material between Princeton University labs are permitted under the following conditions:.

The precautions described below are necessary because packages are occasionally delivered with the wrong materials, may contain highly contaminated inner vials, or vials may unintentionally become pressurized during transport.

All stock vials, sealed sources and plated sources are assigned a unique identification number through the Princeton University radioisotope inventory and tracking database, known as RITA. In order to maintain adequate inventory control over the use and disposal of radioactive materials at the University, the following procedures have been established.

EHS provides the laboratory with detailed written procedures for all phases of the inventory control and tracking process.

Frequent surveys performed by knowledgeable laboratory personnel are the main line of defense to detect spills and to prevent the spread of contamination within and beyond the laboratory.

This section summarizes the requirements for performing surveys. See Appendix A for detailed information about the types of contamination surveys, how to use a survey meter, how to perform a survey using a survey meter and how to perform a wipe test. Table 5. Appendix A provides detailed instructions on the use of a survey meter and how to perform a survey.

The following list is a brief survey checklist:. If an item or area with a sustained count rate of three times background or more is found, the item or area should be considered to be contaminated. Laboratory personnel must conduct individual work area surveys surveys of floors, workbenches, handles, experimental equipment, etc.

Survey areas where splashes or spills may have occurred and areas where a person could unknowingly transfer contamination. Typical survey locations include:. Record survey results in a personal survey log or in the laboratory survey log. Appendix A contains a copy of a blank survey log page. Each log entry should contain the following information:. Call EHS for recommendations and information about purchasing a radiation survey meter. After a new meter arrives, call EHS to register the meter.

Every survey meter must have a check source attached to it. Check sources are available from EHS. EHS performs a periodic electronic calibration of laboratory survey meters. Meters must be calibrated at least annually. Call EHS whenever a survey meter is not functioning properly or needs to be repaired for any reason.

EHS maintains repair and calibration records for each survey meter and can offer limited diagnostic and repair services. Each worker who is monitored for external or internal radiation exposure at the University is notified about the doses he or she receives.

See the table below for a listing of the dose limits established by the state of New Jersey. The University has established investigational levels at doses considerably less than the dose limits. Further information about radiation exposure from radioactive materials taken up internally is provided in Appendix B in the listings of Annual Limits of Intake ALI , the amount of a specific radioisotope taken internally which will produce a whole body dose of millirems.

If a worker is notified that he or she has had an intake of 80 mCi of H-3 with a resulting dose of 5 mrem, then the table below indicates this dose to be 0.

This means that the University must work to keep doses as far below the dose limits as can readily be achieved. Consequently the University has established investigational dose levels and will investigate any dose exceeding these levels in an effort to address causes of unnecessary radiation exposure. External monitoring can be requested by any person working in a laboratory in which gamma emitters or energetic beta emitters are used, even if that person does not meet the criteria for required monitoring.

In such a case, EHS meets with the worker initially to discuss any concerns the worker has and will then initiate radiation monitoring for the next year. After providing dosimetry for a year, EHS meets with the worker again to review doses for the past year and to discuss whether monitoring should be continued.

Monitoring reports are received by EHS approximately six weeks after the end of a monitoring period and forwarded to each Authorized User shortly thereafter. Radioactive materials can be taken up internally when volatile or other airborne radioactive materials are inhaled and when radioactive materials are absorbed through skin or ingested. Internal uptakes may occur when lab personnel unknowingly handle contaminated objects, when permeation occurs through highly contaminated gloves, or when spills occur.

To determine the dose resulting from an intake, bioassays must be performed. For the radioisotopes commonly used at Princeton University, bioassays usually involve urinalysis or external thyroid counting. EHS may request bioassays when widespread contamination has occurred in a laboratory, and when skin contamination has occurred. A worker can request a precautionary bioassay at any time. A bioassay is required under the following circumstances:.

When a person uses H-3 exceeding the amounts listed below which are the amounts a person handles at any one time or the cumulative activity handled by that person during one month :.

When a person uses I exceeding the amounts listed below which are the amounts a person handles at any one time or the cumulative activity handled by that person during any three month period :. Thyroid counting is performed at the EHS office and requires no more than ten minutes. Contact EHS to schedule an appointment. Supplies and instructions for urine bioassays are provided by EHS. Any radiation worker who is pregnant or believes that she may be pregnant should contact EHS.

All inquiries will be kept in confidence. EHS will take the following steps:. Any Princeton University employee or student who plans to do radiation work at other institutions must notify EHS before visiting the other institution.

The radiation exposure of visitors from Princeton University will be monitored by the host institution, using badges supplied by that institution. However, Princeton is required to keep track of the total radiation exposure received by its employees and students. EHS will contact the host institution and request radiation exposure records. Several factors determine the route by which radioactive wastes are disposed.

These factors include: half-life, radionuclide, chemical constituents, physical form liquid or solid , dose rate, and other physical characteristics is the source sealed and encapsulated or open? Mixed wastes are radioactive wastes which also contain hazardous waste components regulated under RCRA the federal Resource Conservation and Recovery Act regulations.

Currently there are limited options for the disposal of mixed wastes, and the options which do exist are often costly. In the laboratory setting the type of mixed wastes most likely to be generated include:. EHS is available to help determine whether specific wastes meet the definition of mixed wastes. Whenever feasible, contact EHS before generating mixed wastes to allow time to determine disposal options or to establish procedures which may prevent a mixed waste from being generated.

The flow charts at the end of this section will allow a user to determine the basic disposal route for any waste form and will either refer the user to detailed disposal procedures or to EHS for further help. Whenever radioactive material is moved from a laboratory to any other facility, even to adjacent buildings, package it and move it in a way that will avoid spilling the material and unnecessary exposure to anyone.

Take the following steps:. Do not ship or transport radioactive materials to another institution without contacting EHS in advance. In order to transfer and ship radioactive materials properly, take the following steps:. A radiation-producing machine is defined to be either any machine primarily intended to produce radiation, such as:. Any electronic tube operating at a potential above 10 kV should be considered as a possible source of x-rays even though it may not have been designed for that purpose.

Such equipment may include:. Any proposed purchase and installation of a radiation-producing machine must be reviewed and approved in advance by the Radiation Safety Officer.

EHS must be notified in advance when any radiation-producing machine is planned to be acquired as a loan, transfer or a gift from another institution or from any individual or department at the University. Radioactive Survey Log. Radioisotope Fact Sheets: Click here for fact sheets for various radioisotopes used at Princeton University. See the Staff sidebar at the top of this page. Click here for the Declaration of Pregnancy Form. Books Video icon An illustration of two cells of a film strip.

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